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Flashcards in 3/22 neuro Deck (109)
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1
Q
Short acting benzos?
-mnemonic?
A
TOM acts fast
-triazolam
-oxazepam
-midazolam

*also alprazolam. AL bundy has a short fuse.
2
Q
Essential tremor
-Tx:
A
propanolol
-2nd line = primidone.
3
Q
3 major types of glial cells
A
astrocytes, oligodendrocytes, microglia
4
Q
astrocytes & oligodendros
-derived from what tissue?
A
neuroectoderm
5
Q
which hypoT nucleus maintains circadian rhythm?
-mnemonic?
A
suprachiasmatic nucleus
-hard to be "super charismatic" when you have jet lag.
6
Q
All sensory information goes through thalamus except:
A
olfaction
7
Q
When a pt needs IV ABxs, can oral ABxs be a good enough substitute?
A
no
-oral ABxs do not adequately penetrate the CSF.
8
Q
heroin withdrawal
-key Sxs:
A
dilated pupils
yawning
lacrimation
9
Q
Alcohol & benzo withdrawal
-key Sxs:
A
tachy
seizures
10
Q
nicotine withdrawal
-key Sxs:
A
inc. appetite
11
Q
Seizures
-opioid or alcohol withdrawal?
A
alcohol withdrawal can produce seizures, opioid withdrawal does NOT.

*benzo withdrawal can also lead to seizures.
12
Q
nicotinic receptor
-how many ACh need to bind for channel to open?
A
2
13
Q
chlorpromazine
-high or low potency?
A
low potency antipsychotic
14
Q
fluphenazine
-high or low potency?
A
high potency antipsychotic
15
Q
entacapone
-mech?
A
peripheral COMT inhibitors, prevent L-DOPA degradation, increased dopamine availability.
16
Q
entacapone vs tolcapone
-difference?
A
Entacapone inhibits peripheral COMT while tolcapone inhibits both central & peripheral COMT.
17
Q
MAO-B
-degrades what?
A
dopamine
18
Q
MAO-A
-degrades what?
A
NE & serotonin
19
Q
Which receptor causes mydriasis?
A
alpha1
20
Q
What nerve inn. all the muscles of mastication?
A
V3 (mandibular) of the trigeminal
21
Q
which muscle opens the jaw?
A
lateral pterygoid
22
Q
Mandibular n. (V3, trigeminal)
-exits skull through which foramen?
A
foramen ovale
23
Q
Maxillary n. (V2, trigeminal)
-exits skull through which foramen?
A
foramen rotundum
24
Q
TCAs
-blockade of what leads to arrythmias?
A
cardiac fast sodium channels

*also keep in mind, blockade of muscarinic receptors can also cause tachy.
25
Q
TCAs have inhibitory effects on what receptors?
A
-NE & serotonin reuptake
-muscarinic
-alpha-1
-histamine
-cardiac fast Na channels
26
Q
Whats the most common cause of death in pts w/anti-depressant toxicity?
A
TCAs inhibit cardiac fast sodium channels resulting in arrythmias.
27
Q
ant pit
-derived from what tissue?
A
rathke pouch = surface ectoderm
28
Q
post pit.
-derived from what tissue?
A
neural tube (which is from ectoderm).
29
Q
Alar plate
-ventral or dorsal?
-motor or sensory?
A
(dorsal): sensory
30
Q
Basal plate
-ventral or dorsal?
-motor or sensory?
A
(ventral): motor
31
Q
Brainstem
-components:
A
midbrain + pons + medulla = brainstem.
32
Q
Forebrain
-aka?
-what does it develop into?
A
-AKA: prosencephalon
-telencephalon => cerebral hemispheres
-diencephalon => thalamus
33
Q
Midbrain
-aka?
-what does it develop into?
A
-AKA: mesencephalon
-midbrain
34
Q
Hindbrain
-aka?
-what does it develop into?
A
-AKA: rhombencephalon
-Metencephalon => pons + cerebellum
-Myelencephalon => medulla
35
Q
3rd ventricle
-which part of brain?
A
thalamus
36
Q
aqueduct of sylvius
-which part of brain?
A
midbrain
37
Q
Neural crest
-origin of what nervous system structures?
A
PNS neurons, Schwann cells.
38
Q
whats the resident macrophage of the CNS and what layer does it derive from?
A
microglia
-from mesoderm like macrophages.
39
Q
Order of closing of neural tube:
-rostal, middle, caudal: order?
A
-neural tube first closes in the middle. Then the rostal
end, then the caudal end.
40
Q
Neuropores
-fuse during which week?
A
4th week
41
Q
Failure of neuropores to close
-persistent connection btwn what two areas?
A
amniotic cavity & spinal canal.
42
Q
Whats the marker for neural tube defect?
-and where can you measure it?
-whats a confirmatory test?
A
inc. AFP
-amniotic fluid & maternal serum
-inc. AChE in amniotic fluid = confirmatory test.
43
Q
Spina bifida occulta
-is dura intact?
A
yes
-only spina bifida lesion w/intact dura.
44
Q
Anencephaly
-what part of brain is missing?
-associated w/what maternal problem?
A
-No forebrain.
-maternal DM 1.
45
Q
Holoprosencephaly
-what is it?
-which signaling pathway is fucked up?
A
-Failure of left and right hemispheres to separate, usually occurs during weeks 5-6.
-sonic hedgehog
46
Q
Holoprosencephaly
-presentation?
-associated w/what genetic disease?
A
-Moderate form has cleft lip/palate, most severe form results in cyclopia.
-patau (trisomy 13)
47
Q
Chiari II (Arnold-Chiari malformation)
-what is it?
-whats it cause?
A
-Significant herniation of cerebellar tonsils and vermis through foramen magnum
- Aqueductal stenosis and hydrocephalus
48
Q
Chiari II (Arnold-Chiari malformation)
-how does it present?
A
-Often presents with lumbosacral myelomeningocele and paralysis below the defect.
49
Q
Dandy-Walker
-what is it?
-associated w/what comorbidities?
A
-Agenesis of cerebellar vermis with cystic enlargement of 4th ventricle.
-Associated with hydrocephalus and spina bifida.
50
Q
Syringomyelia
-what is it?
-what cells are usually damaged first?
A
-Cystic cavity (syrinx) within the spinal cord.
-Crossing anterior spinal commissural fibers are typically
damaged first.
51
Q
Syringomyelia
-Sxs:
-most common location?
A
-Results in a “cape-like” bilateral loss of pain and temperature sensation in upper extremities (fine touch sensation is preserved).
-Most common at C8–T1.
52
Q
Ant. 2/3 of tongue
-which branchial arches?
A
-1st and 2nd branchial arches.
53
Q
Post. 1/3 of tongue
-which branchial arches?
A
-3rd and 4th branchial arches
54
Q
Post. 1/3 of tongue
-somatosensation via?
-taste via?
A
-CN 9 for both.
55
Q
Which CNs carry taste sensation?
-what nucleus do they deliver this to?
A
CN VII, IX, X
-solitary nucleus
56
Q
Ant. 2/3 of tongue
-somatosensation via?
-taste via?
A
-sensation = V3
-taste = CN 7
57
Q
Astrocyte
-handles metabolism of what?
A
potassium
58
Q
HIV-infected microglia: appearance?
A
-fuse to form multinucleated giant cells in the CNS.
59
Q
Oligodendrocyte
-how many axons can it myelinate?
A
A lot (~30)
60
Q
Oligodendrocyte
-how many axons can it myelinate?
-injured in which diseases?
A
-~30.
-Injured in multiple sclerosis, progressive multifocal leukoencephalopathy (PML), and leukodystrophies.
61
Q
Schwann cells
-how many axons can it myelinate?
-mnemonic?
A
-can only myelinate 1 PNS axon.
-Schwann bike only fits one person.
62
Q
Schwann cells
-derived from?
-destroyed in what disease(s)?
A
-neural crest
-Destroyed in Guillain-Barré syndrome.
63
Q
Most common sign of initial periph. neuropathy in DM
pts is loss of what?
-caused by damage to what?
A
Loss of vibration sense
-pacinian corpuscles
64
Q
4 cell types in epidermis:
A
-langerhan dendritic cells, keratinocytes, melanocytes, merkel cells.
65
Q
Endoneurium
-surrounds what?
-inflammatory infiltrate here signals what disease?
A
-single nerve fiber
-inflammatory infiltrate in Guillain-Barré syndrome.
66
Q
Perineurium
-surrounds what?
A
-surrounds a fascicle of nerve fibers.
-Must be rejoined in microsurgery for limb reattachment.
67
Q
Epineurium
-surrounds what?
A
-dense connective tissue that surrounds entire nerve (fascicles and blood vessels).
68
Q
Dopamine
-location of synthesis
A
-Ventral tegmentum and SNc (midbrain)
*SNc = substantia nigra pars compact
69
Q
Serotonin
-inc or dec in anxiety?
-inc or dec. in parkinsons?
A
-dec. in anxiety
-inc. in parkinsons
70
Q
Serotonin
-where is it made?
A
Raphe nucleus (pons, medulla, midbrain)
71
Q
ACh
-where is it made?
A
Basal nucleus of Meynert
72
Q
ACh
-inc or dec in parkinsons
-inc or dec in Alzheimers
-inc or dec in Huntingtons
A
-inc. in Parkinson disease
-dec. in Alzheimer disease
-dec. in Huntington disease
73
Q
GABA
-inc or dec. in anxiety?
A
-dec. in anxiety
74
Q
GABA
-where is it made?
A
-Nucleus accumbens
*strong association w/addiction.
75
Q
Tight junctions aka:
A
-zonula occludens.
76
Q
vasogenic edema
-what is it?
A
-cerebral edema due to infarction and/or neoplasm destroying endothelial cell tight junctions of the BBB.
77
Q
Areas of hypoT not protected by BBB:
A
-OVLT (organum vasculosum of the lamina terminalis) senses change in osmolarity.
-area postrema (responds to emetics)
78
Q
Supraoptic nucleus makes:
A
ADH.
79
Q
Paraventricular nucleus makes:
A
oxytocin.
80
Q
HypoT: lateral area
-function?
-mnemonic?
-inhibited by what?
A
-"Lat makes you Fat"
-controls hunger
-destruction => anorexia
-inhibited by leptin
81
Q
HypoT: Ventromedial area
-function?
-mnemonic?
-stimulated by what?
A
-If you zap your ventromedial area, you grow ventrally & medially.
-satiety center
-destruction => hyperphagia
-stimulated by leptin.
82
Q
Anterior hypothalamus
-function?
-mnemonic?
-stimulated by what?
A
-cooling
-A/C = anterior cooling.
-parasympatheticaly stimulated.
83
Q
Posterior hypothalamus
-function?
-stimulated by what?
A
-heating
-sympathetically stimulated
84
Q
Suprachiasmatic nucleus
-function?
-mnemonic
A
-Circadian rhythm.
-"Hard to be "super charismatic" when you have jet lag".
85
Q
Suprachiasmatic nucleus
-how does it stimulate pineal gland?
-what does pineal gland release when stimulated?
A
-Suprachiasmatic nucleus squirts NE onto pineal gland which then releases melatonin.
86
Q
Two stages of sleep:
A
-rapid-eye movement (REM) and non-REM.
87
Q
Extraocular movements during REM sleep due to activity of:
A
-PPRF (paramedian pontine reticular formation/conjugate gaze center).
88
Q
How often does REM sleep occur?
A
Every 90 minutes, and duration increases through the night.
89
Q
What decreases REM & delta wave sleep?
A
-Alcohol, benzodiazepines, barbiturates, & norepinephrine.
90
Q
Bedwetting: Tx:
A
Oral desmopressin acetate (DDAVP).
-preferred over imipramine.
91
Q
Night terrors and sleepwalking: Tx:
A
Benzodiazepines
92
Q
What stage of sleep does sleepwalking, night terrors, and
bedwetting occur?
A
Non-REM: stage N3
-delta wave sleep
93
Q
What stage of sleep does bruxism occur?
A
Non-REM: stage N2
-Sleep spindles and K complexes
94
Q
Thalamus: VPL nucleus
-inputs?
A
Spinothalamic & DC/ML
95
Q
Thalamus: VPM nucleus
-inputs?
-mnemonic?
A
-inputs: trigeminal and gustatory pathway
-"M"akeup goes on the face (vp"M")
96
Q
Thalamus: LGN nucleus
-inputs?
-destination?
-mnemonic?
A
-input: CN2
-Calcarine sulcus (visual cortex)
-Lateral = Light
97
Q
Thalamus: MGN nucleus
-inputs?
-destination?
-mnemonic?
A
-input: Superior olive and inferior colliculus of tectum.
-Auditory cortex of temporal lobe.
-"M"edial = "M"usic
98
Q
Thalamus: VL nucleus
-inputs?
-destination?
A
-inputs: Basal ganglia, cerebellum.
-Motor cortex
99
Q
Limbic system
-involves which sense?
A
olfaction
100
Q
Cerebellum
-output nerves?
A
Purkinje cells
-the only output cells of the cerebellum.
101
Q
Which cells in cerebellum are very vulnerable to ischemia?
A
Purkinje cells
102
Q
Striatum =
A
= putamen (motor) + caudate (cognitive).
103
Q
Lentiform =
A
= putamen + globus pallidus.
104
Q
Is amygdala part of basal ganglia?
A
No, its part of limbic system.
105
Q
Sertraline
-what is it?
A
SSRI
106
Q
precentral gyrus
A
primary motor cortex
107
Q
Which vitamin inc. peripheral metabolism of levodopa?
A
B6
108
Q
Cimetidine
-s/e:
A
-p450 inhibitor
-anti-androgenic effects
-gynecomastia
-prolactin release
-impotence
-dec. libido
-dec. renal excretion of creatinine
109
Q
What type of drugs are usually more addictive, shorter or longer acting?
A
shorter acting