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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