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268 Cards in this Set
- Front
- Back
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Does Nissel substance move into axons?
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Generally no
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What vascular structure is ruptured in subdural hematomas?
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Cortical bridging veins
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What do the lateral striate arteries supply (2)? What do they arise frome? What condition causes them to bleed?
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Internal capsule and BG. Arise from middle meningeal artery. HTN!
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1st and 2nd most common sites of berry aneurysm rupture?
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1) Acomm 2) Pcomm
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Recurrent small lobar hemorrhages in an elderly person - what cause?
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Cerebral amyloid angiopathy
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4 most common sites of hypertensive hemorrhage?
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BG, internal capsule, thalamus, pons
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Which is more severe; HTN hemorrhages or amyloid angiopathy?
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HTN!
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What are the 2 general causes of polyhydraminos, and 2 examples of each?
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Decreased swallowing (GI obstruction, anencephaly), increased urination (high cardiac output, twin-twin transfusion syndrome)
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What NT is released from the presynaptic terminal of NMJ? What stimulus causes it to be released?
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Ach. Ca2+ influx cause vesicles to fuse and release NT.
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Which dopamine pathway involved prolactin regulation?
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Tuberoinfundibular
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Which dopamine pathway invovles coordination of voluntary movements and is damaged in PD?
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Nigrostriatal
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Which dopamine pathway is involved in behavior control and is upregulated in schizophrenia?
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Mesolimbic-mesocortical
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How are taste and somatosensation divided up on the tongue?
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CN VII (chorda tympani) does front 2/3 taste, V3 (lingual nerve) does front 2/3 somatosensation. CN IX does back 1/3 taste and somatosensation.
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Damage to what nerve might cause decreased tearing and hyperacusis?
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CN VII (can see with Bell's palsy)
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What cranial nerve does palate elevation?
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X!
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What CNs are involved in the gag reflex (afferent and efferent)?
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Afferent: IX, efferent: X
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What CNs are involved in the lacrimation reflex?
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Afferent: V1, efferent VII (loss of reflex does not preclude emotional tears)
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What CNs are involved in the corneal reflex?
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Afferent: V1, Efferent: VII
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What CNs are involved in the jaw jerk reflex?
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V3 (sensory) and V3 (motor)
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What CNs are involved in hte pupillary reflex?
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Afferent: II efferent: III
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Precocious puberty, Parinaud syndrome and obstrcutive hydrocephalus - what is it?
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Pineal gland tumor!
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Most common tumor type in pineal gland tumor?
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Germinomas - similar to testicular seminomas
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Parinaud syndrome is also called what? What structure is being pushed on by tumor?
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Dorsal midbrain syndrome. Tumor is pushing on tectal area - paralysis of upward gaze
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Charcot-Bouchard microaneurysms are associated with what predisposing condition?
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HTN!
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Lower limb hemiparesis with hypoglossal dysfunction on the other side - what syndrome?
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Medial medullary syndrome
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What does the equilibrium potential of an ion reflect?
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How that ion would affect the membrane potential if the membrane were freely permeable to that ion
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What are Pick bodies made of?
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Tau!
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Why do you get speech difficulties with Pick's disease?
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Broca's area - in the frontal lobe!
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Damage to what brain region causes apraxia and contralateral neglect?
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Non-dominant (right) inferior parietal lobe
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R/L confusion, dysgraphia, dyscalculia and dyslexia. Damage to what brain region - called what?
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Gerstmann's syndrome - damage to inferior parietal lobe of dominant (left) hemisphere
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Hemiballismuc is caused by lesions to what brain struction?
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STN!
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What are the superior colliculi important for? The inferior colliculi?
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Superior - conjugate verticle gaze. Inferior - auditory stuff
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The mamillary bodies and fornix are part of what circuit?
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Papez circuit
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What brain cells (3 types) are most susceptible to ischemic injury? What brain region is damaged first in global cerebral ischemia?
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Pyramidal cells of 1) hippocampus and 2) neocortex and 3) purkinje cells of cerebellum. Hippocampus is damaged first.
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What 2 structures make up the striatum? The lentiform?
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Striatum: caudate and putamen. Lentiform: putamen and Gp
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Wilson's disease damages what brain structure?
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Putamen!
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SCLC + ataxia - what is it?
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Paraneoplastic - autoimmune!
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In damage to the FEFs, do the eyes look towards or away from the lesion?
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Towards!
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Broca's and Wernicke's - who has insight and who doesnt?
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Broca's does, Wernicke's does not have insight usually.
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What eye stuff is going on with an INO (2 main things)
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Adduction defect of affected eye with nystagmus of the contralateral eye with abduction.
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CN IV innervated what muscle? Lesion causes difficulty doing what?
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SO. Lesions causes trouble looking down (going down stairs, reading newspaper)
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"endoneural inflammatory infiltration" is seen in what disorder?
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Guillan Barre
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Why do optic tract lesions cause an APD in the contralateral eye if the optic tract only contains the nasal portion of the retina?
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This part of the eye contributes more input to the pretechtal nucleus
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What action do the FEFs generate?
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Contralateral conjugated gaze (R FEF generates conjugate gaze to the left)
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Track the optic fibers from the retina to the visual cortex:
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Retina -> optic nerve -> optic chiasm -> optic tract -> LGN (and some to pretechtal nucleus, which does pupillary relfex) -> meyers loop -> optic radiations -> visual cortex
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Meyer's loop lesion causes what?
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Contralateral upper quandrantanopia
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What lesion can produce a contralateral homonymous hemianopia + a contralateral ADP?
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Optic tract (which contains fibers before they head to pretectal nucleus)
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What is a Marcus Gunn pupil?
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APD
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Thin anterior roots and atrophy of precentral gyrus, what dx?
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ALS (UMN and LMNs)
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What is the only real tx for ALS? MoA.
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Riluzole (decresed glutamte release)
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What is the most common cause of death in ALS?
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Respiratory complications (2/2 muscle weakness)
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B12 deficiency damages which spinal tracts?
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Dorsal column and corticospinal
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Holoprosencephaly is an example of what kind of congenital defect?
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Malformation
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What is an example of a "sequence" defec tin utero?
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Potter syndrome - many things results from one initial insult (oligohydramnios)
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3 postulated mechanisms of morphine tolerance? Stimulation by what NT increasee tolerance?
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Phosphorylation of opiod receptors, increased cAMP or increased NO. Glutamate stimulation of NMDA receptors increases phophorylation and NO release.
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Why do ketamine and dextromethorphan modulate morphine tolerance?
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They both block glutamate action at NMDA receptors, which normally INCREASES tolerance by increasing phosphorylation of morphine receptors and increasing NO release.
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When the maxillary prominences fail to fuse properly with the intermaxillary segment (from the medial nasal prominence) what is formed?
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Cleft lip!
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When the palatine shelves from the maxillary prominence fail to fuse with one and other or the primary palate, what is formed?
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Cleft palate!
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What is the pupillary reflex circuit?
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Retina -> optic nerve -> ilsilateral pretectal nucleus -> ipsi and contralateral Edinger Westfall nucelie -> ipsi and contralateral ciliary ganglions -> iris muscle constrictors
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What powers Kinesin? What does it do?
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ATP. Anterograde movements of vessels down neuron axon
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Sensation to all of the external ear except the posterior wall is by what nerve? What does the posterior wall?
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V3 does most of ear, vagus (small auricular branch) does posterior wall.
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Main long term consequence of childhood hydrocephalus?
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Lower extremity spasticity due to strentching of UMN pyramindal tracts
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What separates the caudate from the Gp and putamen?
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Internal capsule
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How long after ischemic brain injury do you see "red neurons"?
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12-48 hours
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How long after ischemic brain injury do you get necrosis and netrophil ATTACK?
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24-72 hours
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How long after ischemic brain injury do you get macrophage infiltrate?
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3-5 days
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Liquifactive necrosis starts how long after ischemic brain injury?
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1-2 weeks
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A glial scar (cystic area surrounded by gliosis - astrocytes) starts how long after ischemic brain injury?
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2 weeks
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Tinitus, vertigo, sensorineural hearing loss - what d/o?
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Menieres - increased endolymph
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Neurofibromas in NF1 are made of what kind of cell? What is its embryonic origin?
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Schwann cells - neural crest cells.
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What embryonic structure gives rise to the CNS and ependymal cells (cells lining ventricles that make CSF)?
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Neuroectoderm
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What embryonic structure gives rise to the PNS and schwann cells?
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Neural crest cells
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What embryonic structure gives rise to microglia?
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Mesoderm
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What artery supplies collateral blood supply to the macular part of the visual (striate) cortex?
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MCA
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MCA vs ACA stroke -> upper vs lower limb predominant symptoms?
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MCA: upper> lower. ACA lower> upper
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Occlusion of what artery causes lateral medulary syndrome?
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PICA
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Vit E deficiency causes what 2 main effects?
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Neuro symptoms (dorsal column and spinocerebellar) and mild hemolytic anemia (both from increased susceptibility of neuronal and RBC membranes to oxidative stress)
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Ach is largely made in what structure in the brain?
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Nuceus basalis of Meynart
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What part of the spinal cord contains lateral grey matter horns? Why?
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T1-L2 -> sympathetic chain
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Spinal cord is most ovoid in what section?
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Cervial (C3-T1)
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What 4 conditions are associated with carpel tunnel?
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Hypothyroidism, RA, DM, dialysis associated amyloidosis
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What are the 3 main clinical pictures associated with HTN lacunar strokes along with their location?
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Pure motor (posterior internal capsule), pure sensory (thalamus), ataxia hemiplegia syndrome (base of pons, affects cerebellum), dysarthria clumsy hand syndrome (base of pons or genu of internal capsule)
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Effects of valproate on fetus?
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NT defects - meningocoele
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Histologic difference between pilocytic astrocytoma and medulloblastoma?
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astrocytoma: pilocytic astrocytes with Rosenthal fibers (corkscrew eosinophillic bundles). Medullo: primitive cells with many mitotic figures, high N:C ratio
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What is the 3rd most common brain tumor in children? Location? Histology?
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Ependymoma. In walls of ventricles, can obstruct CSF flow and cause hydrocephalus. Forms "pseudorosettes" that are GFAP positive on histology.
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Where is the radial nerve damaged to cause wrist drop with no sensory deficitis?
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At radial head - by subluxation (this is where superficial radial nerve, which does sensation, is given off.)
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Which causes fasciculations - LMN or UMN injury?
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LMN!
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Up until what age is a Babinski normal?
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12 months
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Sudden, painless monocular vision loss with pale retina and cherry red spot in the macula, boxcar segmentaion of retinal vein. What dx?
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Central retinal artery occlusion.
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POMC is a precursor that is cleaved to form B-endorphin. What 2 other substances come from this molecule, and are thus structurally similar?
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ACTH and MSH
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What is another name for somatomedin C?
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IGF-1!!
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What connects the lateral and third ventricles?
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The interventricular foramena of Monroe
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What connects the third and fourth ventricles?
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The cerebral aqueduct (of sylvius)
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Cerebellar hemangioblastoma + cysts of kidney/liver/pancreas - what d/o?
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VHL
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What nerve is near the superior thyroid artery and vein? What does it innervate?
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Superior laryngeal nerve. External brnach innervates crycothyroid muscle (internal brnach does sensation above the vocal chords). All other laryngeal muscles are innervated by the recurrent laryngeal (including sensation below the vocal chords)
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Where is bleeding usually from in IVH? What infants are predisposed to IVH?
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Germinal matrix. Premature infants.
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How do you diagnose tetanus?
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History and physical exam
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When do cluster headaches typically come on, how long do they last for? How frequently?
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Come on during sleep. Last for 30min-2hrs. Come once a day for weeks, then stop for a year or so.
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Which is responsible for satiety and which hungery - ventral or ventromedial area of the hypothalamus?
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Ventral = hunger. VM = satiety.
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Anterior vs posteiror hypothal = which is responsible for heating vs cooling?
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Posteiror = heating (sympathetic), anterior = cooling (parasympathetic)
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What does the SCN of the hypothalamus do?
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Circadian rhythm
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Are saccular and berry aneurysms the same thing?
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Yes.
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Can you lose DTRs in tertiary syphilis? Can you have shooting pain crises?
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Yes! (Dorsal root damage)
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Which normally conducts sound better, air or bone?
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Air!
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To what ear does the Weber lateralize in conductive and sensorineural hearing loss? Why?
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Conductive: lateralizes to affected ear (conduction problem blocks ambient noise in room, so sound is heard better through vibration). Sensorineural: lateralizes to normal ear, since that ear is able to hear better.
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Which is superior, the thyroid cartilidge or the crichoid?
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Thyroid! Crichothyroid ligament connects them.
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What is Dandy-Walker malformation?
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Agenesis of cerebellar vermis with cystic enlargement of 4th ventricle (fills empty posterior fossa). Associated with hydrocephalus and spina bifida.
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Wernicke's is supplied by what artery?
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MCA
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What do you call the changes in a neuron that is undergoing Wallerian degeneration? What does it look like? What is happening in the neuron?
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Axonal reaction. Cell swelling, RER and nucleus move to periphery of cell. Reflects increased protein synthesis in order to repair damaged axon.
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A neuritic process, known as a neuropil, is pathognomonic for what kind of tumor?
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Neuroblastoma
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Whcih pharyngeal arches are associated with the ear bones? Which ones?
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1st pharyngeal pouch = CN V = maleus and incus. 2nd pharyngeal arch = CN VII = stapes
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"Initial jerking resistence to passive extension followed by sudden release" What is it? Seen in what condition?
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Clasp-knife rigidity. Seen in UMN lesions.
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Can you get intracranial Schwannomas?
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Yes!
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All cranial nerves are covered with schwann cells except one. Which one? What is it covered with?
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CN II. Covered with oligodendrocytes
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What is the most common intracranial schwannoma?
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Acoustic neuroma! At CP angle.
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What neural tumor has area of both dense and loose growth patterns?
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Schwannomas!
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What nerve lies near the inferior thyroid artery?
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Recurrent laryngeal!
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What kinds of tumors stain positive for synaptophysin vs GFAP?
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Synaptophysin: neuron origin (rare form of tumor). GFAP: glial origin (oligodendrogliomas, astrocytomas, ependymomas)
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What histological changes take place in Duchenne's to cause psuedohypertrophy?
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Fibrofatty changes (get actual hypertrophy early on)
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Shrinkage of neuron cell body, intense eosinophilia, nuclear pyknosis (shrinkage) and Nissel substance. What is happening?
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This is a "red neuron" irrversible cell damage.
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Hearing loss from prolonged exposure to loud noise is due to what? Where in the ear?
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Hair cell damage in the organ of Corti
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What is the cupula?
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At the apex of the cochlea -> houses cells that sense rotation
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What NTs are decreased in Huntingtons? Increased?
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GABA and Ach are decreased. Dopamine is increased.
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What NTs are decreased and increased in PD?
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DA decreased, 5-HT and Ach increased.
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What d/o has albumino-cytologic dissociation in the CSF?
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Guillan Barre!
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"Endomysial inflammatory infiltrate" is characteristic of what disease?
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Polymyositis
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New focal neuro signs after SAH, dx? Tx?
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Vasospasm. Tx with Nimodipine (CCB)
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How do you dx rebleeding after a SAH?
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New region of blood on non-con CT.
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Deposition of fatty tissue behind the retina (drusen) is seen in what?
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Dry macular degeneration
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What distinguishes wet from dry macular degeneration?
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Neovascularization in wet MD.
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What CN travels through the cribiform plate?
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CN I
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What 3 things pass through the optic canal?
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CN II, ophthalmic artery, central retinal vein
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What 6 things pass through the superior orbital fissure?
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CN III, IV, V1, VI, opthalmic vein, sympathetic fibers
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What 7 things pass through the cavernous sinus?
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CN III, IV, V1, V2, VI post ganglionic sympathetic fibers, internal carotid
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What 1 thing passes through the foramen rotundum?
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CN V2
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What 1 thing passes through the foramen ovale?
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CN V3
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What 1 thing passes through the foramen spinosum?
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Middle meningeal artery
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What two things pass through the internal auditory meatus?
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CN VII and VIII
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What 4 things run through the jugular foramen?
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IX, X, XI, jugular vein
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What runs through the hypoglossal canal?
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CN XII
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What 3 things go through the foramen magnum?
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spinal roots of CN XI, brain stem, vertebral arteries
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What CN passes through the inferior orbital fissure?
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CN2 (after going through foramen rotundum)
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A tumor in the CP angle gets what 3 CNs?
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V, VII, and VIII
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What gives you a down and out gaze?
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CN III palsy
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In addition to a down and out eye, what other physical finding will you have with a CN III lesion?
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Ptosis! (lavator palpebrae muscle)
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Calcified cystic brain tumor with thick brownish/yellow fluid full of cholesterol. What kind of tumor? From what embryologic structure? What other strcutre dervies from there?
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Craniopharyngioma. Rathke's pouch. Anterior pituitary
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In orbital blowout fractures, which sides of the orbit are most commonly invovled? Which sinuses are on the other sides of those walls?
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Inferior (maxillary sinus) and medial (ethmoid air cells)
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Alls ensory information passes through the thalamus except what type?
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Smell!
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The VPL thalamus receives input from what two pathways?
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Spinothalamic and dorsal column
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The VPM thalamus recieves input from what two pathways?
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Trigeminal and gustatory
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The medial geniculate nucleus is part of what? Receives input from what pathway?
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Part of thalamus. Receives auditory input from superior olive and inferior colliculus of tectum.
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The VL thalamus receives input from where? Sends to where?
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BG. Motor cortex.
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What travels in the middle cerebellar peduncle?
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Inputs from the contralateral motor cortex
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What travels in the inferior cerebellar peduncle?
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Inputs: Ipsilateral proprioceptive info from the spinal cord
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What travels in the superior cerebellar peduncle?
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Output to the contralateral motor cortex
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What role do the mossy fibers play in the cerebellum?
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Input nerves!
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What is the area postrema of the posterior medulla?
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Chemoreceptor trigger zone that causes vomitting after chemo - fenestrated BBB allows sampling of blood.
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What do you see on non-con CT immediately following an ischemic stroke vs a hemorrhagic stroke?
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Nothing on ischemic stroke (darkness develops over time) BRIGHT on a hemorrhagic stroke
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Elevated levels of what are diagnostic of B12 deficiency?
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Methylmalonic acid (homocysteine elevated in B12 and folate deficiency)
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Worry about what serious sequela of pseudotumor cerebri?
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Optic nerve atrophy and blindness
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Is there an increase in ICP in hydrocephalus ex vacuo?
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Nope!
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Encephalitis with olfactory hallucinations, think what bug? What other symptoms are classic?
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HSV-1! Temporal lobes! Aphasia (speech areas) and personality changes (amygdala)
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Why do macrophages that are cleaning up an ischemic brain injury stain positive for lipids?
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Because they have phagocytosed myelin nom nom nom
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Where are the astrocytes involved in gliosis following an ischemic brain injury located with respect to the injury?
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Around the periphery
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Mechanism of decreased pain transmission in morphine?
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Mu opiod receptor is a GPCR that increases potassium efflux from cells, hyperpolarizing them.
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What does the dystrophin protein (as in Duchenne's) normally do?
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Is a structural protein that normally links ECM to intracellular contraction apparatus
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What disease is caused by a gene responsible for the synthesis of myelin?
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Charcot-Marie-Tooth (decreased nerve conduction as a result)
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Aneurysms or atherosclerotic calcifications of the internal carotid can cause what kind of visual defects?
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Nasal hemianopsia 2/2 lateral impingement on the uncrossed fibers of the optic chiasm
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The ossicles attach to which "window"?
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Oval window
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Where are high vs low frequency sounds transmitted in the cochlea (base vs apex):
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High @ base (early on). Low at apex (late, near helicotrema)
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What is the helicotrema? What type of sound is detected there?
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Apex of the cochlea, where the lowest frequency sounds are trasmitted.
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What does the round window do? Where is it located?
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Allows cochlear fluid to move when oval window is pushed in - allows sound to be trasnmitted (but is at BASE of cochlea, not apex)
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The middle meningeal artery is a branch of what artery? What is that a branch of?
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Branch of the maxillary, which is a branch of the external carotid.
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What lies at the junction of hte frontal, temporal, parietal and sphenoid bones? Why do we care?
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Pterion - middle meningeal artery is jst deep to this - epidural hematoma!
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What is thalamic syndrome?
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2/2 thalamic vascular lesion. Total loss of sensation on one side of the body (upper and lower) often accompanied by proprioceptive difficultly (through no motor defects)
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What is the first symptom to arise in EtOH withdrawal? Which comes first, seizures or DTs?
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Shakes (and autonomic dysfunction). Seizures come first (~24-48 hrs) then DTs @ 48 hours.
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Pathogenesis NPH? Is it reversible?
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Diminished resorptive capacity of the arachnoid villi. Can improve clinical symptoms by removing CSF (but cant fix arachnoid villi)
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An unvaccinated child experiences ataxia, myoclonus and visual problems caused by a virus. What is it? What is found in CSF?
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Subacute sclerosing encephalitis -> late sequelae of measels, after infection has apparently cleared. Oligoclonal bands of Abs to measels are found in CSF.
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Subacute sclerosing encephalitis is caused by the measels virus missing a certain antigen - what is it?
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M protein
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Is giant cell arteritis continuous or segmental?
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Segmental!
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In addition to AFP, levels of what else are elevated in neural tube defects? Can you detect this in the mothers serum or just the amniotic fluid?
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Acetylcholinesterase. Just in amniotic fluid (though AFP can be found ins erum)
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What two conditions are caused by the anterior neural pore not closing? Posterior?
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Anterior: encephalocoele (brain sticking out through defect) and anencephaly. Posterior causes the spina bifida syndromes.
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Arnold-Chiari 2 is associated with what other things besides cerebellar herniation?
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Myelomeningocoele and aqueductal (3->4) stenosis
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When do Chiari I and II present, respectively?
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1 may present in adulthood with headaches and cerebellar symptoms, 2 presents in the newborn with seriousness.
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The dense walls of old cystic cavities in the brain formed from previous ischemic injuries are made of what?
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Astrocytes! (from gliosis)
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What 2 veins fuse to form the R brachiocephalic?
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IJ and subclavian
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A 2-4 week old child prefers to hold its head to one side, and on the opposite side has a palpable mass that doesn't move with swallowing. What dx and what cause?
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Congenital torticolis, due to uterine malpositioning.
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Paralysis of what nerve gives you hyperacusis? Why?
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CN VII. Innervates stapedius muscle, which attaches to stapes bone. When paralyzed, relaxes, and stapes can move more - LOUDNESS
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Kyphoscoliosis + upper extremity segmental sensory loss + lower extremity UMN sign - what dx?
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Syringomyelia
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Is there sensory involvement in ALS?
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Nope!
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What nerve and nerve root does plantar flexion?
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Tibial and S1
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What nerve and nerve root does dorsi flexion?
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Peroneal and L5
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What nerve and nerve root does foot inversion?
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tibial and L5
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What nerve and nerve root does foot eversion?
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Peroneal nerve and S1
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Child with bursts of non-rhythmic conjugate eye movements, hypotonia and myoclonus - what is this syndrome called and what should you suspect?!
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Opsoclonus-myoclonus - neuroblastoma!
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What structure does syringomyelia damage?
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Ventral white comissures (area where ST tract fibres are crossing over, right in front of midline of butterfly in spinal cord)
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A pcomm/PCA artery causes ipsilateral or contralateral blown pupil?
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Ipsilateral
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What 2 tracts degenerate in Friedrich's ataxia?
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Spinocerebellar and dorsal column/dorsal root ganglia
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What spine problem do people with Friedrich's ataxia have? Metabolic problem?
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Kyophoscoliosis, diabetes
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What order do the following things resolve in in Wernicke's: eye problems, gait, memory?
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eyes first, then gait, then memory
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Lesion of CN IX causes what?
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Loss of gag reflex (IX does afferent limb) loss of taste and sensation on posterior 1/3 of tongue, loss of sensation upper pharynx, tonsils, and middle ear cavity
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"Rapidly progressive dementia and myoclonic jerks" what d/o?
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CJD!
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What is seen on hisotlogy in myotonic dystrophy? What kind of inheritence pattern is it?
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Type 1 fiber atrophy. AD trinucleotide repeat disorder showing anticipation.
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What 3 other clinical features are frequently seen with myotonic dystrophy?
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Cataracts, frontal balding, gonadal atrophy
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Type of nerve injury in diabetic CN III palsy. Why is parasymp function preserved?
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Ischemic - somatic and parasymp fibers have different blood supplies
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What 2 muscles are inervated by CN III parasympathetics? What does paralysis cause?
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Iris sphincter and ciliary muscle - paralysis causes fixed dilation
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When neurons die in ischemic brain injury, they release what substance that digests tissue?
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Lysosomal enzymes! Nomnomnom.
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What causes urinary incontinence in NPH (early and late)?
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Early: stretching of descending cortical fibers from enlarged ventricles that control sphincter late: stretching/damage of corticol inhibitory fibers, so every time bladder gets full - pee!
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What 4 CNs arise at the pontomedullary junction?
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VI - IX
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What CN arises at the level of the middle cerebral peduncle?
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CN V.
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What is the only cranial nerve to cross before exiting the brainstem?
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CN IV
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Are fibroblasts involved in brain necrosis?
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Nope!!
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The PICAs come off what artery?
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Vertebrals!
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What are the primary mediators of the blood brain barrier?
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Tight junctions!
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What nerve does motor to the tongue? (except for what muscle done by whom)?
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CN XII. Except palatoglossus muscle (CN X - think vagus does all that palate stuff)
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What are the terminal sulcus and foramen cecum of the tongue?
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Terminal sulcus separates anterior 2/3 from posterior 1/3 of tongue. Foramen cecum lies on the terminal sulcus.
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How does demyelination affect the length constant and the time constant?
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Length constant decresaes:this is HOW FAR an impulse can travel in a given time. Time constant increases: this is HOW LONG it takes for a membrane to depolarize (myelination decreases membrane capacitance)
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Saddle anesthesia and loss of the anocutaneous relfex reflect damage to what nerve roots?
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S2-S4
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If only the superficial peroneal nerve were injured, instead of the common, what symptoms would you have?
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Superficial alone would have trouble everting, but could still dorsiflex. Need to hurt common to lose both.
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Uncal herniation can cause what 3 main clinical findings?
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Ipsilateral blown pupil from CN III compression, ipsilateral hemiplegia from compression of contralateral cerebral peduncle (can get contralateral too if herniated enough) and contralateral monocular visual loss with ocular sparing due to PCA compression.
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Do the cranial nerves cross?
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NO! Except for CN IV
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Round eosinophillic structures in a brain tumor are probably....?
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Psammoma bodies! Meningioma
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Tumor cells with "fried egg" appearance? What type of tumor?
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Oligodendroglioma
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"Spastic quadreplegia and psuedobulbar palsy" - caused by what?
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Central pontine myelinolysis
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What is preserved in anterior spinal artery syndrome?
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Positional sense (ST and corticospinal tract are cut off)
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What are the 3 types of glial cells?
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Astrocytes, oligodendrocytes, microglia
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Vitamin E deficiency affects what 3 things in the nervous system?
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Dorsal column, spinocerebellar, peripheral nerves
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What 2 layers is an epidural hematoma between?
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Bone and dura
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Precentral vs postcentral gyrus - which is motor vs sensory?
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Precentral = motor, postcentral = sensory
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What does the notochord become in adults?
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Nucleus pulposus of the intervetebral disc
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What does the embryonic forebrain become? What does that become?
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Becomes telencephalon (-> cerebral hemispheres, lateral ventricles) and diencephalon (-> thalamus, third ventricle)
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What does the embryonic midbrain become? What does that become?
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Mesencephalon -> midbrain, aqueduct
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What does the embryonic hindbrain become? What does that become?
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metancephalon (-> pons and cerebellum, upper part of 4th ventricle) and myelencephaol (-> medulla, lower part of 4th ventricle)
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What maternal condition increases risk for anencephaly?
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Maternal diabetes. Folate intake decreass risk
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Syringomyelia is associated with what congenital malformation?
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Chiari I
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What brainstem nucleus is associated with taste?
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Solitary nucleus (CNs VII, IX, X)
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What kind of touch do Meissner's corpuscles do?
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FDyanimc, fine/light touch; position sense. Adapt quickly. Large, myelinated fibers.
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What kind of touch do Pacinian corpuscles do? Where are they found?
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Vibration, pressure. Deep skin layers, ligaments and joints
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All corpuscles (including merkel's discs) are made of what kind of nerve fibers?
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Large, myelinated fibers
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Where are Merkel's discs located? What do they do?
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Hair follicles. Pressure, deep static touch (adapt slowly)
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What is the OVLT? Where is it located, and what does it?
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Hypothalamus - senses plasma osmolarity (break in BBB)
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Which dopamine receptors are invovled in the inhibitory and excitatory pathways in the BG?
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D1 - excitatory, D2 - inhibitory
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When dopamien binds tot he D2 receptor in the BG, what happens?
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This inhibits the inhibitory pathway -> activation!
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What is Kluver-Bucy syndrome? What bug is it associated with?
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Get from lesion to amygdala. Hyperprality, hypersexuality, disinhibited behavior. Associated with HSV-1.
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In a PPRF lesion, do eyes looks towards or away from the lesion?
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Away from (opposite of FEF lesion)
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What is the main regulator of cerebral perfusion? What else can do it?
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CO2! Causes vasodilation. Hypoxia can at PO2 < 50
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In the brainstem, which type of nuclei are lateral and which are medial?
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Lateral = sensory. Medial = motor
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What is the nucleus ambiguus invovled in? What nerve?
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IX, X. Motor innervation of the pharynx, larynx, and upper esophagus.
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What does the dorsal motor nucleus do? What nerve?
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CN X. Sends atuonomic (parasym) fibers to heart, lungs and upper GI.
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With a CN V lesion, does the jaw deviate towards or away from side of lesion?
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Towards! (unopposed force from opposite side)
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With CN X lesion, does uvula deviate away or towards the lesion?
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Away! Weak side collapses down and pushes uvula away
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In a CN XI lesion, turning head which way is weakened?
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Turning head away from lesion is weakened.
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Hypothalamus inputs
(2) |
-OVLT (osmotic)
-Area Postrema (chemo/vomit) |
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Hypothalamic tract for Hunger
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Lateral Nucleus of hypothalamus
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Hypothalamic tract for Satiety
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Ventromedial nucleus of Hypothalamus
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Hypothalamic tract for Cooling/Parasympathetics
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Anterior Hypothalamus
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Hypothalamic tract for Heating/Sympathetics
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Posterior Hypothalamus
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Brain area for Circadian Rhythms
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Suprachiasmatic nucleus of Hypothalamus
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ADH tract
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Supraoptic nucleus of Hypothalamus --> Post. Pit
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Oxytocin tract
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Paraventricular nucleus of Hypothalamus --> Post. Pit
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Thalamic area of Pain/Temp/Body Sensation
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VPL
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Thalamic area of Face Sensation and Taste
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VPM
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Thalamic area for Vision
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LGN
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Thalamic tract for audio
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Superior olive & Inferior Colliculus of tectum --> MGN --> Auditory cortex
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Thalamic tract for Motor
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Basal Ganglia --> VL of Thalamus --> Motor cortex
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Excitatory Pathway of Basal Ganglia
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Cortex --> Striatum --> GABA disinhibits Thalamus via GRi/SNr --> movement
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Inhibitory Pathway of Basal Ganglia
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Cortex --> Striatum disinhibits STN via GPe; STN --> GPi/SNr to inhibit Thalamus --> No movement
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What does Dopamine do in Basal Ganglia?
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Stimulates Excitatory Pathway & Inhibits Inhibitory Pathway --> Movement
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