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114 Cards in this Set
- Front
- Back
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Tests for neural tube/forebrain defects |
Maternal AFP Amniotic AFP Amniotic Acetylcholine Esterase |
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Neural Tube Defects in severity |
- Spina bifida occulta - Meningocele - Meningomyelocele - Raschischisis |
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Frog-like appearance Polyhydramnios (why?) Associated with maternal type 1 diabetes and decreased folate intake during pregnancy |
Anencephaly (forebrain absence) No swallowing center in brain |
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Holoprosencephaly |
Absent corpus callosum/commisural fibers. Connected left/right cerebral hemispheres. Sonic Hedgehog Gene defect. Occurs during 5-6 week of development. Cyclopia most severe form. Milder forms associated with cleft lip/palate. |
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Arnold Chiari Malformations |
Type I - Herniation of the cerebellar tonsils >3mm below foramen magnum. Presents later. Headaches + cerebellar symptoms. Type II - Larger displacement with cerebellar tonsils AND vermis. Associated with meningomyelocele. Paralysis below level of lesion. Type III - Occipital encephalocele. Massive neurological defects. Type IV - Lack of cerebellar maturation. Incompatible with life. |
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Dandy Walker Malformation |
Agenesis of the cerebellar vermis with cystic enlargement of the 4th ventricle. |
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Syringomyelia |
Associated with Chiari I malformation. C8-T1 most common. Usually cape-like loss of sensation in upper extremeties (why loss of sensation?). |
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Tongue innervation |
Motor - Hypoglossal (CN XII) Pain - CN V3 (mandibular branch of the trigeminal), glossopharyngeal (IX) and vagus (X). Taste - Facial (VII), glossopharyngeal (IX) and the solitary nucleus of the vagus nerve (X) |
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Branchial arches |
1st and 2nd = anterior two thirds of tongue (supplied by mandibular branch of trigeminal [sensation] and facial [taste]) 3rd and 4th = posterior one third of the tongue (glossopharyngeal and vagus). |
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Nissl substance |
Stains rough endoplasmic reticulum (only present in dendrites). Does NOT stain axons. |
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Astrocyte marker |
GFAP (Glial fibrillary acidic protein) |
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Microglia |
Macrophages of the CNS. From the Mesoderm. |
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Astrocytes |
Many, many functions (reactive gliosis, K metabolism, BBB, etc...). From neuroectoderm. |
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Multinucleated giant cells in CNS. Hx of a patient who is sexually active. |
HIV-infected microglia. |
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Diseases with damaged oligodendrocytes |
MS, progressive multifocal leukoencephalopathy and leukodystrophies. |
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Acoustic neuromas |
Schwanomma in the vestibulocochlear nerve. If bilateral, associated with neurofibromatosis type 2. |
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Sensory corpuscles |
Free nerve endings -- pain and temperature. Meissner's corpuscles -- fine touch and position sense. Pacini's corpuscles -- vibration and pressure. Merkel discs -- position sense, pressure,. |
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What neurotransmitter is associated with the following locations of neurotransmitter synthesis? Locus ceruleus Ventral tegmentum and substantia nigra compacta Raphe's nucleus Basal nucleus of Myenert Nucleus accumbens |
Locus ceruleus - Norepinephrine Ventral tegmentum and substantia nigra compacta - dopamine Raphe's nucleus - 5HT Basal nucleus of Myenert - Acetylcholine Nucleus accumbens - GABA |
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Vomiting center |
Area postrema |
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Areas in the brain not affected by BBB |
- Area postrema (vomiting) - Supraoptic crest/OVLT (osmotic sensing and ADH release via supraoptic nuclei)
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Areas of the hypothalamus and function |
Lateral hypothalamus - hunger. Ventromedial hypothalamus - satiety. Anterior hypothalamus - cooling, parasympathetic. Posterior hypothalamus - heating, sympathetic. Suprachiasmatic - circadian rhythm.
What happens when these areas are damaged? |
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What does the pineal gland secrete? |
Melatonin |
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EEG wave form and sleep cycle |
At night, BATS Drink Blood. Beta waves = awake. Alpha waves = awake with eyes closed. Theta waves = Stage N1 (light sleep). Sleep spindles = Stage N2 (deeper sleep when bruxism orccurs). Delta waves = Stage N3 (deepest sleep when night terrors and bed wetting occurs). Beta waves = REM sleep (loss of motor tone, penile/clit tumescence, dreaming). |
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Sleep enuresis treatment |
DDAVP |
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Thalamus relays all ascending sensory information |
Ventral lateral nucleus - motor Ventral posterior lateral nucleus - pain, temperature, pressure, touch, proprioception. Ventral posterior medial nucleus - face sensation and taste. Lateral genticulate nucleus - vision (lateral = light) Medial genticulate nucleus - hearing (medial = music) |
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Lateral cerebellar lesions |
voluntary movement of extremities; when injured, propensity to fall toward injured |
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Medial cerebellar lesions |
Lesions involving midline structures (vermal cortex, fastigial nuclei) and/or the |
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Parkinson's presentation.
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Parkinson's TRAPS your body.
Tremor (at rest) Rigidity (cogwheel) Akinesia Postural instability Shuffling gait |
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Alpha synuclein intercellular Eosinophilic inclusions.
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Present in Parkinson's and Lewy body dementia.
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Caudate atrophy
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Huntington's disease.
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Left sided upper limb hemiballismus
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Right sub thalamic nucleus infarct (lacunar stroke)
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Essential tremor
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Genetic predisposition.
Treatment: beta blockers, primidone |
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Broca's area
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Dominant hemisphere.
Frontal lobe. Motor aphasia/expressive aphasia. |
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Damage to the Sylvian gyrus
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Complete aphasia.
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Bilateral amygdala lesions
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Kluver bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)
Associated with HSV-1 |
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Bilateral amygdala lesions
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Kluver bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)
Associated with HSV-1 |
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Anterior spinal artery infarct.
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Medial medullary syndrome.
Lateral corticospinal tract. Medial leminiscus. Hypoglossal. What will be the symptoms? |
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Bilateral amygdala lesions
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Kluver bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)
Associated with HSV-1 |
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Anterior spinal artery infarct.
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Medial medullary syndrome.
Lateral corticospinal tract. Medial leminiscus. Hypoglossal. What will be the symptoms? |
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Posterior inferior cerebellar artery |
Lateral medullary syndrome (of Wallenberg). |
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Post-meningitis hydrocephalus |
Communicating hydrocephalus - decreased in CSF absorption. |
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CSF pathway |
CSF is synthesized by the ependymal cells of the choroid plexus. Lateral ventricles -> foramen of Monroe -> third ventricle -> aqueduct of Sylvius -> fourth ventricle -> spinal cord (via foramena of Magendie/Luschka). |
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Dorsal column pathway |
1st order neurons ascends ipsilaterally synapse at the nucleus gracilis or cuneatus. 2nd order neurons decussate at the medulla in the medial leminiscus and synapses with the VPL. 3rd VPL -> brain. |
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Spinothalamic tract |
Lateral spinothalamic - pain, temperature. Anterior spinothalamic - crude touch, pressure. Crosses at the level of the spinal cord. Ascends contralaterally. VPL -> sensory cortex. |
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Superoxide dismutase 1 deficiency |
Amyotrophic lateral sclerosis. Treat with rilouzole (decreased glutamate) |
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MCC of death in Freidrich's ataxia |
Hypertrophic cardiomyopathy |
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Parinaud syndrome |
Loss of vertical conjugate gaze. Typically caused by compression of the superior colliculus by a Pinealoma. |
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Superior colliculus function |
Conjugate gaze |
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Inferior colliculus function |
Auditory |
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Pineal gland function |
Melatonin secretion |
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Accessory nerve injury |
Contralateral neck weakness (SCM pulls head towards other side). Ipsilateral shrugging |
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Structures passing through the optic canal |
CNII, central retinal vein, ophthalmic artery |
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Structures passing through the superior orbital fissure |
CNIII, IV, V1, VI, ophthalmic vein, sympathetic fibers |
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Fractured foramen rotundum |
V2 damaged |
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Cavernous Sinus syndrome |
CN III CN IV Opthalmic of trigeminal Maxillary of trigeminal CN VI (Ophthalmoplegia, decreased corneal reflex, decreased maxillary sensation) |
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CN V lesion |
Loss of sensation in face ipsilaterally + jaw deviating TOWARDS the side of the lesion (due to unapposed lateral pterygoid) |
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CN X lesion |
Uvula pointed AWAY from the lesion |
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CN XI |
Weakness turning head to the contralateral side. Shoulder droop on the side of the lesion. |
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CN XII |
Tongue deviating towards the side of the lesion |
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Sounds best heard at the apex of the helicotrema |
Low frequency sounds (helicotrema is wide and flexible) |
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Sounds best heard at the base of the cochlea |
High frequency sounds (cochlea is narrow and rigid) |
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Noise induced hearing sounds |
Hearing loss for high frequency sounds |
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Rinne's test |
Bone > air in conductive hearing loss. Air > bone in sensorineural hearing loss. |
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Weber's test |
Conductive hearing loss - localized towards the affected side. Sensorineural hearing loss - localized to the unaffected side |
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Facial lesions |
UMN facial lesion - contralateral lower face palsy (due to bilateral nerve innervation). LMN facial lesion - ipsilateral palsy of all face. |
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Innervation of the stapedius muscle |
Facial nerve |
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Inflammation of anterior uvea and iris with hypopyon. Often accompanied by conjunctival redness. Often due to immune disorders -- autoimmune disease, Juvenile Infantile Arthritis, sarcoidosis, HLAB27 associated. |
Uveitis |
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Retinitis |
Often immunosuppression and viral associated (CMV, HSV, HZV). Retinal edema and necrosis leading to scarring. |
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Conotruncal abnormalities |
Abnormalities associated with abnormal rotation of the truncus arteriosus or the aorticopulmonary septum. They are: - Persistent Truncus Arteriosus - Transposition of the great vessels - Tetralogy of Fallot (overriding aorta) |
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Describe the process of the septation of atrial chambers |
Septum primum + foramen primum -> Foramen secundum + foramen primum -> Foramen secundum -> Septum secundum |
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Three circulation shunts in utero |
1. Foramen Ovale (Fossa ovale) 2. Ductus venosus (ligamentum venosum) 3. Ductus arteriosus (ligamentum arteriosum) |
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Drugs for PDA |
Indomethacin - closes PGE1 PGE2 - keeps open |
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What does the left anterior descending artery supply? |
Anterior 2/3 of the interventricular septum, anterior papillary muscle, and anterior surface of left ventricle |
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What does the left circumflex artery supply? |
Supplies lateral and posterior walls of the left ventricle |
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What does the posterior descending artery supply? |
Posterior 1/3 of the interventicular septum and posterior walls of the ventricles |
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Fick's Principle |
Rate of O2 consumption OVER arterial O2 content - venous O2 content |
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Causes of increased pulse pressure |
Hyperthyroidism Aortic regurg Exercise Obstructive sleep apnea Arteriosclerosis
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Signs of hyperdynamic circulation |
Head bobbing, nail bobbing, bounding pulse |
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Causes of decreased pulse pressure |
Aortic stenosis Cardiac tamponade Advanced heart failure |
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Causes of increased contractility |
Catecholamines Increased intracellular calcium Decreased extracellular sodium Digitalis (blocks Na K pump) |
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MOA of digitalis |
Na K pump inhibitor Increased intracellular sodium would cause less activity of the sodium/calcium exchanger and subsequent build up of intracellular calcium (which increases contractility). |
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Causes of decreased contractility |
B1 blockade (beta blockers) Heart failure Acidosis Hypoxia/hypercapnia Non-dihydropyridine Calcium channel blockers |
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Causes of increased blood viscosity |
Polycythemia Hyperproteinemic states Hereditary sphreocytosis |
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Holosystolic, high pitched blowing murmur enhanced by hand grip |
Mitral regurg |
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Holysystolic, high pitched blowing murmur enhanced by inspiration |
Tricuspid regurg |
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Holosystolic, harsh sounding murmur |
VSD |
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Crescendo, decrescendo systolic ejection murmur |
Aortic stenosis |
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Murmur radiating to the neck |
Aortic stenosis |
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Machine-like murmur, continuous |
PDA |
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Ventricular action potential |
Phase 0 - Rapid upstroke and depolarization Na channels open Phase 1 - initial repolarization, inactivation of voltage gated sodium channels and opening of voltage gated potassium channels. Phase 2 - plateau phase. Calcium influxes through voltage gated calcium channels and balances potassium efflux. Calcium-induced calcium release occurs from the sarcoplasmic reticulum and muscle contraction. Phase 3 - rapid repolarization. Massive efflux of potassium due opening of voltage gated slow potassium channels. Closure of calcium channels. Phase 4 - resting potential |
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U wave |
Hypokalemia/Bradycardia
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Normal QRS duration |
<120msec (3 blocks) |
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Normal PR uration |
<200msec (5 blocks) |
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Medications that can cause torsades de pointes |
Typically caused by decreased K and Mg, treat with MgSO4. Some Risky Medications Can Prolong QT Sotalol Risperidone Macrolides Chloroquine Protease inhibitos Quinidine Thiazides |
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Congenital long QT |
Romano-Ward - autosomal dominant Jervell Lange Nielsen syndrome - autosomal recessive + sensorineural deafness |
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Persistent bundle of Kent |
Wolff-Parkinson-White syndrome, causes delta wave. Associated with supraventricular tachycardia. |
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Lesion of Brodmann's area 44(dominant frontal lobe)
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Broca's aphasia
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Lesion of Brodmann's area 44(dominant frontal lobe)
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Broca's aphasia
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Lesion of dominant superior temporal gyrus (Brodmann's area 22)
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Wernicke's aphasia
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Lesion of Brodmann's area 44(dominant frontal lobe)
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Broca's aphasia
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Lesion of dominant superior temporal gyrus (Brodmann's area 22)
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Wernicke's aphasia
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Lesion in parietal lobe or arcuate fasciculations
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Conductive aphasia
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Lesion of Brodmann's area 44(dominant frontal lobe)
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Broca's aphasia
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Lesion of dominant superior temporal gyrus (Brodmann's area 22)
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Wernicke's aphasia
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Lesion in parietal lobe or arcuate fasciculations
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Conductive aphasia
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Wide lesion in the presylvian area
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Global aphasia
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Lesion of Brodmann's area 44(dominant frontal lobe)
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Broca's aphasia
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Lesion of dominant superior temporal gyrus (Brodmann's area 22)
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Wernicke's aphasia
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Lesion in parietal lobe or arcuate fasciculations
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Conductive aphasia
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Wide lesion in the presylvian area
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Global aphasia
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Functions of the parietal lobe and associated pathology
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Intellectual processing of sensory information.
Dominant lobe lesion - Gertsmann's syndrome. Non dominant lobe lesion - hemineglect |
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Dopamine acting on the tuberoinfundibular system
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Decreases prolactin
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Dopamine acting on the tuberoinfundibular system
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Decreases prolactin
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Dopamine blockade on the nigrostriatal pathway
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Tremors, muscle rigidity and bradykinesia (Parkinson's due to decreased dopamine from the substantia nigra pars compacta)
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