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1

What abnormalities are often found with a Chiari malformation?

Type 1: cerebellar tonsil herniates down; syringomyelia

Type 2: lumbosacral myelomeningocele, hydrocephaly

2

What are the classic presenting sxs of a syringomyelia? (2)

- capelike dist. loss of p/t in upper extremities
- hand weakness + atrophy

3

What amniotic fluid lab abnormalities might point you to a diagnosis of anencephaly?

increased AFP (in mom's serum and amniotic fluid)

4

From which branchial pouch are each of the following structures derived?

a. middle ear and eustachian tubes
b. superior parathyroid
c. inferior parathyroids
d. epithelial lining of the palatine tonsil
e. thymus

a. 1st pouch
b. 4th pouch
c. 3rd pouch
d. 2nd pouch
e. 3rd pouch

5

Which nervous system cell looks like fried eggs under histo staining?

oligodendrocytes

6

Which nervous system cell forms multinucleated giant cells in the CNS when infected with HIV?

microglia

7

Which nervous system cell is damaged in GBS?

schwann cell

8

Which nervous system cell is the macrophages of the CNS?

microglia

9

In which neurological diseases is Ach altered? (3)

Alzheimers (decreased)
Huntington (decreased)
Parkinson (increased)

10

In which diseases are levels of GABA altered? (2)

Anxiety (decreased)
Huntington (decreased)

11

What are the components of the BBB? (3)

1. non-fenestrated capillary endothelial cells with tight junctions
2. BM
3. foot process of astrocytes

12

A lesion to which area of the brain is responsible for hemispatial neglect?

non-dominant parietal lobe

13

A lesion to which area of the brain is responsible for poor repetition?

Arcuate fasciculus (conductive aphasia)

14

A lesion to which area of the brain is responsible for poor comprehension?

Wernicke's

15

A lesion to which area of the brain is responsible for poor verbal expression?

Broca's

16

A lesion to which area of the brain is responsible for personality changes and disinhibition?

frontal lobe

17

A lesion to which area of the brain is responsible for dysarthria?

cerebellar vermis

18

A lesion to which area of the brain is responsible for agraphia and acalculia?

angular gyrus in dominant parietal lobe (Gerstmann syndrome)

19

What typically is the cause of a lesion to the mammillary bodies?

Thiamine deficiency

20

Where is the pathology located in each of the following scenarios?

a. right anopsia
b. bilateral hemianopsia
c. right homonymous hemianopsia

a. right optic nerve
b. optic chiasm
c. left optic tract

21

What 2 nerves are tested with the gag reflex?

9 (aff)
10 (eff)

22

A 19yo man presents with a furuncle on his philtrum, and the cavernous sinus becomes infected. What neurological deficits might you see in this patient?

CN 3, 4, 6 --> ophthalmoplegia, diplopia

CN5 --> pain, numbness of upper face

23

How can a stroke of the facial motor cortex be distinguished from Bell's palsy?

Facial motor cortex = contralateral paralysis of lower face, with forehead/eyebrow sparing (central)

Bell's palsy = paralysis to both upper and lower face

24

What artery supplies the medullary pyramids and the medial lemniscus in the medulla?

anterior spinal artery

25

What artery supplies the inferior cerebellar peduncle, nucleus ambiguus, and the lateral spinothalamic tract in the medulla?

PICA

26

What is the triad of Horner syndrome?

1. Ptosis
2. Anhidrosis (decreased sweating)
3. Miosis (constriction)

27

A patient comes to the ER with double vision and left-sided weakness. On p/e, she cannot abduct her right eye. In addition to motor weakness of the left arm and leg, she also has loss of fine touch, proprioception, and vibration sense in the left arm and leg. Where is the lesion and what vessel is most likely involved?

Right medial pontine syndrome

paramedian branches of basilar artery

28

A patient presents with vertigo, nystagmus, and slurred speech. P/e reveals right-sided ptosis and miosis, decreased gag reflex on the right, deviation of the uvula to the left, diminished P/T on the right side of his face, and left side of his body. Where is the lesion and what vessel is most likely involved?

Right lateral medullary syndrome (Wallenberg)

Right PICA

29

A patient presents with double vision, slurred speech, hoarse voice and acute right-sided weakness. P/e shows weakness of the right arm and leg, and left eye is depressed and abducted. Where is the lesion and what vessel is most likely involved?

Left anterior midbrain (Weber syndrome)

L PCA

1. cerebral peduncle lesion leads to
- corticobulbar tract damage (dysphagia, dysphonia, dysarthria)
- corticospinal tract damage
(contralateral spastic hemiparesis)

3. CN3 palsy --> down and out

30

savage behavior and obesity result from STIMULATION of which hypothalamic nuclei?

dorsomedial (regulates hunger)