Usmle Neuro

Front 1

Parkinson's drug that selectively inhibits MAO-B

Back 1

selegiline

Front 2

epilepsy drug that can cause agranulocytosis

Back 2

carbamazepine

Front 3

what do you use to treat benzodiazepine overdose?

Back 3

flumazenil (competitive antagonist at GABA receptor)

Front 4

seizure drug that can cause SLE-like syndrome

Back 4

phenytoin

Front 5

what is the mechanism of dilantin/phenytoin?

Back 5

use-dependent blockade of Na+ channels

Front 6

chronic use of this anti-epileptic can cause gingival hyperplasia in kids, peripheral neuropathy, hirsutism, megaloblastic anemia, and malignant hyperthermia

Back 6

phenytoin

Front 7

mechanism of action of barbiturates?

Back 7

facilitate GABA action by increasing duration of Cl- channel opening, thus decreasing neuron firing

Front 8

what seizure drug is contraindicated in porphyria?

Back 8

barbiturates

Front 9

barbiturates do what to the P-450 system?

Back 9

induce it

Front 10

what epilepsy drug is associated with hepatotoxicity and neural tube defects?

Back 10

valproic acid

Front 11

what drug is used to treat neuroleptic malignant syndrome (rigidity, myoglobinuria, autonomic instability, hyperprexia)

Back 11

dantrolene and dopamine agonists

Front 12

tardive dyskinesia can result from long-term use of what class of drugs?

Back 12

neuroleptics (antipsychotics) - thioridazine, haloperidol, fluphenazine, chlorpromazine

Front 13

schizophrenia drug that can cause agranulocytosis

Back 13

clozapine

Front 14

side effects of lithium?

Back 14

polyuria (ADH antagonist causeing nephrogenic diabetes insipidus), hypothyrodism

Front 15

what is the mechanism of action of atypical antipsychotics (clozapine, olanzapine, risperidone)

Back 15

block 5-HT2 and dopamine receptors

Front 16

what is 'serotonin syndrome'?

Back 16

can occur when SSRIs are given with MAOI's - hperthermia, muscle rigidity, CV collapse

Front 17

fluoxetine, sertaline, paroxetine, and citalopram are what type of drugs?

Back 17

SSRIs

Front 18

how do TCAs work?

Back 18

block reuptake of NE and serotonin - imipramine, amitrptyline, desipramine, nortriptyline, clomipramine, doxepin

Front 19

what TCA can be used for bedwetting?

Back 19

imipramine

Front 20

which TCA is the least sedating?

Back 20

desipramine

Front 21

which class of antidepressants has convulsions, coma, arrythmias, respiratory depression as potential toxicities?

Back 21

tricyclics

Front 22

tricyclics can cause confusion and hallucinations in elderly due to anticholinergic side effects - what do you use?

Back 22

nortriptyline

Front 23

which of the SSRIs inhibits the P-450 system?

Back 23

fluvoxamine

Front 24

which atypical antipsychotic can also be used to treat OCD, GAD, depression, mania?

Back 24

olanzapine

Front 25

what is the mechanism of antipsychotic drugs?

Back 25

block dopamine D2 receptors

Front 26

this parkinson's drug agonizes dopamine receptors

Back 26

bromocriptine

Front 27

mechanism of action of amantadine? what is it used for?

Back 27

increased dopamine - parkinson's

Front 28

entacapone and tolcapone are parkinson's drugs that inhibit what?

Back 28

COMT - prevent dopamine breakdown

Front 29

this parkinson's drug curbs excess cholinergic activity

Back 29

benztropine - antimuscarinic, improves tremor and rigidity but has littel effect on bradykinesia

Front 30

mechanism of l-dopa

Back 30

increased level of dopamine in brain

Front 31

what is l-dopa administered with and why?

Back 31

carbidopa - a peripheral decarboxylase inhibitor - increases the bioavailability of l-dopa in the brain and to limit peripheral side effects

Front 32

what is sumatriptan and what is it used for?

Back 32

5-HT1D agonist - causes vasoconstriction; used for acute migraine & cluster headache attacks

Front 33

sumatriptan is contraindicated in patients with what? why?

Back 33

can cause coronary vasospasm, so contraindiicated in pts. with CAD or prinzmental's angina

Front 34

which 2 epilepsy drugs can cause stevens-johnson syndrome?

Back 34

lamotrigine, ethosuximide

Front 35

what is the first line drug for absence seizures?

Back 35

ethosuximide

Front 36

what is the first line drug for acute status epilepticus?

Back 36

benzodiazepines (diazepam or lorazepam)

Front 37

what is the first line drug for prophylaxis of status epilepticus?

Back 37

phenytoin

Front 38

what is the first-line seizure drug for pregnant women, children?

Back 38

phenobarbital

Front 39

this drug is a first-line treatment for tonic-clonic seizures and trigeminal neuralgia

Back 39

carbamazepine

Front 40

what is the mechanism of action of benzodiazepines?

Back 40

facilitate GABAa action by increasing frequency of Cl- channel opening

Front 41

this class of antidepressants can cause sedation, alpha-blocking effects, atropine-like effects (tachycardia, urinary retention)

Back 41

TCAs

Front 42

what is the mechanism of action of venlafaxine?

Back 42

heterocyclic antidepressant - inhibits serotonin, NE, and dopamine reuptake

Front 43

mechanism of action of mirtazapine?

Back 43

alpha2 agonist - increases release of NE and serotonin, and potent 5-HT2 and 5-HT3 receptor antagonist

Front 44

this heterocyclic antidepressant blocks NE reuptake

Back 44

maprotiline

Front 45

what is the clinical use of MAOIs?

Back 45

atypical depression (i.e. with psychotic or phobic features(, anxiety, hypochondriasis

Front 46

MAOIs are contraindicated with what two classes of drugs?

Back 46

SSRIs and beta blockers (prevent serotonin syndrome)

Front 47

what is a sensitive indicator of alcohol use?

Back 47

serum gamma-glutamyltransferase

Front 48

disinhibition, emotional lability, slurred speech, ataxia, coma, and blackout are signs of what type of intoxication?

Back 48

alcohol

Front 49

tremor, tachycrdia, hypertension, malaise, nausea, seizures, agitation, hallucinations are signs of withdrawal from what?

Back 49

alcohol

Front 50

CNS depression, nausea and vomiting, constipation, pinpoint pupils, and seizures may be signs of what type of intoxication?

Back 50

opiods

Front 51

anxiety, insomnia, anorexia, sweating, dilated pupils, fever, rhinorrhea, piloerection, nausea, cramps, diarrhea, yawning are signs of withdrawal from what type of drug?

Back 51

opiods

Front 52

psychomotor agitation, impaired judgement, pupillary dilation, hypertension, tachycardia, euphoria, prolonged wakefulness and attention, cardiac arrythmias, delusions, hallucinations, and fever may be signs of what type of intoxication?

Back 52

amphetamines

Front 53

post use crash, including depression, lethargy, headache, stomach cramps, hunger, and hypersomnolence are characteristic of withdrawal from what?

Back 53

amphetamines

Front 54

euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, hypertension, hallucinations (including tactile), paranoid ideations, angina, and sudden cardiac death may be signs of intoxication with what drug?

Back 54

cocaine

Front 55

post use crash, including severe depression and suicidality, hpersomnolence, fatigue, malaise, severe psychologial craving are characteristic of withdrawal from what?

Back 55

cocaine

Front 56

belligerence, impulsiveness, fever, pschomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis, and delerium are indicative of intoxication with what drug?

Back 56

PCP

Front 57

recurrence of intoxication symptoms due to reabsorption in GI tract, sudden onset of severe, random, homicidal violence may occur with withdrawal from what substance?

Back 57

PCP

Front 58

what 2 drugs are not typically associated with withdrawal symptoms?

Back 58

marijuana, LSD

Front 59

marked anxiety or depression, delusions, visual hallucinations, flashbacks, and pupil dilation are characteristic of intoxication with what substance?

Back 59

LSD

Front 60

euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social withdrawal, increased appetite, dry mouth, and hallucinations are characteristics of what type of substance use?

Back 60

marijuana

Front 61

which has a higher safety margin: barbiturates or benzodiazepines?

Back 61

benzodiazepines

Front 62

anxiety, seizures, delerium, life-threatening CV collapse are potential side effects of withdrawal from what?

Back 62

barbiturates

Front 63

what drug inhibits opiods?

Back 63

naltrexone

Front 64

this drug of abuse causes pupillary constriction/pinpoint pupils

Back 64

opiods

Front 65

these 3 drugs of abuse can cause pupillary dilation

Back 65

amphetamines, cocaine, LSD

Front 66

this drug of abuse can cause vertical and horizontal nystagmus

Back 66

PCP

Front 67

this drug of abuse can cause angina and sudden cardiac death

Back 67

cocaine

Front 68

which drug of abuse is associated wtih homicidality?

Back 68

PCP

Front 69

which epilepsy drug can cause kidney stones?

Back 69

topiramate

Front 70

name two MAOIs

Back 70

phenelzine, tranylcypormine

Front 71

what class of benzodiazepines are the most appropriate for acute insomnia and jet lag?

Back 71

short-acting, e.g. triazolam

Front 72

alpazolam is what type of benzodiazepine and what is it most often used for?

Back 72

intermediate-acting; panic attacks

Front 73

is secobarbital short- or long-acting?

Back 73

short

Front 74

what is xerostomia?

Back 74

dry mouth

Front 75

what type of drug is benztropine?

Back 75

anticholinergic - leads to anti-SLUDG side effects

Front 76

how do methamphetamine/amphetamine work?

Back 76

gain entrance to dopamine and NE nerve terminals, causing the release of these NTs via the uptake carriers; DA is a significant factor in the reinforcing effects of stimulants

Front 77

how does supatriptan work?

Back 77

serotonin1D agonist

Front 78

this type of cell is important for physical support & repair, K+ metabolism, and helps to maintain BBB

Back 78

astrocyte

Front 79

what are microglia responsible for?

Back 79

phagocytosis

Front 80

where are ependymal cells found?

Back 80

inner lining of ventricles

Front 81

from where do microglia originate?

Back 81

mesoderm (like macrophages; M)

Front 82

how many axons does each oligodendrocyte myelinate?

Back 82

multiple - up to 30 each

Front 83

what is the predominant type of glial cell in white matter?

Back 83

oligodendroglia

Front 84

how many axons do Schwann cells myelinate?

Back 84

only one each; also promote axonal regeneration

Front 85

what fuses to form multinucleated giant cells in CNS of HIV infected patients?

Back 85

HIV-infected microglia

Front 86

what peripheral nerve layer serves as a permeability layer?

Back 86

perineurium - must be rejoined in microsurgery for limb reattachment

Front 87

what layer surrounds the entire nerve (fascicles and blood vessles)?

Back 87

epineurium

Front 88

what peripheral nerve layer invests single nerve fibers?

Back 88

endoneurium

Front 89

these are found in dermis of palms, soles, and digits

Back 89

Meissner's corpuscles

Front 90

what is involved in light discriminaory touch of glabrous (hairless) skin?

Back 90

Meissner's corpuscles

Front 91

these are large, encapsulated nerve endings found in deeper layers of skin at ligamnts, joint capsusles, serous membranes, mesnteries

Back 91

pacinian corpuscles

Front 92

these are involved in pressure, coarse touch, vibration, and tension

Back 92

pacinian corpuscles

Front 93

these are cup-shaped nerve endings (tactile disks) in dermis of fingertips, hair follicles, and hard palate that are invovled in light, crude touch

Back 93

Merckel's corpuscles

Front 94

perilymph is rich in what?

Back 94

Na+ (peri- think outside the cell)

Front 95

endolymph is rich in what?

Back 95

K+ (endo-think inside the cell)

Front 96

what does the bony labyrinth include?

Back 96

filled with perilymph - cochlea, vestibule, semicircular canals

Front 97

what does the membranous labyrinth include?

Back 97

filled with endolymph - cochlear duct (within the cochlea), utricle and saccule (within the vestibule), and semicircular canals

Front 98

what frequency sound does the base of the cochlea pick up?

Back 98

narrow and stiff - picks up high-frequency

Front 99

what frequency sounds does the apex of the cochlea pick up?

Back 99

wide and flexible - picks up low-frequency

Front 100

what do the ampullae detect?

Back 100

angular acceleration

Front 101

how does hearing loss progress in the elderly?

Back 101

high frequency - low frequency

Front 102

what do the utricle and saccule contain and detect?

Back 102

maculae - detect linear acceleration

Front 103

what produces endolymph?

Back 103

stria vascularis

Front 104

what 3 structures form the blood-brain barrier?

Back 104

1. tight junctions between nonfenestrated capillary membranes 2. basement membrane, 3. astrocyte process

Front 105

how do glucose and AA's cross the BBB?

Back 105

carrier-mediated transport mechanism

Front 106

which crosses the BBB more readily: nonpolar/lipid-soluble substances or polar/water-soluble substances?

Back 106

nonpolar/lipid soluble substances

Front 107

name 2 specialized brain regions with fenestrated capillaries and no BBB that allow molecules in the blood to affect function or neurosecretory products to enter circulation

Back 107

1. area postrema- vomiting after chemo 2. neurohypophysis - ADH release

Front 108

what hypothalamic nucleus is responsible for thirst and water balance?

Back 108

supraoptic nucleus

Front 109

the neurohypophysis releases hormones that were synthesized where?

Back 109

hypothalamic nuclei

Front 110

destruction of what hypothalamic nucleus leads to anorexia and starvation?

Back 110

lateral nucleus

Front 111

destruction of what hypothalamic nucleus leads to hyperphagia and obesity?

Back 111

ventromedial (you grow ventrally and medially)

Front 112

what part of the hypothalamus regulates the parasympathetic NS?

Back 112

anterior

Front 113

what part of the hypothalamus regulates the sympathetic nervous system?

Back 113

posterior

Front 114

what part of the hypothalamus regulates circadian rhythms?

Back 114

suprachiasmatic nucleus

Front 115

what part of the hypothalamus regulates heat conservation and production when cold?

Back 115

posterior hypothalamus

Front 116

what part of the hypothalamus coordinates cooling when hot?

Back 116

anterior (A/C)

Front 117

what part of the hypothalamus controls sexual urges and emotions? (destruction of this nucleus leads to rage)

Back 117

septal nucleus (S-sexual/septal)

Front 118

the posterior pituitary recieves axonal projections from where?

Back 118

supraoptic (ADH) and periventricular (oxytocin) nuclei

Front 119

which thalamic nucleus is responsible for relaying visual information?

Back 119

lateral geniculate nucleus - (Lateral for Light)

Front 120

which thalamic nucleus is responsible for relaying auditory information?

Back 120

medial geniculate nucleus (M-music)

Front 121

which thalamic nucleus is responsible for relaying body sensation?

Back 121

VPL

Front 122

which thalamic nucleus is responsible for relaying facial sensation?

Back 122

VPM

Front 123

which thalamic nucleus is responsible for relaying motor information?

Back 123

VA/VL nuclei

Front 124

what is the limbic system responsible for?

Back 124

feeding, fighting, feeling, flight, and sex (famous 5 Fs)

Front 125

premotor area is what Broadman's area?

Back 125

6

Front 126

principal motor area is what Broadman's area?

Back 126

4

Front 127

principal sensory area is what Broadman's areas?

Back 127

3, 1, 2

Front 128

principal visual cortex is what Broadman's area?

Back 128

17

Front 129

associative auditory cortex/Wernicke's area is what Broadman's area?

Back 129

22

Front 130

primary auditory cortex is what Broadman's area?

Back 130

41, 42

Front 131

motor speech/Broca's area is what Broadman's area?

Back 131

44, 45

Front 132

frontal eye fields are what Broadman's area?

Back 132

8

Front 133

what is most notable in a frontal lobe lesion?

Back 133

lack of social judgment

Front 134

this supplies the medial surface of the brain, leg-foot area of motor and sensory cortices

Back 134

anterior cerebral artery

Front 135

what artery supplies the lateral apsect of the brain, trunk-arm-face area of motor and sensory cortices, and Broca's and Wernicke's areas?

Back 135

MCA

Front 136

what artery is the most common circle of Willis aneurysm; lesion may cause visual field defects?

Back 136

anterior communicating artery

Front 137

lesion of this artery causes CN III palsy

Back 137

posterior communicating artery - common area of aneurysm

Front 138

these are known as the 'arteries of stroke'

Back 138

lateral striate areries - divisions of MCA

Front 139

what do the lateral striate arteries supply?

Back 139

internal capsule, caudate, putamen, globus pallidus

Front 140

a stroke of what circle leads to general sensory and motor dysfunction and aphasia?

Back 140

anterior

Front 141

a stroke of what circle leads to cranial nerve deficits, coma, and cerebellar deficits?

Back 141

posterior

Front 142

cerebral veins drain into what?

Back 142

venous sinuses - internal jugular vein

Front 143

what is the main location of CSF return via arachnoid granulations?

Back 143

superior saggital sinus

Front 144

hemisection above TI presents with what?

Back 144

Horner's syndrome

Front 145

what waveform is present when awake with eyes open?

Back 145

beta

Front 146

awake with eyes closed - what waveform?

Back 146

alpha

Front 147

stage 1/light sleep - what waveform?

Back 147

theta

Front 148

stage 2/deeper sleep - what waveform?

Back 148

sleep spindles and K complexes

Front 149

stage 3-4/deepest, non-REM sleep, sleepwalking, night terrors, bed-wetting (slow-wave) - what waveform?

Back 149

delta - lowest frequency, highest amplitude

Front 150

in what stage of sleep is there dreaming, loss of motor tone, possibly a memory processing function, erections, increased brain O2 use?

Back 150

REM

Front 151

what waveform is associated with REM sleep?

Back 151

beta

Front 152

serotonergic predominance of raphe nucleus is key to initiating what?

Back 152

sleep

Front 153

what neurotransmitter reduces REM sleep?

Back 153

NE

Front 154

what is responsible for the extraocular movements seen during REM sleep?

Back 154

PPRF (paramedian pontine reticular formation/conjugate gaze center)

Front 155

what drugs shorten stage 4 sleep? what are they therefore useful for?

Back 155

benzodiazepines - night terrors and sleepwalking

Front 156

why is imipramine used to treat enuresis?

Back 156

because it decreases stage 4 sleep

Front 157

what happens to pulse and BP during REM sleep?

Back 157

increased and variable

Front 158

how often does REM sleep occur?

Back 158

every 90 minutes - duration increases throughout the night

Front 159

what is the principal neurotransmitter involved in REM sleep?

Back 159

ACh

Front 160

where's the lesion: motor (nonfluent/expressive) aphasia with good comprehension

Back 160

Broca's area

Front 161

where's the lesion: sensory (fluent/receptive) aphasia with poor comprehension

Back 161

Wernicke's area

Front 162

where's the lesion: conduction aphasia; poor repetition with good comprehension, fluid speech

Back 162

arcuate fasciculus

Front 163

where's the lesion: Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)

Back 163

bilateral amygdala

Front 164

where's the lesion: personality changes and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes

Back 164

frontal lobe

Front 165

where's the lesion: spatial neglect syndrome (agnosia of the contralateral side of the world)

Back 165

right parietal lobe

Front 166

where's the lesion: coma

Back 166

reticular activating system

Front 167

where's the lesion: Wernicke-Korsakoff syndrome

Back 167

bilateral mammilary bodies

Front 168

where's the lesion: tremor at rest, chorea, or athetosis

Back 168

basal ganglia

Front 169

where's the lesion: intention tremor, limb ataxia

Back 169

cerebellar hemisphere (laterally located, affect lateral limbs)

Front 170

where's the lesion: truncal ataxia, dysarthria

Back 170

cerebellar vermis (centrally located - affects central body)

Front 171

where's the lesion: contralateral hemiballismus

Back 171

subthalamic nucleus - loss of inhibition of thalamus through globus pallidus

Front 172

what do you call slow, writhing movements, especially of fingers? what are these characteristic of?

Back 172

athetosis; basal ganglia lesion

Front 173

where is Broca's area?

Back 173

inferior frontal gyrus

Front 174

where is Wernicke's area?

Back 174

superior temporal gyrus

Front 175

familial form of AD (10%) is associated with genes on what chromosomes?

Back 175

1, 14, 19 - APOE4 allele (ch 21 pApp gene)

Front 176

intracellular, abnormally phosphorylated tau protein is associated with what?

Back 176

neurofibrillary tangles in AD

Front 177

dementia, aphasia, parkinsonian aspects & specificity for frontal and temporal lobes?

Back 177

Pick's disease

Front 178

intracellular, aggregated tau protein is associated with what?

Back 178

Pick bodies

Front 179

what disease is associated with Lewy bodies?

Back 179

Parkinson's

Front 180

what 2 degenerative diseases are associated with spinocerebellar atrophy?

Back 180

olivopontocerebellar atrophy, Friedreich's ataxia

Front 181

this disease is associated with degeneration of anterior horns

Back 181

Werdnig-Hoffman disease

Front 182

this disease presents at birth as a 'floppy baby'; tongue fasciculations are characteristic

Back 182

Werdnig-Hoffman disease

Front 183

how is Werdnig-Hoffman disease inherited; what is the median age of death?

Back 183

AR, 7 months

Front 184

polio is associated with degeneration of what?

Back 184

anterior horns - LMN destruction

Front 185

how is poliovirus transmitted?

Back 185

fecal-oral

Front 186

what are the CSF findings in poliomyelitis?

Back 186

lymphocytic pleocytosis with slight elevation of protein

Front 187

what is the classic triad associated with MS?

Back 187

scanning speech, intention tremor, nystagmus (SIN)

Front 188

what is the treatment for MS?

Back 188

beta-interferon or immunosuppressant therapy

Front 189

the prevalance of this disease increases with distance from equator

Back 189

MS

Front 190

what are periventricular plaques?

Back 190

areas of oligodendrocyte loss and reactive gliosis seen in MS (preservation of axons)

Front 191

patients with what disease can present with optic neuritis, MLF syndrome, hemiparesis, hemisensory symptoms, or bladder/bowel incontinence?

Back 191

MS

Front 192

what is progressive multifocal leukoencephalopathy associated with?

Back 192

JC virus - seen in 2-4% of AIDS patients (reactivation of latent virus)

Front 193

what is the treatment for Guillain Barre?

Back 193

respiratory support until recovery; plasmapheresis, IVIg

Front 194

symmetric ascending muscle weakness beginning in distal lower extremities is seen in what disease?

Back 194

Guillain Barre

Front 195

what are the CSF findings in Guillain Barre?

Back 195

elevated CSF protein with normal cell count - albuminocytologic dissociation; elevated protein leads to papilledema

Front 196

this disease is marked by inflammation and demyelination of peripheral nerves and motor fibers of ventral roots

Back 196

Guillain Barre - sensory effect is less severe than motor

Front 197

what are the causes of seizures in children?

Back 197

genetic, infection, congenital, trauma, metabolic

Front 198

what are the causes of seizures in adults?

Back 198

tumors, trauma, stroke, infection

Front 199

what are the causes of seizures in elderly?

Back 199

stroke, tumor, trauma, metabolic, infection

Front 200

this type of seizures involves one area of the brain

Back 200

partial

Front 201

rupture of middle meningeal artery causing an epidural hematoma is often secondary to what?

Back 201

fracture of temporal bone

Front 202

what does CT show in epidural hematoma?

Back 202

biconvex disk not crossing suture lines

Front 203

what kind of intracranial hemorrhage is most likely to be seen in a shaken baby, elderly person, or alcoholic?

Back 203

subdural hematoma - rupture of bridging veins

Front 204

this type of intracranial hemorrhage is caused by hypertension, amyloid angiopathy, DM, and tumor

Back 204

parenchymal hematoma

Front 205

what does CT show in the case of subdural hematoma?

Back 205

crescent-shaped hemorrhage that crosses suture lines

Front 206

what is the drug of choice for status epilepticus?

Back 206

diazepam

Front 207

what is the most common site of obstruction causing hydrocephalus?

Back 207

aqueduct of sylvius

Front 208

what is the underlying lesion in retinopathy of prematurity?

Back 208

inappropriate proliferation of vessels in the inner layers of the retina

Front 209

location at the junction of cortical gray and white matter is typical for what type of tumor?

Back 209

metastatic; round shape is also characteristic

Front 210

progressive dementia with diffuse loss of deep hemispheric white matter?

Back 210

subcortical leukoencephalopathy - Binswanger disease - one of the neurologic syndromes associated with hypertension

Front 211

what degenerative disorder is characterized by ophthalmoplegia, pseudobulbar palsy, axial dystonia, and bradykinesia?

Back 211

progressive supranuclear palsy - widespread neuronal loss and gliosis in subcortical sites with sparing of the cerebral and cerebellar cortices

Front 212

confusion, ataxia, vestibular dysfunction, sluggish pupillary light reflexes, anisocoria, and oculomotor dysfunction are acute sympmtoms as what?

Back 212

Wernicke's syndrome - thiamine deficiency usually second to chronic alcohol abuse (chornic form includes anterograde amnesia and confabulation and is called wernicke korsakoff)

Front 213

syringomyelia is often associated with what?

Back 213

Arnold-Chiari malformation, in which there is a congenital protrusion of the cerebellum and medulla through the foramen magnum

Front 214

this type of benign tumor often involves the lateral ventricles of young boys

Back 214

choroid plexus papilloma - can affect the caudate because it comprises part of the wall of the lateral ventricle

Front 215

atrophy of the caudate and putamen can make what look large on imaging?

Back 215

ventricles

Front 216

a pituitary tumor that expands laterally will first affect what?

Back 216

abducens nerve

Front 217

lesion of the right parietal lobe will cause what?

Back 217

sensory neglect syndrome of left side (most common pattern in right handed patients)

Front 218

what is the most common primary brain tumor?

Back 218

glioblastoma multiforme - grade IV astrocytoma

Front 219

what stains astrocytes?

Back 219

GFAP

Front 220

this type of tumor has 'pseudopalisading cells' that border central areas of necrosis and hemorrhage

Back 220

glioblastoma multiforme

Front 221

this type of brain tumor has spindle cells concentrically arranged in a whorled pattern' psammoma bodies (laminated calcifications)

Back 221

meningioma

Front 222

this is the second most common type of brain tumor - most often occurs in convexities of hemispheres and parasagittal region

Back 222

meningioma

Front 223

from what does a meningioma arise?

Back 223

arachnoid cells external to brain

Front 224

this is the third most common primary brain tumor - originates from Schwann cells

Back 224

Schwannoma - often localized to 8th nerve (acoustic neuroma)

Front 225

this tpe of tumor contains 'fried egg' cells

Back 225

oligodendroglioma - often calcified

Front 226

where are oligodendrogliomas most frequently found?

Back 226

frontal lobes

Front 227

the majority of adult primary tumors are located where?

Back 227

supratentorial

Front 228

the majory of childhood primary tumors are found where?

Back 228

infratentorial

Front 229

this tumor has a peak incidence in childhood - diffusely infiltrating glioma, most often found in posterior fossa; benign with good prognosis

Back 229

pilocytic (low-grade) astrocytoma

Front 230

this type of childhood peak incidence brain tumor has Rosenthal fibers - eosinophilic, corkscrew fibers

Back 230

pilocytic (low-grade) astrocytoma

Front 231

this is a highly malignant cerebellar tumor & a form of primitive neuroectodermal tumor (PNET); found primarily in children; can compress the 4th ventricle to cause hydrocephalus

Back 231

medulloblastoma

Front 232

this type of childhood tmor contains rosettes or perivascular pseudorosete pattern of cells & is radiosensitive

Back 232

medulloblastoma

Front 233

where are ependymomas most commonly found? what is the prognosis?

Back 233

4th ventricle; poor prognosis

Front 234

foamy cells and high vascularity are characteristic of what type of childhood-predominant tumor?

Back 234

hemangioblastoma

Front 235

this type of brain tumor is associated with von Hippel-Lindau

Back 235

hemangioblastoma

Front 236

this type of tumor shows characteristic perivascular pseudorosettes; rod-shaped blepharoplasts are found near the nucleus

Back 236

ependymoma

Front 237

this type of child-predominant tumor can produce EPO, leading to secondary polycythemia

Back 237

hemangioblastoma

Front 238

this is a benign childhood tumor, confused with pituitary adenoma

Back 238

craniopharyngioma

Front 239

this is the most common childhood supratentorial tumor

Back 239

craniopharyngioma

Front 240

where does syringomyelia most commonly occur?

Back 240

C8-T1

Front 241

contralateral paralysis of lower face only

Back 241

lesion of motor cortex or connection between cortex and facial nucleus (UMN CN VII)

Front 242

cingulate herniation under falx cerebri can compress what?

Back 242

anterior cerebral artery

Front 243

what results with downward transtentorial (central) herniation?

Back 243

coma and death - if compress brainstem

Front 244

ipsilateral dilated pupil/ptosis in uncal herniation results from what?

Back 244

stretching of CN III

Front 245

contralateral homonymous hemianopia in uncal hernaition results from what?

Back 245

compression of ipsilatearal posterior cerebral artery

Front 246

ipsilateral paresis in uncal herniation results from what?

Back 246

compression of contralateral crus cerebri (Kernohan's notch)

Front 247

Duret hemorrhages - paraemdian artery rupture in uncal herniation results from what?

Back 247

caudal displacement of brain stem

Front 248

lesion in MLF results in what on attempted lateral gaze?

Back 248

medial rectus palsy; nystagmus is seen in the abducting eye; convergence is normal

Front 249

why are local anesthetics less effective in areas of infection?

Back 249

they are weak bases and are only effective at penetrating tissue in the unprotonated form - abscesses have lower pH and thus lidocane, etc. becomes protonated and poor anesthesia results

Front 250

transient global amnesia usually represents a variant of what?

Back 250

TIA (typically in the posterior cerebral territory): migraine and epileptic attacks have also been implicated in some cases of transient global amnesia

Front 251

what level is normal for CSF glucose?

Back 251

about 2/3 of the serum value

Front 252

how is the hypophysis approached transnasally?

Back 252

through the spenoid sinus

Front 253

what becomes atrophic in tabes dorsalis?

Back 253

dorsal column

Front 254

to what class of drugs does phenelzine belong?

Back 254

MAOI

Front 255

what condition is characterized by demyelination of the central pons following overly rapid correction of severe hyponatremia

Back 255

central pontine myelinolysis

Front 256

coagulative necrosis of brain parenchyma with macrophage-rich chronic inlammatory infiltration mixed with microscopic cysts containing bradyzoites: ring-enhancing lesions in AIDS patient

Back 256

toxoplasmosis

Front 257

what drugs will reverse the paralysis of vercuronium?

Back 257

neostigmine, edrophonium, and other cholinesterase inhibitors

Front 258

what does the recurrent laryngeal nerve innervate?

Back 258

all of the intrinsic laryngeal muscles except the cricothyroid

Front 259

meningitis - encapsulated yeast, HIV patient, Mississippi/Missouri river beds

Back 259

Cryptococcus

Front 260

what type of fungus is cryptococcus?

Back 260

monomorphic - encapsulated yeast form is found in both clinical specimens and in the environment as the infectious form

Front 261

occlusion of what artery causes a lateral medullary syndrome characterized by deficits in pain and temperature sensation over contralateral body, ipsilateral dysphagia, hoarseness, diminished gag reflex, vertigo, diplopia, nystagmus, and vomiting, ipsilateral Horner's, and ipsilateral loss of pain and temperature sensation of the face?

Back 261

PICA

Front 262

occlusion of what artery causes ipsilateral facial paralysis, ipsilateral cochlear nucleus damage, nystagmus, and ipsilateral pain and temperature loss of face; ipsilateral dystaxia?

Back 262

AICA

Front 263

occlusion of what artery results in homonymous hemianopsia of the contralateral visual field?

Back 263

posterior cerebral artery

Front 264

fever, headache, nuchal rigidity, and low Glascow coma score along with increased neutrophils, elevated protein, and reduced glucose in the CSF indicate waht type of meningitis?

Back 264

bacterial

Front 265

what is the most frequent organism causing meningitis in the elderly?

Back 265

strep pneumo

Front 266

severe ocular pain accompanied by blurred vision associated with halos around lights; eye that is red and hard; mydriasis?

Back 266

acute angle-closure glaucoma

Front 267

what is the treatment for acute angle-closure glaucoma?

Back 267

IV acetazolamide - inhibits carbonic anhydrase, leading to reduced production of aqueous humor and a concomitant reduction in intraocular pressure; osmotic diuretics can also be used

Front 268

what nerve lies in the tonsillar fossa?

Back 268

glossopharyngeal nerve - general sensory innervation to the mucosa of pharynx, and general sensory and taste sensation to the mucosa of the posterior 1/3 of the tongue

Front 269

what do you call the inability to recognize, despite adequate sensation?

Back 269

agnosia

Front 270

what type of drug is amitryptiline? what are its side effects?

Back 270

TCA - strong anticholinergic properties

Front 271

what gyrus will be most affected in a subfalcine herniation?

Back 271

cingulate gyrus - runs along the medial aspect of the cerebral hemisphere, just above the corpus callosum

Front 272

what are the two active metabolites of primidione (an anticonvulsant used for the treatment of tonic-clonic, psychomotor, and focal epileptic seizures)?

Back 272

phenobarbital and phenethylmalonamide (PEMA)

Front 273

subacute sclerosing panencephalitis can follow infection with what virus?

Back 273

measles

Front 274

what are cortical tubers?

Back 274

malformed (hemartomatous) nodules of the cortex - seen in tuberous sclerosis

Front 275

supendymal giant cell astrocytoma grows from the walls of the lateral ventricles and is pathognomonic for what?

Back 275

tuberous sclerosis

Front 276

intracytoplasmic spherules composed of paired helical filaments seen best with silver stains

Back 276

Pick bodies

Front 277

paralysis of upward gaze?

Back 277

lesion/ compression of the superior colliculi

Front 278

aneurysm of superior cerebellar artery, posterior cerebral artery, or basilar artery can all compress what nerve?

Back 278

oculomotor

Front 279

tumors of what compress the vertical gaze center?

Back 279

pineal gland

Front 280

what does the pineal gland manufacture from serotonin?

Back 280

melatonin

Front 281

in what anatomic space is the middle meningeal artery located?

Back 281

middle cranial fossa

Front 282

lesion of what produces central scotoma?

Back 282

macula

Front 283

lesion of what causes ipsilateral blindness?

Back 283

optic nerve

Front 284

lesion of what causes bitemporal hemianopia?

Back 284

optic chiasm

Front 285

lesion of what causes homonymous hemianopia?

Back 285

optic tract

Front 286

lesion of what auses upper homonymous quadrantanopia?

Back 286

temporal optic radiations

Front 287

lesion of what causes lower homonymous quadrantanopia?

Back 287

parietal optic radiations

Front 288

what CN is responsible for the gag reflex?

Back 288

CN IX

Front 289

the posterior half of the ear canal receives sensory information from what?

Back 289

auricular branch of vagus

Front 290

naegleria fowleri crosses what to enter the brain via the olfactory nerves?

Back 290

cribriform plate - trauma to nose predisposes to meningoencepalitis

Front 291

on what chromosome is Rb located?

Back 291

13

Front 292

perivenous microglial encephalitis with demyelination is characteristic of what?

Back 292

post-infectious encephalomyelitis after measles

Front 293

in smaller muscles, how many muscle fibers does an alpha motor neuron innervate?

Back 293

just a few - results in finer control of movement

Front 294

cerebellum influences motor activity on which side?

Back 294

ipsilateral - projects to contralateral motor cortex and red nuclei whose fibers cross back over

Front 295

what does the anterolateral system/spinothalamic tract carry?

Back 295

pain, temperature, crude touch, and pressure

Front 296

what information do the dorsal columns carry?

Back 296

fine touch, vibration, concious proprioception

Front 297

where does the corticospinal tract deccussate?

Back 297

as it descends through the inferior aspect of the medulla through the medullary pyramids

Front 298

where do the dorsal columns cross over?

Back 298

between their nuclei in the brainstem and the thalamus via the arcuate fibers of the medial lemniscus

Front 299

where do the axons of the spinothalamic tract cross over?

Back 299

almost immediately after their first-order synapes in the dorsal horn

Front 300

what are the neurological deficits that occur in Brown-Sequard syndrome?

Back 300

ipsilateral motor loss and loss of touch, vibration, propriceptive sense; contralateral pain and temperature loss

Front 301

where do the motor and sensory deficits manifes in patients with a lesion of the internal capsule?

Back 301

corticospinal tract, dorsal columns, and spinothalamic tract travel to or from the cerebral cortex through the posterior limb - contralateral hemiplegia and contralateral sensory loss

Front 302

what is the primary mode of analgesic relief of opiods?

Back 302

inhibition of the spinothalamic tract

Front 303

what disorder is characterized by loss of pyramidal cells in the cerebral motor cortex that leads to fibrosis of the lateral corticospinal tracts

Back 303

ALS

Front 304

what is usually spared in ALS?

Back 304

sensory tracts and cognitive function

Front 305

what are signs of UMN lesions?

Back 305

spastic paralysis, hyperactive deep tendon reflexes, and clonus - UMNs are tonically inhibitory to LMNs

Front 306

what are signs of LMN lesions?

Back 306

hporeflexia, fasciculations, flaccid paralysis

Front 307

familial forms of ALS have been associated with what?

Back 307

mutations in the zinc/copper superoxide dismutase gene, which plays an important role in scavenging free radicals in metabolically active cells such as neurons

Front 308

periventricular plaques on MRI and oligoclonal bands in CSF are indicative of what?

Back 308

MS

Front 309

what is destroyed in Parkinson's?

Back 309

dopaminergic neurons in the substantia nigra

Front 310

what kind of drug is bromocriptine?

Back 310

dopamine receptor agonist

Front 311

what is benztropine? why is it useful in PD?

Back 311

anticholinergic - relative excess of Ach because of dopamine deficiency; anticholinergics can be useful in treating motor symptoms

Front 312

what compound that may be found in ilicit drugs can cause PD?

Back 312

MPTP - selectively destroys neurons in the substantia nigra

Front 313

what is the difference between tremor in PD and tremor in cerebellar dysfunction?

Back 313

PD - resting tremor, cerebellar dysfunction - tremor associated with volitional movements

Front 314

what is MG often associated with?

Back 314

thymoma

Front 315

what is the pathophysiology of motor weakness in MG?

Back 315

antibodies to the post-synaptic nicotinic ACh receptors on skeletal muscle fibers

Front 316

what type of receptors are nicotinic receptors?

Back 316

ligand-gated sodium channels

Front 317

what kind of drug is edrophonium?

Back 317

short-acting cholinesterase inhibitor - increases concentration of ACh in synaptic cleft

Front 318

what are the long-acting cholinesterase inhibitors?

Back 318

pyridostigmine and neostigmine

Front 319

what are the side effects of cholinesterase inhibitors?

Back 319

excessive PNS stimulation - diarrhea, miosis, bronchospasm, excessive urination, bradycardia, salivation, lacrimation; also sweating because SNS stimulates sweating via ACh

Front 320

how do you treat organophosphate poisoning?

Back 320

treatment aimed at reducing total cholinergic activity - palidoxine regenerates active cholinesterase, and anticholinergic atropine

Front 321

what is Lambert-Eaton syndrome?

Back 321

AI disease with antibodies to voltage-gated calcium channels located in terminal bouton of presynaptic neurons result in impaired ACh release

Front 322

what is Lambert-Eaton syndrome often associated with?

Back 322

paraneoplastic syndromes, particularly small cell CA of lung

Front 323

bilateral loss of pain and temperature sensation?

Back 323

syringomyelia

Front 324

what is syringomyelia?

Back 324

expanded fluid-filled cavity in spinal cord that affects the spinothalamic tract

Front 325

what produces atrophy of the muscles of hands and hypoactive reflexes of the upper extremities in syringomyelia?

Back 325

expansion of the syrinx to compress the ventral horns - produces LMN signs

Front 326

what should you examine for masses in a patient with trigeminal neuralgia?

Back 326

posterior fossa

Front 327

what drug is used to treat trigeminal neuralgia?

Back 327

carbamazapine - reduces rate of nerve transmission by inhibiting voltage-gated sodium channels of neurons

Front 328

what are CSF findings in MS?

Back 328

oligoclonal immunoglobulin bands (absent in serum), elevated IgG, and myelin basic protein

Front 329

this is a disease that involves demyelination of various white matter areas of the CNS

Back 329

MS

Front 330

what cell type is attacked and destroyed during an exacerbation of MS?

Back 330

oligodendrocytes

Front 331

this syndrome is due to demyelination of peripheral nerves

Back 331

Guillan-Barre

Front 332

this type of stroke primarily results from atherosclerosis and subsequent thrombus/embolism or from hypercoaguability in LA (e.g. atrial fibrillation) or LV (after MI)

Back 332

ischemic stroke

Front 333

this type of stroke results predominantly from trauma, ruptured AV malformation, ruptured aneurysm, or vessel rupture due to hypertension

Back 333

hemorrhagic

Front 334

how does atrial fibrillation predispose to stroke?

Back 334

makes it easier for blood to pool and clot within the atria, and the clots can then embolize to brain

Front 335

what serves the motor and sensory cortex devoted to the contralateral leg?

Back 335

anterior cerebral artery

Front 336

what does the MCA supply?

Back 336

motor and sensory cortex for contralateral upper extremity, head, neck, and face

Front 337

what artery supplies Broca's and Wernicke's areas?

Back 337

MCA (typically on left)

Front 338

occlusion of what can cause left homonymous hemianopsia?

Back 338

right posterior cerebral artery - supplies visual cortex in occipital lobe

Front 339

worst headache of life, N&V, stiff neck, photophobia?

Back 339

subarachnoid hemorrhage

Front 340

where do you do an LP?

Back 340

L3-L4 or L4-L5 (SC terminates at L1-L2)

Front 341

what are the common causes of subarachnoid hemorrhage?

Back 341

ruptured berry aneurysm, ruptured AVM, head trauma (most common)

Front 342

patients with PKD most often have berry aneurysms in what location?

Back 342

bifurcation of anterior communicating artery

Front 343

almost one-half of cases of this are idiopathic; the rest develop after meningitis, subarachnoid hemorrhage, or intracranial surgery or develop as a result of a tumor

Back 343

hydrocephalus

Front 344

CSF flows from the lateral ventricles into the third ventricle via what?

Back 344

foramen of Monroe

Front 345

CSF flows from the third ventricle to the fourth ventricle via what?

Back 345

cerebral aqueduct (aqueduct of Sylvius)

Front 346

how is CSF reabsorbed?

Back 346

empties into dural venous sinuses via arachnoid granulations

Front 347

trauma that causes unconsciousness followed by lucid interval followed by confusion, lethargy, disorientation

Back 347

epidural hematoma - intracranial bleeding that dissects periosteal dura away from skull

Front 348

this is composed of a periosteal layer adherent to bone and a meningeal layer continuous with the arachnoid layer

Back 348

dura mater

Front 349

what artery is most commonly involved in an epidural hematoma?

Back 349

middle meningeal artery - ruptures between dura and skull

Front 350

this layer attaches directly to brain parenchyma

Back 350

pia

Front 351

does CSF show RBCs in an epidural bleed?

Back 351

no - blood does not reach subarachnoid space where CSF is located

Front 352

what structures are typically involved in a subdural hematoma?

Back 352

bridging veins that interconnect the subarachnoid space and the dural (venous) sinuses - more common in elderly people whose brains have atrophied

Front 353

what carries the efferent part of the corneal reflex?

Back 353

facial nerve - causes contraction of the orbicularis oculi

Front 354

what carries the afferent part of the corneal reflex?

Back 354

V1

Front 355

anticonvulsant with gingival hyperplasia, nystagmus, and ataxia as side effects?

Back 355

phenytoin

Front 356

anticonvulsant with hepatotoxicity as potential side effect?

Back 356

valproic acid

Front 357

anticonvulsants that can cause Stevens-Johnson syndrome?

Back 357

lamotrigine, ethosuximide

Front 358

anticonvulsants that can cause respiratory depression?

Back 358

phenobarbital, diazepam

Front 359

anticonvulsant that can cause agranulocytosis?

Back 359

carbamazepine

Front 360

anticonvulsant that can cause tremor?

Back 360

gabapentin

Front 361

what is the first line treatment for absence seizures?

Back 361

ethosuximide

Front 362

what effects do most anticonvulsants have on neuronal discharge?

Back 362

decrease the frequency of neuronal discharge by increasing the threshold for neuronal discharge - most do so by blocking sodium or calcium channels, but benzos activate chloride channels to hyperpolarize neurons

Front 363

how are AD and Pick's disease different?

Back 363

AD: diffuse cerebral atrophy vs. Picks: selective atrophy of frontal and temporal lobes

Front 364

what class of drug is used to treat AD?

Back 364

cholinesterase inhibitors - AD is associated with selective destruction of cholinergic neurons

Front 365

if a patient with AD has depression, what drugs should not be prescribed?

Back 365

TCAs because they have powerful anticholinergic side effects that may exacerbate the cognitive decline due to AD

Front 366

what is the mechanism whereby short-term memory is consolidated into long-term memory?

Back 366

long-term potentiation - occurs in hippocamus

Front 367

what is the second most common cause of dementia in the elderly?

Back 367

multi-infarct dementia - focal neurologic defects

Front 368

what is the most common primary brain tumor?

Back 368

astrocytoma

Front 369

what is the worst grade of astrocytoma?

Back 369

glioblastoma multiforme

Front 370

what type of tumor has a characteristic pseudopaliasding arrangement of tumor cells?

Back 370

glioblastoma multiforme

Front 371

why are lomustine and carmustine more suitable for treating brain tumors?

Back 371

belong to a class of alkylating agents - nitrosureas - can effectively penetrate the BBB

Front 372

what is a meningioma?

Back 372

benign tumor that arises from the arachnoid cells of the meninges - external to brain and so usually can be surgically resected

Front 373

loss of dorsiflexion (foot drop) - what nerve is injured?

Back 373

common peroneal nerve (L4-S2) - PED - Peroneal Everts and Dorsiflexes

Front 374

loss of plantar flexion - what nerve is injured?

Back 374

tibial (L4-S3) -TIP - tibial inverts and plantarflexes; if injured, can't stand on TIPtoes`

Front 375

loss of knee jerk - what nerve is injured?

Back 375

femoral (L2-L4)

Front 376

loss of hib adduction - what nerve is injured?

Back 376

obturator (L2-L4)

Front 377

positive anterior drawer sign indicates what?

Back 377

tearing of ACL

Front 378

anterior and posterior in ACL and PCL refer to what?

Back 378

sites of tibial attachment

Front 379

abnormal passive abduction indicates what?

Back 379

torn MCL

Front 380

what are the rotator cuff muscles?

Back 380

SITS: supraspinatus, infraspitatus, teres minor, subscapularis

Front 381

what rotator cuff muscle helps deltiod abduct arm?

Back 381

supraspinatus

Front 382

what rotator cuff muscle laterally rotates arm?

Back 382

infraspinatus

Front 383

what rotator cuff muscle adducts and laterally rotates arm?

Back 383

teres minor

Front 384

what medially rotates and adducts arm?

Back 384

subscapularis

Front 385

what nerve injury is often secondary to injury of the shaft of the humerus?

Back 385

radial

Front 386

injury to what nerve results in loss of triceps brachii (triceps reflex), brachioradialis (brachioradialis reflex), and extnsor carpi radialis longus (wrist drop)?

Back 386

radial nerve

Front 387

what nerve is affected in an injury of the supracondyle of the humerus?

Back 387

median nerve

Front 388

injury to what nerve is not related to loss of power in any arm muscles but loss of forearm pronation, wrist flexion, finger flexion, and several thumb movements?

Back 388

median nerve

Front 389

injury to what nerve eventually results in thenar atrophy?

Back 389

median nerve

Front 390

injury to what nerve results in loss of sensation over the lateral palm and thumb and the radial 2 1/2 fingers?

Back 390

median nerve

Front 391

which nerve passes through pronator teres?

Back 391

median nerve

Front 392

what nerve may be affected with an injury to the medial epicondyle?

Back 392

ulnar

Front 393

what nerve injury is associated with impaired wrist flexion and adduction and imaired adduction of thumb and pinky and ring finger?

Back 393

ulnar nerve

Front 394

what nerve injury causes loss of sensation over the medial palm and the pinky and 1/2 ring fingers?

Back 394

ulnar nerve

Front 395

what nerve passes through the flexor carpi ulnaris?

Back 395

ulnar nerve

Front 396

what nerve injury is associated with a loss of function of coracobrachialis, biceps, and brachialis muscles (biceps reflex)?

Back 396

musculocutaneous

Front 397

what nerve passes through coracobrachialis?

Back 397

musculocutaneous

Front 398

waiter's tip results from what?

Back 398

traction or tear of the superior trunk - C5/C6 roots, follows blow to the shoulder or trauma during delivery (aka Erb-Duchenne palsy)

Front 399

limb hangs by side (paralysis of abductors), is medially rotated (paralysis of lateral rotators), and forearm is pronated (loss of biceps)

Back 399

Erb-Duchenne palsy - C5/C6 injury

Front 400

what does the radial nerve provide innervation to?

Back 400

great extensor nerve': BEST: brachioradialis, extensors of wrist and fingers, supinator, triceps

Front 401

this is the result of an embryologic defect & can compress the subclavian artery and inferior trunk of brachial plexus (C8, T1)

Back 401

thoracic outlet syndrome - Klumpke's palsy

Front 402

what are the results of thoracic outlet syndrome?

Back 402

atrophy of thenar and hypothenar eminences, atrophy of interosseous muscles, sensory deficits on medial forearm and hand, disappearnace of radial pulse on turning head toward opposite side

Front 403

what are the thenar muscles?

Back 403

opponens pollicis, abductor pollicis brevis, flexor pollicis brevis

Front 404

what are the hypothenar muscles?

Back 404

opponens digiti minimi, abductor digiti minimi, flexor digiti minimi

Front 405

what 3 muscles close the jaw?

Back 405

Masseter, teMporalis, Medial pterygoid (M's munch)

Front 406

what muscle opens the jaw?

Back 406

lateral pterygoid (Lateral Lowers)

Front 407

all muscles with root glossus (except palatoglossus - vagus) are innervated by what?

Back 407

hypoglossal

Front 408

all muscles with root palat are innervated by what nerve? what is the exception?

Back 408

vagus (except tensor veli palatini - innervated by mandibular branch of CN V (TENSor was too TENSE)

Front 409

clinical landmark for pudendal nerve block?

Back 409

ischial spine

Front 410

clinical landmark for lumbar puncture?

Back 410

iliac crest

Front 411

nerve root for biceps reflex?

Back 411

C5

Front 412

nerve root for triceps reflex?

Back 412

C7

Front 413

nerve root for patella reflex?

Back 413

L4

Front 414

nerve root for achilles reflex?

Back 414

S1

Front 415

the muscles of mastication are innervated by what CN?

Back 415

V3

Front 416

what dermatome includes the kneecaps?

Back 416

L4 (down on L4s)

Front 417

what dermatome is at the inguinal ligament?

Back 417

L1 (LI is IL)

Front 418

where is McBurney's point?

Back 418

2/3 of the way from the umbiblicus to the anterior superior iliac spine

Front 419

winged scapula is the result of an injury to what nerve?

Back 419

long thoracic

Front 420

claw hand results from injury to what?

Back 420

lower trunk (C8/T1) - ulnar nerve

Front 421

injury to what nerve causes deltoid paralysis?

Back 421

axillary

Front 422

injury to this nerve causes difficulty flexing elbow, variable sensory loss

Back 422

musculocutaneous

Front 423

decreased thumb function/Pope's blessing results from what nerve injury?

Back 423

median nerve

Front 424

what nerve is likely to be injured after falling asleep with arm over chair?

Back 424

radial nerve - 'saturday night palsy'

Front 425

what dermatome is at the xyphoid process?

Back 425

T7

Front 426

what dermatome is at the nipple?

Back 426

T4 - T4 at the teat pore

Front 427

what dermatome is a high turtleneck shirt?

Back 427

C3

Front 428

what dermatome is a low collar shirt?

Back 428

C4

Front 429

what dermatome is a posterior half of a skull cap?

Back 429

C2

Front 430

what cranial nerve passes through the cribriform plate?

Back 430

CN I

Front 431

what cranial nerve passes through the optic canal?

Back 431

II

Front 432

what cranial nerves pass through the superior orbital fissure?

Back 432

III, IV, V1, VI

Front 433

what cranial nerve passes through the foramen rotundum?

Back 433

V2

Front 434

what cranial nerve passes through the foramen ovale?

Back 434

V3

Front 435

what cranial nerves pass through the internal auditory meatus?

Back 435

VII, VIII

Front 436

what cranial nerves pass through the jugular foramen?

Back 436

IX, X, XI

Front 437

what cranial nerve passes through the hypoglossal canal?

Back 437

XII

Front 438

muscle spindles help monitor what?

Back 438

muscle length

Back 439

(help you pick up a heavy suitcase when you didn't know how heavy it was)

Front 440

golgi tendon organs monitor what?

Back 440

muscle tension - senses tension and provides inhibitory feedback to alpha motor neurons

Back 441

(make you drop a heavy suitcase you've been holding too long)

Front 442

how is a muscle spindle oriented with respect to muscle fibers?

Back 442

in parallel: muscle stretch - intrafusal stretch - stimulates Ia afferent - stimulates alpha motor neuron - reflex muscle (extrafusal contraction)

Front 443

what is the gamma loop?

Back 443

CNS stimulates gamma motor neuron - contracts intrafusal fiber - increased sensitivity of reflex arc

Front 444

primitive reflex in which infant extends limbs when startled

Back 444

moro reflex

Front 445

primitive reflex in which infant seeks nipple

Back 445

rooting reflex

Front 446

primitive reflex in which infant grasps objects in palm

Back 446

palmar reflex

Front 447

primitive reflex in which large toe dorsiflexes with plantar stimulation

Back 447

Babinski

Front 448

what CNs lie medially at brainstem?

Back 448

III, VI, XII

Front 449

what CN is responsible for taste from anterior 2/3 of tongue, lacrimation, salivation (submaxillary & sublingual glands), eyelid closing?

Back 449

facial nerve CN VII (also facial movement)

Front 450

what CN is responsible for taste from posterior 1/3 of tongue, swallowing, salivation (parotid gland), monitoring carotid body and sinus chemo- and baroreceptors

Back 450

CN IX (glossopharyngeal)

Front 451

what CN is responsible for taste from epiglottic region, swallowing, palate elevation, talking, thoracoabdominal viscera, monitoring aortic arch and chemo- and baroreceptors?

Back 451

vagus

Front 452

which CN is responsible for monitoring carotid body and sinus chemo- and baroreceptors?

Back 452

glossopharyngeal (IX)

Front 453

which CN is responsible for monitoring aortic arch chemo- and baroreceptors?

Back 453

vAgus (Aortic arch)

Front 454

what cranial nerve is responsible for mastication and facial sensation?

Back 454

trigeminal

Front 455

where are the nuclei of CN III, IV located?

Back 455

midbrain

Front 456

where are the nuclei of CN V, VI, VII, VIII located?

Back 456

pons

Front 457

where are the nuclei of CN IX, X, XI, XII located?

Back 457

medulla

Front 458

which vagal nucleus carries visceral sensory information (e.g. taste, baroreceptors, gut distention)

Back 458

nucleus Soliatarius (Sensory)

Back 459

VII, IX, X

Front 460

which vagal nucleus is responsible for motor innervation of pharynx, larynx, and upper esophagus (e.g. swallowing, palate elevation)?

Back 460

nucleus aMbiguus (M-motor)

Back 461

IX, X, XI

Front 462

which vagal nucleus is responsible for sending autonomic (parasympathetic) fibers to heart, lungs, and upper GI?

Back 462

dorsal motor nucleus

Front 463

which artery passes through the foramen spinosum?

Back 463

middle meningeal artery

Front 464

what passes through the optic canal (3 structures)?

Back 464

CN II, ophthalmic artery, central retinal vein

Front 465

what passes through the foramen magnum?

Back 465

spinal roots of CN XI, brain stem, vertebral arteries

Front 466

what nerves pass through the cavernous sinus?

Back 466

CN III, IV, V1, V2, VI and postganglionic sympathetic fibers en route to the orbit (nerves that control extraocular muscles plus V1 and V2)

Front 467

among the nerves that pass through the cavernous sinus, which is the only one that is free floating?

Back 467

CN VI

Front 468

ophthalmoplegia, ophthalmic and mandibular sensory loss are symptoms of what?

Back 468

cavernous sinus syndrome (due to mass effect)

Front 469

this extraocular muscle moves the eye nasally

Back 469

medial rectus (moves medial)

Front 470

this extraocular muscle moves the eye temporally

Back 470

lateral rectus (moves lateral)

Front 471

this extraocular muscle moves the eye up and out

Back 471

superior rectus

Front 472

this extraocular muscle moves the eye down and out

Back 472

inferior rectus

Front 473

this extraocular muscle moves the eye up and in

Back 473

inferior oblique

Front 474

this extraocular muscle moves the eye down and in

Back 474

superior oblique

Front 475

how does the pupillary light reflex work?

Back 475

light in either retina sends a signal via CN III to pretectal nuclei in the midbrain that activate bilateral Edinger-Westphal nuclei; pupils contract bilaterally

Front 476

what does kuh-kuh-kuh test?

Back 476

palate elevation - CN X

Front 477

what does la la la test?

Back 477

tongue CN XII

Front 478

what does mi mi mi test?

Back 478

CN VII - facial

Front 479

what innervates the lower 1/3 of the esophagus?

Back 479

splanchnic plexus - contains SM from splanchnic mesoderm

Front 480

what innervates the upper 2/3 of the esophagus?

Back 480

vagus

Front 481

what are the order of layers that a needle passes through in an LP?

Back 481

skin - superficial fascia - deep fascia - supraspinous ligament - interspinous ligament - interlaminar space - epidural space - dura - arachnoid - subarachnoid space

Front 482

in a CN XII LMN lesion, which way does the tongue deviate?

Back 482

toward the side of the lesion

Front 483

in a CN V motor lesion, which way does the jaw deviate?

Back 483

toward the side of the lesion

Front 484

in a unilateral lesion of the cerebellum, which way does the patient tend to fall?

Back 484

toward the side of lesion

Front 485

in a CN X lesion, which way does the uvula deviate?

Back 485

away from the side of the lesion

Front 486

in an CN XI lesion, there is weakness turning the head which way?

Back 486

to the contralateral side of the lesion

Front 487

in a CN XI lesion, on which side does the shoulder droop?

Back 487

on the side of the lesion

Front 488

wrist flexion is dependent on what nerve roots?

Back 488

C6, C7, C8, T1

Front 489

elbow flexion is dependent on what nerve roots?

Back 489

C5, C6, C7

Front 490

elbow extension is dependent on what nerve roots?

Back 490

C6, C7, C8

Front 491

arm abduction is dependent on what nerve roots?

Back 491

C5, C6

Front 492

sensation over the deltoid is dependent on what nerve roots?

Back 492

C5, C6

Front 493

palmar surface of first three digits derives its sensory innervation from what?

Back 493

median nerve, C6, C7, C8

Front 494

where is the chemoreceptor trigger zone?

Back 494

floor of 4th ventricle

Front 495

what is Ki-67?

Back 495

a nuclear factor whose expression correlates with neoplastic replicative activity; Ki-67 labeling correlates with a neoplasm's rate of growth and, therefore, with prognosis

Front 496

facial nerve and vestibulocochlear nerve emerge from the brain stem where?

Back 496

cerebellopontine angle

Front 497

momentary loss of consciousness followed by lucid interval?

Back 497

epidural hemorrhage

Front 498

what is the most common type of herniation?

Back 498

posterolateral herniation of the nucleus polposus

Front 499

what spinal nerve is between vertebrae C4 and C5

Back 499

C5 spinal nerve

Front 500

both neuronal and glial differentiation in a brain tumor

Back 500

medulloblastoma