Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
273 Cards in this Set
- Front
- Back
- Large cells w/prominent nucleoli
- Nissl substance (RER) in cell body (not axon) |
Neurons
|
|
- Physical support, repair, K+ metabolism,
- removal of excess neurotransmitter - maintains the BBB |
Astrocytes
|
|
Astrocyte response to injury
|
Reactive gliosis
|
|
Astrocyte marker
|
GFAP
|
|
- CNS phagocytes
- not readily discernible in Nissl stains - small irregular nuclei and relatively little cytoplasm |
Microglia
|
|
Microglia originates from what germ layer
|
Mesoderm
|
|
Free nerve ending sense
|
Pain/temperature
|
|
Meissner's corpuscles
|
Position sense, fine touch
|
|
Pacinian corporpuscles
|
Vibration, pressure
|
|
Merkel's disk
|
static touch (shapes, edges, textures) position sense
|
|
Peripheral nerve layers
- surrounds a fascicle of nerve fibers - permeability layer - must be rejoined in microsurgery for limb |
Perineuriem
|
|
Peripheral nerve layers
- invest single nerve fiber - inflammatory infiltrate in Guillain-Barre |
Endoneurium
|
|
Peripheral nerve layers
- dense connective tissue that surrounds entire nerve - fascicles and blood vessels |
Epineurium
|
|
Neurotransmitters
Type: Norepinephrine Location: ? |
Locus ceruleus
|
|
Neurotransmitters
Type: Dopamine Location: ? |
Ventral tegmentum and SNc
|
|
Neurotransmitters
Type: serotonin (5-HT) Location: ? |
Raphe nucleus
|
|
Neurotransmitters
Type: ACh Location: ? |
Basal nucleus of Meynert
|
|
Neurotransmitters
Type: GABA Location: ? |
Nucleus accumbens
|
|
Neurotransmitters
Disease: increases in anxiety, decreases in depression Transmitter: ? |
Norepinephrine
|
|
Neurotransmitters
Disease: increase in schizophrenia, decrease in Parkinson's and depression Transmitter: ? |
Dopamine
|
|
Neurotransmitters
Disease: decreases in anxiety and depression Transmitter: ? |
Serotonin (5-HT)
|
|
Neurotransmitters
Disease: decreases in Alzheimer's Huntington's, and REM sleep Transmitter: ? |
ACh
|
|
Neurotransmitters
Disease: decreases in anxiety and Huntingtons Transmitter: ? |
GABA
|
|
Neurotransmitter area responsible for stress and panic
|
Locus ceruleus
|
|
Neurotransmitter area responsible for reward center, pleasure, addiction
|
Nucleus accumbens & septal nucleus
|
|
The blood-brain barrier is formed by?
|
- tight junctions
- basement membrane - astrocyte processes |
|
Area of Hypothalamus
- makes ADH |
Supraoptic nucleus
|
|
Area of Hypothalamus
- makes oxytocin |
Paraventricular nucleus
|
|
Area of Hypothalamus
- controls hunger |
Lateral area
|
|
Area of Hypothalamus
- controls satiety |
Ventrolateral area
|
|
Destruction of the later area of the hypothalamus result in
|
Weight lost (never hungry)
|
|
Destruction of the ventrolateral area of the hypothalamus result in
|
Weight gain (never satisfied)le for cool
|
|
Area of Hypothalamus
- responsible for cooling - controlled by parasympathetic |
Anterior Hypothalamus
|
|
Area of Hypothalamus
- responsible for heating - controlled by sympathetic |
Posterior Hypothalamus
|
|
Anterior Pituitary gland makes?
|
- FSH
- LH - ACTH - TSH - GH - Prolactin |
|
Posterior Pituitary gland makes?
|
- ADH
- Oxytocin |
|
Thalamus
Nucleus: VPL Input: ? |
Spinothalamic and dorsal columns
|
|
Thalamus
Nucleus: VPM Input: ? |
CN V (trigeminal)
|
|
Thalamus
Nucleus: LGN Input: ? |
CN II (optics)
|
|
Thalamus
Nucleus: MGN Input: ? |
inferior colliculus of the pon and Superior olive
|
|
Thalamus
Nucleus: VPL Info received: ? |
Spinothalamic and Dorsal column
|
|
Thalamus
Nucleus: VPM Info received: ? |
CN V (trigeminal)
|
|
Thalamus
Nucleus: LGN Info received: ? |
CN II (optic)
|
|
Thalamus
Nucleus: MGN Info received: ? |
inferior colliculus of pons and superior olive
|
|
Parts of the limbic system
|
- cingulate gyrus
- hippocampus - fornix - mammillary bodies - septal nucleus |
|
Degenerative disorder of CNS associated w/ Lewy bodies (alpha-synuclein)
|
Parkinson's Disease
|
|
Parkinson's is depigmentation of the?
|
substantia nigra pars compacta
|
|
Sudden, wild flailing of 1 arm +/- leg
|
Hemiballismus
|
|
Hemiballismus is characterized by?
|
contralateral subthalamic nucleus lesion
(lacunar stroke "Hx: of HTN") |
|
Hemiballismus is loss of inhibition of?
|
thalamus through globus pallidus
|
|
In Huntington's, neuronal death is via?
|
NMDA-R binding and glutamate toxicity
|
|
Huntington's leads to atrophy of?
|
striatal nuclei
|
|
Tremor
- action tremor (worse when holding posture) - Pts often self medicate with alcohol |
Essential "familial" tremor
|
|
Treatment for Essential "familial" tremor
|
Beta-blocker
|
|
Tremor
- most noticeable distally - seen in Parkinson's Pts |
Resting tremor
|
|
Tremor
- slow, zigzag motion when pointing toward a target - associated w/cerebellar dysfunction |
Intention tremor
|
|
Brain lesions
-Sign/Symptoms: Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibition) - Area of Lesion: ? |
Amygdala (bilateral)
|
|
Brain lesions
-Sign/Symptoms: disinhibition and defects in concentration, lacks judgement - Area of Lesion: ? |
Frontal lobe
|
|
Brain lesions
-Sign/Symptoms: Spatial neglect syndrome (left side) - Area of Lesion: ? |
Right parietal lobe
|
|
Brain lesions
-Sign/Symptoms: reduced levels of arousal and wakefulness - Area of Lesion: ? |
Reticular activating system (midbrain)
|
|
Brain lesions
-Sign/Symptoms: Wernicke-Korsakoff syndrome (confusion, ataxia, memory loss) - Area of Lesion: ? |
Mammillary bodies (bilateral)
|
|
Brain lesions
-Sign/Symptoms: tremor at rest, chorea, or athetosis - Area of Lesion: ? |
Basal ganglia
|
|
Brain lesions
-Sign/Symptoms: intention tremor, falls toward lesion - Area of Lesion: ? |
Cerebellar hemisphere
|
|
Brain lesions
-Sign/Symptoms: contralateral hemiballismus (arm flailing) - Area of Lesion: ? |
Subthalamic nucleus
|
|
Brain lesions
-Sign/Symptoms: Truncal ataxia, dysarthria (broken speech) - Area of Lesion: ? |
Central cerebellar vermis
|
|
Brain lesions
-Sign/Symptoms: anterograde amnesia ( no new memories) - Area of Lesion: ? |
Hippocampus
|
|
Brain lesions
-Sign/Symptoms: Eyes can't look toward lesion - Area of Lesion: ? |
Paramedian pontine reticular formation (PPRF)
|
|
Brain lesions
-Sign/Symptoms: Eye look toward lesion - Area of Lesion: ? |
Frontal eye fields
|
|
Brain lesions
-Sign/Symptoms: acute paralysis, dysarthria, dysphagia, diplopia, and loss of consciousness - Area of Lesion: ? |
Central pontine myelinolysis
|
|
Central pontine myelinolysis is caused by?
|
rapid infusion of Na+
|
|
Higher-order inability to speak
|
Aphasia
|
|
Motor inability to speak
|
Dysarthria
|
|
Loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective
|
Agnosia
|
|
reading disorder
|
Alexia
|
|
Nonfluent aphasia w/intact comprehension
|
Broca's
|
|
Fluent aphasia w/impaired comprehension
|
Wernicke's
|
|
Nonfluent aphasia w/impaired comprehension
|
Global aphasia
|
|
Poor repetition but fluent speech, intact comprehension
|
Conduction aphasia (arcuate fasciculus)
|
|
Broca's area
|
inferior frontal gyrus
|
|
Wernicke's area
|
superior temporal gyrus
|
|
Conduction Aphasia area
|
arcuate fasciculus
|
|
Circle of Willis
-area/defect: 1. Contralateral hemiparesis (lower extremities) 2. medial lemniscus (decreased contralateral proprioception) 3. ipsilateral paralysis of hypoglossal nerve. (decrease in pain/temp) |
Anterior spinal artery (medial medullary syndrome)
|
|
Circle of Willis
-area/defect: 1. contralateral loss of pain/temp 2. ipsilateral dysphagia, 3. hoarseness, decrease gag, vertigo, diplopia, nystagmus, vomiting, 4. ipsilateral Horner's, face pain/temp |
PICA (posterior inferior cerebellar artery)
|
|
Circle of Willis
-area/defect: 1. ipsilateral facial paralysis, cochlear, nystagmus, 2. ipsilateral face pain/temp |
AICA (anterior inferior cerebellar artery)
|
|
Circle of Willis
-area/defect: 1. contralateral hemianopia w/macular sparing 2. supplies occipital cortex |
Posterior cerebral artery
|
|
Circle of Willis
-area/defect: 1. contralateral face and arm paralysis and sensory loss 2. aphasia 3. left-side neglect |
Middle cerebral artery
|
|
Circle of Willis
-area/defect: 1. Supplies medial surface of the brain 2. leg-foot area of motor and sensory cortices |
Anterior cerebral artery
|
|
Circle of Willis
-area/defect: 1. most commons site of willis aneurysm 2. lesions may cause visual field defects |
Anterior communicating Artery
|
|
Circle of Willis
-area/defect: 1. causes CN III palsy 2. 2nd common site for aneurysm |
Posterior communicating artery
|
|
Circle of Willis
-area/defect: 1. divisions of middle cerebral artery 2. supplies internal capsule, caudate, putamen, globus pallidus 3. "arteries of stroke" 4. infarct of posterior limb of the internal capsule causes pure motor hemiparesis |
Lateral striate
|
|
Circle of Willis
-area/defect: 1. damage in severe hypotension 2. upper leg/arm weakness 3. defects in higher-order visual processing |
Watershed zone
|
|
Watershed zones in the circle of willis
|
- anterior/middle cerebral arteries
- middle/posterior cerebral arteries |
|
Circle of Willis
-area/defect: 1. "locked-in syndrome" |
Basilar artery
|
|
What is typically left unaffected in a basilar artery defect
|
CN III (oculomotor)
|
|
Epidural hematoma is most often due to the rupture of?
|
Middle meningeal artery (2nd temporal bone fracture)
|
|
Intracranial hemorrhage
- lucid interval is seen - CT shows biconvex disk - high pressure bleed - CN III palsy |
Epidural hematoma
|
|
Intracranial hemorrhage
- rupture on the bridging veins - low pressure bleed - CT shows crescent-shaped hemorrhage - seen in elderly, alcoholics, shaken babies |
Subdural hematoma
|
|
Intracranial hemorrhage
- rupture of an aneurysm - worst headache of their life - bloody/yellow spinal tap |
Subarachnoid hematoma
|
|
Subarachnoid hematoma can lead to
|
vasospasms (due to blood product breakdown)
|
|
Treatment for Subarachnoid hematoma
|
Calcium channel blockers
|
|
Ischemic brain disease (timeline)
- 12-48 hours |
red neurons
|
|
Ischemic brain disease (timeline)
- 24-72 hours |
necrosis + neutrophils
|
|
Ischemic brain disease (timeline)
- 3-5 days |
macrophages
|
|
Ischemic brain disease (timeline)
- 1-2 weeks |
reactive gliosis + vascular proliferation
|
|
Ischemic brain disease (timeline)
- more than 2 weeks |
glial scar
|
|
CSF is made by
|
choroid plexus
|
|
CSF is reabsorbed by
|
arachnoid granulation
|
|
The lateral ventricles flow to the 3rd ventricle via
|
Foramen of Monro
|
|
The 3rd ventricle flows to the 4th ventricle via
|
The cerebral aqueduct
|
|
- Expansion of ventricles distorts the fibers of the fibers of the corona radiata and leads to the clinical triad of dementia, ataxia, and urinary incontinence.
- does not result in increased subarachnoid space volume - reversible |
Normal pressure hydrocephalus
|
|
Wet, wobbly, wacky
|
Normal pressure hydrocephalus
(urinary incontinence, ataxia, dementia) |
|
Normal pressure hydrocephalus leads to distortions of the fibers of?
|
Corona radiata
|
|
- Decreased CSF absorption be arachnoid villi
- leads to increase intracranial pressure - papilledema and herniation |
Communicating hydrocephalus
|
|
A communicating hydrocephalus is caused by
|
arachnoid scarring post-meningitis
|
|
- caused by structural blockage of CSF circulation w/in the ventricular system
- ex. stenosis of the aqueduct of Sylvius |
Obstructive (noncommunicating) hydrocephalus
|
|
- false appearance of increase CSF due to atrophy
- intracranial pressure is normal; triad is not seen |
Ex Vacuo (hydrocephalus)
|
|
Conditions that can lead to Ex Vacuo (hydrocephalus)
|
Alzheimer's disease, advanced HIV, Pick's disease
|
|
Nerves C1-C7 exit via intervertebral foramina (above or below)
|
Above
|
|
Vertebral disk herniation usually occurs between?
|
L5-S1
|
|
where Lumbar punctures are performed
|
L4-L5
|
|
Synapse point of the Dorsal column
|
Ipsilateral nucleus cuneatus or gracilis
|
|
Decussates (cross midline) point of the Dorsal column
|
Medulla
|
|
Synapse point of the Spinothalamic tract
|
Ipsilateral gray matter (in spinal cord)
|
|
Decussates (cross midline) point of the Spinothalamic tract
|
Anterior white commissure
|
|
Decussates (cross midline) point of the Corticospinal tract
|
Caudal Medulla
|
|
Spinal cord lesions (site?)
- Poliomyelitis and Werdnig-Hoffmann disease |
Low motor only; destruction of anterior horns
|
|
Spinal cord lesions (site?)
- Multiple sclerosis (MS) |
- mostly white matter of cervical region
- random lesions |
|
Spinal cord lesions (site?)
- ALS |
both upper and lower motor neurons
|
|
Spinal cord lesions (site?)
- Anterior spinal artery |
- spares dorsal columns & tract of Lissauer
- all else is lost |
|
A complete occlusion of anterior spinal artery would lead to effect of a watershed area where?
|
Upper Thoracic ASA
|
|
Artery that supplies the anterior spinal artery below T8
|
Adamkiewicz
|
|
Spinal cord lesions (site?)
- Tabes dorsalis (3rd degree syphilis) |
Dorsal root and dorsal column
|
|
Spinal cord lesions (site?)
- Syringomyelia |
- damage of anterior white commissure
- loss of pain/temp |
|
Spinal cord lesions (site?)
- Vit B12 neuropathy & Vit E deficiency |
demyelination of:
- dorsal columns - lateral corticospinal - spinocerebellar |
|
Spinal cord lesions (site?)
- Friedreich's axtaxia |
demyelination of:
- dorsal columns - lateral corticospinal - spinocerebellar |
|
Defect in what causes of (ALS) amyotrophic lateral sclerosis
|
superoxide dismutase 1 (SOD1)
|
|
Treatment with what will modest lengthen the survival of a ALS Pt.
|
Riluzole
|
|
Riluzole's mechanism of action
|
decreased presynaptic glutamate
|
|
- Associated w/Charcot's joints
- absent DTRs (deep tendon reflex) - positive Romberg test |
Tabes dorsalis
|
|
Cause of Friedreich's ataxia
|
- Autosomal-recessive (FXN gene)
- trinucleotide repeat (GAA) - leads to impaired mitochondrial functioning |
|
Common cause of death for a Pt w/Friedreich's ataxia
|
Hypertrophic cardiomyopathy
|
|
Seen in childhood Friedreich's ataxia
|
kyphoscoliosis
|
|
- Ptosis
- Anhidrosis - Miosis |
Horner's syndrome
|
|
Oculosympathetic pathway that can disrupted causing Horner's Syndrome
|
- Hypothalamus
- intermediolateral column (lateral horn) - Superior cervical ganglion |
|
Associations these lesions leads to Horner's Syndrome
|
- Pancoast tumor
- Brown-Sequard syndrome (hemisection) - late stage syringomyelia |
|
Diaphragm and gallbladder pain referred to
|
right shoulder via the phrenic nerve
|
|
Appearance of primitive reflexes after 1yrs of age
|
frontal lobe lesion
|
|
Primitive reflexes
- "hang on for life" reflex; abduct/extend limbs when startled, and then draw together |
Moro reflex
|
|
Primitive reflexes
- movement of head toward one side if cheek or mouth is stroked (nipple seeking) |
Rooting reflex
|
|
Primitive reflexes
- sucking response when roof of mouth is touched |
Sucking reflex
|
|
Primitive reflexes
- curling of fingers/toes if palms of hands/feet stroked |
Palmar and plantar reflex
|
|
Primitive reflexes
- dorsiflexion of large toe and fanning of others toes w/plantar stimulation |
Babinski sign
|
|
conjugate vertical gaze center
|
Superior colliculi
|
|
Parinaud syndrome
|
paralysis of conjugate vertical gaze due to lesion in superior colliculi (ei. pinealoma)
|
|
paralysis of conjugate vertical gaze due to
|
lesion in superior colliculi (ei. pinealoma)
|
|
lesion in superior colliculi due to
|
pinealoma
|
|
Cranial nerves
- Nerve: Olfactory - Function(s): ? |
smell (only CN w/out thalamic relay to cortex)
|
|
Cranial nerves
- Nerve: Optic - Function(s): ? |
Sight
|
|
Cranial nerves
- Nerve: Oculomotor - Function(s): ? |
- Eye movement (SR, IR, MR, IO)
- Pupillary constriction - accommodation - eye lid opening |
|
Cranial nerves
- Nerve: Trochlear - Function(s): ? |
Eye movement (SO)
|
|
Cranial nerves
- Nerve: Trigeminal - Function(s): ? |
- Mastication
- facial sensation |
|
Cranial nerves
- Nerve: Abducens - Function(s): ? |
Eye movement (LR)
|
|
Cranial nerves
- Nerve: Facial - Function(s): ? |
- facial movements
- taste anterior 2/3 of tongue - lacrimation, salivation - eye closing - stapedius in ear |
|
Cranial nerves
- Nerve: Vestibulocochlear - Function(s): ? |
- hearing
- balance |
|
Cranial nerves
- Nerve: Glossopharyngeal - Function(s): ? |
- Taste poster 1/4 of tongue
- swallowing, salivation - monitors carotid body and sinus chem & baroreceptors - stylopharyngeus |
|
Cranial nerves
- Nerve: Vagus - Function(s): ? |
- taste epiglottic region
- swallowing, palate elevation, uvula - talking, coughing - monitors aortic arch chemo & barorecptors |
|
Cranial nerves
- Nerve: Accessory - Function(s): ? |
- head turning
- shoulder shrugging (SCM, trapezius) |
|
Cranial nerves
- Nerve: Hypoglossal - Function(s): ? |
tongue movement
|
|
Cranial nerve reflex
- Afferent: V(1) ophthalmic - Efferent: VII - Reflex: ? |
Corneal
|
|
Cranial nerve reflex
- Afferent: V(1) "doesn't produce tears" - Efferent: VII - Reflex: ? |
Lacrimation
|
|
Cranial nerve reflex
- Afferent: V(3) "muscle spindle from masseter" - Efferent: V(3) "motor-masseter" - Reflex: ? |
Jaw Jerk
|
|
Cranial nerve reflex
- Afferent: CN II - Efferent: CN III - Reflex: ? |
Pupillary
|
|
Cranial nerve reflex
- Afferent: CN IX - Efferent: CN IX,X - Reflex: ? |
Gag
|
|
Vagal nuclei:
- visceral Sensory information (taste, baroreceptors, gut distention) |
Nucleus Solitarius
|
|
Vagal nuclei:
- Motor innervation of pharynx, larynx, and upper esophagus |
Nucleus aMbiguus
|
|
Vagal nuclei:
- send autonomic (parasympathetic) fibers to heart, lungs, and upper GI |
Dorsal motor nucleus
|
|
Cranial nerve and vessel pathways
- Cribriform plate |
CN I- olfactory
|
|
Cranial nerve and vessel pathways
- optical canal |
CN II- optic
|
|
Cranial nerve and vessel pathways
- Superior orbital fissure |
CN III, IV, V(1), VI
|
|
Cranial nerve and vessel pathways
- Foramen Rotundum |
CN V(2)
|
|
Cranial nerve and vessel pathways
- Foramen Ovale |
CN V(3)
|
|
Cranial nerve and vessel pathways
- Foramen Spinosum |
Middle meningeal artery
|
|
Cranial nerve and vessel pathways
- internal auditory meatus |
CN VII, VIII
|
|
Cranial nerve and vessel pathways
- jugular foramen |
CN IIX, IX, X
|
|
Cranial nerve and vessel pathways
- hypoglossal canal |
CN XII
|
|
Cranial nerve and vessel pathways
- Foramen megnum |
CN XI
|
|
Cranial nerve lesions
- CN XII lesion (LMN) |
- Tongue deviates TOWARD lesion (lick your wounds)
-Decussates (crosses before medulla and synapse on contralateral hypoglossal nucleus) |
|
Cranial nerve lesions
- CN V motor lesion |
- Jaw deviates TOWARD lesion
- Bilateral cortical input to lateral pterygoid muscle |
|
Cranial nerve lesions
- CN X lesion |
- Uvula deviates AWAY from lesion
- week side collapses and points away |
|
Cranial nerve lesions
- CN XI lesion |
- weakness turning head to AWAY from lesion (SCM)
- shoulder droop on side of lesion (trapezius) |
|
Kuh-kuh-kuh test- motor movement?
|
palate elevation
|
|
Kuh-kuh kuh test- Cranial Nerve?
|
CN X- vagus
|
|
La-la-la test- motor movement?
|
tongue movement
|
|
La-la-la test- cranial nerve?
|
XII- hypoglossal
|
|
Mi-mi-mi test- motor movement
|
lip movement
|
|
Mi-mi-mi test- cranial nerve
|
VII- facial
|
|
Produces aqueous humor
|
Ciliary procress
|
|
Absorbs aqueous humor
|
Trabecular Meshwork
|
|
Collects aqueous humor from trabecular meshwork
|
Canal of Schlemm
|
|
Uncal herniation
Sign: ipsilateral dilated pupil/ptosis Cause:? |
Stretching if CN III
|
|
Uncal herniation
Sign: Contralateral homonymous hemianopia Cause:? |
Compression of ipsilateral posterior cerebral artey
|
|
Uncal herniation
Sign: Ipsilateral paresis Cause:? |
Compression of contralateral crus cerebri (Kernohan's notch)
|
|
Uncal herniation
Sign: Duret (hemorrhages paramedian artery rupture) Cause:? |
Caudal displacement of brain stem
|
|
Primary brain tumor
- can cross corpus callosum "butterfly glioma" - most common brain tumor - Stained with GFAP - prognosis grave |
Glioblastoma multiforme
|
|
Primary brain tumor
- "pseudopalisading" pleomorphic tumor cells - border central areas of necrosis and hemorrhage |
Glioblastoma multiforme
|
|
Primary brain tumor
- often occurs in convexities of hemispheres and parasagittal - arises from arachnoid cell external to brain - resectable |
Meningioma
|
|
Primary brain tumor
- spindle cells concentrically arranged in a whorled pattern - psammoma bodies (laminated calcifications) |
Meningioma
|
|
Primary brain tumor
- localized to CN VIII - found at cerebellopontine angle - S-100 positive - resectable |
Schwannoma
|
|
Primary brain tumor
- often in frontal lobes - chicken-wire capillary pattern - rare and slow growing |
Oligodendroglioma
|
|
Primary brain tumor
- round nuclei w/clear cytoplasm - often calcified |
"fried egg"appearance
Oligodendroglioma |
|
Primary brain tumor
- bitemporal hemianopia - due to pressure on optic chiasm |
Pituitary adenoma
|
|
Primary brain tumor
-located in Rathke's pouch |
Pituitary adenoma
|
|
Primary brain tumor
- often found in posterior fossa/ maybe supratentorial - GFAP positive - most common in children |
Pilocytic astrocytoma
|
|
Primary brain tumor
- eosinophilic corkscrew fibers - cystic + solid (gross) |
(Rosenthal fibers)
Pilocytic astrocytoma |
|
Primary brain tumor
- form of primitive neuroectodermal tumor (PNET) - can compress 4th ventricle - highly malignant cerebellar tumor |
Medulloblastoma
|
|
Primary brain tumor
- rosettes or perivascular pseudorosette pattern of cells - small blue cells |
Medulloblastoma
|
|
Primary brain tumor
- found in 4th ventricle - cause hydrocephalus - poor prognosis |
Ependymoma
|
|
Primary brain tumor
- perivascular pseudorosette pattern of cells - rod-shaped blepharoplasts |
(basal ciliary bodies)
Ependymoma |
|
Primary brain tumor
- found w/retinal angiomas - associated w/von Hippel=Lindau - can produce EPO ->polycythemia |
Hemangioblastoma
|
|
Primary brain tumor
- foamy cells - high vascularity |
Hemangioblastoma
|
|
Primary brain tumor
- often confused w/pituitary adenoma - can also cause bitemporal hemianopia - benign - most common child supratentorial tumor |
Craniopharyngioma
|
|
Primary brain tumor
- calcification is common (tooth like enamel) - derived from remnants of RAthke's pouch |
Craniopharyngioma
|
|
Pain due to irritation of structures sech as dura, cranial nerves, or extracranial structures, but not the brain parenchyma it's self
|
Headache
|
|
- unilateral 4-72 hours of pulsating pain w/nausea, photophobia, or phonophobia.
- aura |
Migraine
|
|
Migraine is caused by?
|
- irritation of CN V
- release of substance P, CGRP, vasoactive peptides |
|
Treat meant for migrane
|
- propranolol
- NSAIDS - sumatriptan |
|
- bilateral headache
- more than 30 mins long - not aggravated by light or noise; no aura |
Tension Headache
|
|
- unilateral; repetitive brief headaches
-periorbital pain - asso: w/ipsilateral lacrimation, rhinorrhea, Horner's |
Cluster headache
|
|
Treatment for Cluster headaches
|
sumatriptan
|
|
- inner ear etiology
- delayed horizontal nystagmus |
Peripheral vertigo
|
|
Cause of Peripheral vertigo
|
- Meniere's disease
- semicircular canal debris - vestibular nerve infection |
|
- brainstem or cerebellar lesion
- immediate nystagmus in any direction; may change directions |
Central vertigo
|
|
Neurocutaneous disorder
- V(1) ophthalmic distribution - leptomeningeal angiomas - pheochromocytomas - port-wine stain (nevus flammeus) - glaucoma, seizure, retardation |
Sturge-Weber syndrome
|
|
Neurocutaneous disorder
- Hamartomas in CNS, skin, organs - rhabdomyoma - subependymal giant cell astrocytoma - ash leaf spots |
Tuberous sclerosis
|
|
Neurocutaneous disorder
- cafe-au-lait spots - lisch nodules (pigmented iris) - optic gliomas |
Neurofibromatosis type I
|
|
Neurofibromatosis type I cause?
|
mutation in NF-1 gene on chromosome 17
|
|
Neurocutaneous disorder
- cavernous hemangiomas in skin, mucosa, organs - bilateral renal cell carcinoma - hemangioblastoma in retina |
von-Hippel-Lindau disease
|
|
von-Hippel-Lindau disease is caused by?
|
mutated tumor suppressor VHL on chromosome 3
|
|
Simple partial seizure
|
motor, sensory, autonomic, and psychic
(consciousness left intact) |
|
Complex partial seizure
|
motor, sensory, autonomic, and psychic
(consciousness imparied) |
|
Absence seizure (petit mal, 3Hz)
|
blank stare
|
|
Myoclonic seizure
|
quick, repetitive jerk
|
|
Tonic-clonic (grand mal)
|
alternating stiffening and movement
|
|
Tonic seizure
|
stiffening
|
|
Atonic seizure
|
"drop" seizure; often mistaken for fainting
|
|
- Demyelination of CNS due to destruction of oligodendrocytes
- Rapidly progressive and fatal - seen in 2-4% of AIDS Pts |
Progressive multifocal leukoencephalopathy (PML)
|
|
Virus associated w/Progressive multifocal leukoencephalopathy (PML)
|
JC virus
|
|
-Multifocal perivenular inflammation and demyelination
- seen after infection (VZV; measles) - seen after vaccination (rabies, smallpox) |
Acute disseminated (postinfectious) encephalomyelitis
|
|
- autosomal-recessive lysosomal storage disease
- due to arylsulfatase A deficiency - buildup of sulfatides leads to impaired production of myelin sheath |
Metachromatic leukodystrophy
|
|
Dysmyelinating disease
- hereditary motor and sensory neuropathy (HMSN) |
Charcot-Marie-Tooth disease
|
|
- ascending muscle weakness
- facial paralysis in 50% of case - Autonomic function affected (cardiac, hypo/hypertension) |
Guillain-Barre syndrome
|
|
associated w/infection; autoimmune attack of peripheral myelin due to molecular mimicry
|
campylobacter and herpesvirus
|
|
Multiple sclerosis (MS) findings
|
- increased protein (IgG)
- oligoclonal bands are diagnostic - MRI is gold standard - periventricular plaques (reactive gliosis) |
|
Treatment for Multiple sclerosis (MS)
|
- Beta- interferon
- immunosuppressant therapy |
|
Familial form associated w/Early onset Alzheimer's
|
APP (21); presenilin-1 (14); presenilin-2 (1)
|
|
Familial form associated w/Late onset Alzheimer's
|
ApoE4 (19)
|
|
Protective association of Alzheimer's
|
ApoE2 (19)
|
|
Alzheimer's histologic/gross findings
|
- decreased ACh
- senile plaques (extracellular; beta-amyloid) - neurofibrillary tangles (intracellular; phosphorylated tau protein) |
|
- Dimension, aphasia, parkinsonian aspects, change in personality
- spares parietal lobe and posterior 2/3 pf superior temporal gyrus |
Pick's disease
|
|
Pick's disease histologic/gross findings
|
- intracellular, aggregated tau protein
- frontotemporal atrophy |
|
intracellular, aggregated tau protein
|
Pick bodies
|
|
Parkinsonism w/dementia and hallucinations
|
Lewy body dementia
|
|
"Parkinsonism w/dementia and hallucinations" histologic/gross findings
|
alpha-synuclein defect (Lewy body dementia)
|
|
rapidly progressive (weeks to months) dementia w/myoclonus
|
Creutzfeldt-Jakob disease (CJD)
|
|
Creutzfeldt-Jakob disease (CJD) histologic/gross findings
|
- spongiform cortex
- prions (alpha helix -> beta sheet [resistant to proteases]) |
|
Second most common cause of dementia
|
multi-infarct
|
|
Papilledema
|
- increased intracranial pressure
- elevated optic disk w/blurred margins - bigger blind spot |
|
Extraocular nerves
- eye looks down and out - pupillary dilation - ptosis |
CN III damage
|
|
Extraocular nerves
- eye drifts upward causing vertical diplopia - problems reading newspaper and going down stairs |
CN V damage
|
|
Extraocular nerves
- medially directed eye |
CN VI damage
|
|
Extraocular muscle
- eye drifts upward causing vertical diplopia - problems reading newspaper and going down stairs |
Superior Oblique
|
|
Extraocular muscle
- medially directed eye |
Lateral Rectus
|
|
- afferent pupillary defect
- due to optic nerve damage or retinal detachment - decreased bilateral pupillary constricition |
Marcus Gunn pupil
|