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Board Review > "Neuro Gold" > Flashcards

"Neuro Gold" Flashcards

1
Q

3 components of blood-brain barrier

A

Endothelial cells, basement membrane, astrocytic end feet

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2
Q

Conditions associated with proximal symmetric weakness but no sensory loss

A

Myopathies

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3
Q

Symptoms associated with peripheral neuropathies

A

Distal asymmetric weakness with atrophy, fasciculations, sensory loss and pain

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4
Q

Two most common conditions that result in peripheral neuropathies

A

Diabetes and alcoholism

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5
Q

Distribution of sensory loss in polyneuropathies

A

Stocking/glove pattern

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6
Q

Symptoms of Guillan-Barre syndrome

A

Ascending symmetric muscle weakness, areflexia and paresthesias in hands and feet 1-3 weeks following a viral respiratory or GI infection

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7
Q

CSF findings in Guillan-Barre syndrome

A

CSF has elevated protein without elevated WBC

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8
Q

Motor neuron disease characterized by UMN and LMN lesions

A

Amyotrophic lateral sclerosis

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9
Q

MRI and CSF findings of MS

A

MRI: white matter lesions

CSF: oligoclonal bands on electrophoresis

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10
Q

Conditions that cause pain/loss in a dermatomal pattern

A

Radiculopathies

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11
Q

Signs of UMN lesions

A

Spastic paralysis, hyper-reflexia, positive Babinksi, Hoffman sign, and clonus

With an acute UMN lesion, there may be hyporeactive reflexes and flaccid paralysis

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12
Q

Cause of lower facial paralysis (can wrinkle their forehead but cannot smile)

A

Sign of damage to the corticobulbar tract in the pons or higher (internal capsule or crus cerebri)

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13
Q

Signs of LMN lesions

A

Flaccid paralysis, hyporeflexia, fasciculations, atrophy

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14
Q

Symptoms of spinal shock

A

Temporary flaccid paralysis, hyporeflexia, sensory loss and loss of bladder tone

Hyper-reflexia develops over a period of days to weeks

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15
Q

Cause and symptoms of anterior spinal artery syndrome

A

Cause: occlusion of the artery of Adamkiewicz

Symptoms: bilateral weakness, loss of pain and temperature and hyper-reflexia below the lesion

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16
Q

Symptoms of cauda equina syndrome

A

Weakness and sensory loss in the lower extremities, radicular pain, saddle anesthesia, and urinary incontinence

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17
Q

Cause and symptoms of syringomyleia/hyromelia

A

Cause: cavitation of the central spinal cord

Symptoms: impinges the anterior white commissure producing bilateral loss of pain and temperature in a dermatomal pattern

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18
Q

Cause and symptoms of Brown-Sequard syndrome

A

Cause: hemisection of the spinal cord

Symptoms: ipsilateral UMN paralysis and loss of discriminative touch and contralateral loss of pain and temperature

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19
Q

Cause and symptoms of anterior cord syndrome

A

Cause: compression of anterior spinal artery

Symptoms: affects the neurons of the anterior horn, spinothalamic tract and lateral corticospinal tract

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20
Q

Symptoms of tabes dorsalis

A

Loss of posterior columns (discriminative touch, proprioception, and vibration)

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21
Q

Cause and symptoms of subacute combined degeneration

A

Cause: B12 deficiency

Symptoms: peripheral neuropathy that can progress to cord (posterior columns and lateral corticospinal tracts)

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22
Q

Cause and symptoms of medial medullary syndrome

A

Cause: infarct within anterior spinal artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), ipsilateral deviation of the tongue on protrusion (hypoglossal nucleus or nerve) and contralateral loss of discriminative touch, proprioception and vibration (medial lemniscus)

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23
Q

Cause and symptoms of lateral medullary syndrome

A

Cause: infarct within posterior inferior cerebellar artery

Symptoms: ipsilateral loss of pain and temperature on face (spinal trigeminal tract), contralateral loss of pain and temperature on body (spinothalamic tract), nystagmus, dizziness, nausea (vestibular nuclei), hoarseness, ipsilateral sagging palate, dysphagia (nucleus ambiguous), loss of taste (solitary nucleus), ataxia (restiform body, inferior cerebellar peduncle), Horner syndrome (hypothalamospinal fibers)

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24
Q

Cause and symptoms of Foville syndrome

A

Cause: infarct within paramedian branches of basilar artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), diplopia, paralysis of abduction (CN VI; maybe also intranuclear ophthalmoplegia), ataxia (middle cerebellar peduncle), contralateral loss of discriminative touch, proprioception, and vibration (medial lemniscus)

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25
Q

Cause and symptoms of Gubler syndrome

A

Cause: infarct within paramedian branches of basilar artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), ipsilateral facial paralysis (facial nerve or nucleus), ipsilateral loss of pain and temperature on face (CN V), contralateral loss of pain and temperature on body (spinothalamic tract)

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26
Q

Cause and syndrome of midpontine base syndrome

A

Cause: infarct within paramedian or short circumferential branches of basilar artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), paralysis of jaw muscles (CN V), loss of sensation on face (CN V), ataxia (middle cerebral peduncle)

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27
Q

Symptoms of tonsillar herniation

A

Central apnea, hypertension, hyperventilation, loss of consciousness

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28
Q

Injury to the facial nerve (or nucleus) results in complete or lower facial paralysis

A

COMPLETE facial paralysis

29
Q

Corticonuclear lesions (at pons or above) results in complete or lower facial paralysis

A

Lower facial paralysis

30
Q

Cause and symptoms of Parinaud syndrome

A

Cause: lesion of the midbrain

Symptoms: paralysis of vertical gaze (vertical gaze center), obstructive hydrocephalus (pinealoma)

31
Q

Cause and symptoms of Weber syndrome

A

Cause: infarct within branches of the posterior cerebral artery within the midbrain

Symptoms: contralateral spastic hemiparesis (corticospinal tract), diplopia, dilated pupil (CN III), paralysis of lower face, deviation of tongue to contralateral side, weakness of ipsilateral SCM and trapezius (corticonuclear tract), tremor (substantia nigra)

32
Q

Cause and symptoms of Claude syndrome

A

Cause: infarct within branches of the posterior cerebral artery within the midbrain

Symptoms: diplopia, dilated pupil (CN III), tremor, hyperkinesia (red nucleus), ataxia (cerebellothalamic fibers)

33
Q

Symptoms of an uncal herniation

A

Diplopia, dilated pupil (CN III), contralateral hemiparesis (corticospinal tract), paralysis of lower face, deviation of tongue to contralateral side, weakness of SCM and trapezius (corticonuclear tract)

34
Q

Findings for Weber test

A

Tests bone conduction

Normally localizes to midline

Sensorineuronal loss - localizes to good ear

Conductive loss - localizes to bad ear

35
Q

Findings for Rinne test

A

Compares air and bone conduction; air conduction is normally better than bone conduction

Sensorineuronal loss - air > bone

Conductive loss - bone > air

36
Q

Cause of anisocornia (unequal pupils)

A

Lesion to CN III or sympathetics

A dilated pupil indicates injury to CN III

37
Q

Cause of ipsilateral blindess

A

Lesion to retina or optic nerve

38
Q

Cause of bitemporal hemianopsia

A

Lesion to optic chiasm

39
Q

Cause of contralateral homonymous hemianospia

A

Lesion to optic tract

40
Q

Cause of contralateral homonymous hemianopsia, maybe quantrantopia

A

Lesion to optic radiations

41
Q

Marcus-Gunn pupil

A

Pupil that appears to dilate with direct stimulation of light on a swinging light test

Indicates lesion to optic nerve

42
Q

Cause and symptoms of intranuclear ophthalmoplegia

A

Cause: lesion of the medial longitudinal fasciculus (in the pons or caudal midbrain)

Symptoms: eye that fails to adduct on lateral gaze (but convergence is intact)

43
Q

Cause and symptoms of one-and-a-half syndrome

A

Cause: lesion involving both the medial longitudinal fasciculus and abducens nucleus

Symptoms: on testing horizontal gaze, one eye can only abduct and other eye cannot abduct or adduct

44
Q

Cause of Argyll-Robertson pupil

A

Tabes dorsalis

45
Q

Decorticate posturing

A

UL flexed, LL extended (rubrospinal tract intact)

46
Q

Decerebrate posturing

A

All limbs in extension (rubrospinal tract damaged)

47
Q

Damage to what structure results in coma

A

Reticular formation

48
Q

Cause and symptoms of Meniere’s syndrome

A

Cause: excess endolymph in the scala media

Symptoms: episodic vertigo, tinnitus and hearing loss

49
Q

Cause and symptoms of benign positional vertigo

A

Cause: free otoliths in the semicircular canals

Symptoms: outbursts of vertigo and nystagmus with particular positions of the head

50
Q

Caloric testing

A

Cold=nystagmus to Opposite side
Warm=nystagmus to Same side

COWS

51
Q

Cause of ballismus

A

Lesion to subthalamuc nucleus

52
Q

Cause of hemiballismus

A

Lesion to subthalamic nucleus on opposite side

53
Q

Differentiate between sensory vs cerebellar ataxia with the Romberg test

A

In sensory ataxia, the patient sways considerably when eyes are closed

In cerebellar ataxia, the patient sways with eyes open

54
Q

Cause and symptoms of Friedreich’s ataxia

A

Cause: autosomal recessive disorder, degeneration of posterior columns and spinocerebellar tracts

Symptoms: progressive limb and gait ataxia, dysarthria, loss of joint position and vibration senses, absent tendon reflexes in the lower extremity and Babinski sign

55
Q

Symptoms resulting from blockage of anterior choroidal artery

A

Contralateral hemiparesis (corticospinal tract) and contralateral homonymous hemianopsia (optic tract)

56
Q

Symptoms resulting from blockage of lenticulostriate arteries

A

Contralateral hemiparesis and hemianesthsia (posterior limb of internal capsule)

57
Q

Symptoms resulting from blockage of MCA: superior division

A

Motor and sensory symptoms involving the contralateral face (lower facial paralysis), upper limb and trunk (lower extremity is spared); on the left will produce expressive (Broca’s) aphasia

58
Q

Symptoms resulting from blockage of MCA: inferior division

A

Contralateral homonymous hemianopsia; on left receptive (Wernicke’s ) aphasia

59
Q

Symptoms resulting from blockage of ACA

A

Motor and sensory symptoms involving the contralateral trunk and lower limb (upper limb and face are spared) with frontal lobe signs (magnetic gate, personality changes, release of primitive reflexes [grasp, root, suck])

60
Q

Symptoms resulting from blockage of PCA

A

Produces visual symptoms - contralateral homonymous hemianopsia, macular sparring is possible; may infarct thalamus (thalmogeniculate and thalamoperforating) = contralateral homonymous hemianopsia/somoatosensory loss

61
Q

Symptoms of Broca’s aphasia

A

Impaired comprehension, repetition, naming and speech output

62
Q

Symptoms of Wernicke’s aphasia

A

Fluent speech full of nonsense words and phrases

63
Q

Cause and symptoms of conductive aphasia

A

Cause: damage to the arcuate fasciculus

Symptoms: poor repetition

64
Q

Symptoms of anterior watershed strokes

A

Expressive aphasia and lower limb affects

65
Q

Symptoms of posterior watershed strokes

A

Receptive aphasia and visual loss

66
Q

Definition of apraxia

A

Loss of the ability to perform a learned and familiar motor task

67
Q

Definition of agnosia

A

Inability to recognize a familiar object regardless of intact sense

68
Q

Cause and symptoms of Gerstmann syndrome

A

Cause: damage to the angular gyrus in the dominant hemisphere

Symptoms: acalculia, agraphia, finger agnosia, and left-right confusion

69
Q

Cause and symptoms of Kluver-Bucy syndrome

A

Cause: bilateral lesions of the amygdala

Symptoms: docility, placidity, hypersexuality, hyperorality, and hypermetamorphosis

Board Review (49 decks)

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