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Final FA review > 3/24 neuro > Flashcards

3/24 neuro Flashcards

1
Q

corticospinal, spinothalamic tracts

-organization

A

-Legs (Lumbosacral) are Lateral in Lateral corticospinal, spinothalamic tracts.

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2
Q

DC/ML

-organization

A

-Dorsal column is organized as you are, with hands at sides. Arms outside, legs inside.

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3
Q

lateral corticospnial vs lateral spinothalamic

-so both are lateral, but which one is more ventral?

A

lateral spinothalamic = more ventral.

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4
Q

Which tract exclusively conveys vibration sense?

A

DC/ML

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5
Q

Remember, ascending tracts synapse and then cross.

A

remember that

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6
Q

gracile fasciculus = upper or lower limb?

A

Lower limb

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7
Q

cuneate fasciculus = upper or lower limb?

A

Upper limb

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8
Q

DC/ML

-where does it decussate?

A

medulla

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9
Q

Lissauer’s fasciculus

A

what the spinothalamic tract uses to ascend 1-2 levels before synapsing in dorsal horn.

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10
Q

UMN lesions

-where can the lesion be?

A

-any lesion in neurons from motor cortex up until

they synapse at anterior horn.

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11
Q

Atrophy

-UMN or LMN lesion or both?

A
  • atrophy in LMN lesion.

- you get hypertonia w/UMN lesion.

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12
Q

Poliomyelitis & Werdnig Hoffman

-whats the lesion?

A

destruction of anterior horns.

  • strictly a LMN lesion.
  • flaccid paralysis.
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13
Q

ALS

-whats the only motor system that can not be affected?

A

oculomotor

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14
Q

ALS

-familial cases due to defect in what protein?

A

superoxide dismutase 1.

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15
Q

ALS

  • aka?
  • Tx? & how does Tx work?
  • mnemonic?
A
  • Lou Gehrig’s disease
  • Riluzole treatment modestly inc. survival by dec.  presynaptic glutamate release.

-for LOU gehrigs gives ri”LOU”zole.

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16
Q

Complete occlusion of anterior spinal artery

  • what part of s. cord gets infarcted?
  • whats spared?
A
  • anterior 2/3rd

- dorsal columns & lissauers tracts

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17
Q

Complete occlusion of anterior spinal artery

  • which part of s.cord hit the hardest?
  • why?
A

-Upper thoracic ASA territory is a watershed area, as artery of Adamkiewicz supplies ASA below ~T8.

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18
Q

Complete occlusion of anterior spinal artery

-presentation?

A

-Complete loss of strength below the level of the injury w/loss of pain & temp sensation but preserved vibratory sense (DC spared).

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19
Q

Tabes dorsalis

-whats the lesion?

A

-demyelination of DC/ML.

-

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20
Q

Romberg test

-what does it test?

A

proprioception

-DC/ML test.

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21
Q

Tabes dorsalis

  • DTRs?
  • Romberg test?
A
  • absence of DTRs

- (+) romberg test (aka you have a problem w/proprioception).

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22
Q

Besides B12, what other vitamin def. can cause subacute combined degeneration?

A

vitamin E.

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23
Q

subacute combined degeneration

-which tracts are affected?

A
  • DC/ML
  • lateral corticospinal tract
  • spinocerebellar tract
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24
Q

Poliomyelitis

  • where does it replicate before entering the blood stream?
  • where can you recover the virus?
A
  • oropharynx & small intestine.

- stool or throat.

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25
Q

Spinal muscular atrophy

  • aka?
  • lesion?
  • inheritance?
A
  • Werdnig-Hoffmann disease
  • Congenital degeneration of anterior horns of spinal cord = LMN lesion.
  • auto recessive.
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26
Q

Friedreich ataxia

  • inheritance pattern?
  • repeat?
  • which chrom?
  • which gene product?
A
  • auto recessive
  • GAA
  • chrom. 9
  • frataxin
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27
Q

Friedreich ataxia

-whats the problem?

A

-No frataxin (iron binding protein) => impairment in mitochondrial functioning => degen. of multiple s.cord tracts.

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28
Q

Friedreich ataxia

  • Sxs?
  • presentation?
A
  • Muscle weakness and loss of DTRs, vibratory sense, and proprioception.
  • Presents in childhood with kyphoscoliosis.
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29
Q

Friedreich ataxia

-DTRs?

A

-loss of DTRs.

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30
Q

Friedreich ataxia

-cause of death?

A

hypertrophic cardiomyopathy

-you can get iron deposition in heart.

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31
Q

Brown-Séquard syndrome

  • what is it?
  • whats the only tract that will be contralateral problems?
A
  • hemisection of s.cord.

- spinothalamic bc it synapses so low.

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32
Q

which organ is the master controller of the autonomic nervous system?

A

hypothalamus

-sends neurons that activate sym/pres and para/pres.

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33
Q

T4

-dermatome?

A

nipple

-“teat pore”

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34
Q

T10

-dermatome?

A

umbilicus

  • belly but-ten.
  • important for early appendicitis pain referall.
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35
Q

L1

-dermatome?

A

inguindal ligament

-L1 = IL

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36
Q

Kneecaps

-dermatome?

A

L4

Down on ALL 4’s (L4).

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37
Q

Erection and sensation of penile and anal zones.

  • aka the good stuff.
  • dermatome?
A

S2, S3, S4

-“S2, 3, 4 keep the penis off the floor.”

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38
Q

About what level is the diaphragm?

A

nipple line

-T4

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39
Q

Achilles reflex

A

S1, 2—“buckle my shoe”

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40
Q

Patellar reflex

A

L3, 4—“kick the door”

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41
Q

Biceps reflex

A

C5, 6—“pick up sticks”

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42
Q

Triceps reflex

A

C7, 8—“lay them straight”

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43
Q

Cremaster reflex

A

L1, L2—“testicles move”

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44
Q

Anal wink reflex

A

S3, S4—“winks galore”

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45
Q

Primitive reflexes

  • disappear by what age?
  • inhibited by what part of the brain?
  • why would they re-emerge?
A
  • 1 year old
  • frontal lobe
  • frontal lobe lesion
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46
Q

Galant reflex

A

Stroking along one side of the spine while newborn is in ventral suspension (face down) causes lateral flexion of lower body toward stimulated side.

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47
Q

Which CNs lie medially at brainstem

  • what do they have in common?
  • mnemonic?
A

Purely motor CNs leave medially from brainstem.
-CN 3, 6, 12

  • 3*2 = 6
  • 6*2 = 12
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48
Q

Which is the only CN that arises from dorsal aspect of brainstem?

A

trochlear

-also the only one that decussates before innervating target (sup. oblique).

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49
Q

sup/inf colliculi

  • which one is visual/auditory?
  • mnemonic?
A

Your eyes are above your ears, and the superior

colliculus (visual) is above the inferior colliculus (auditory).

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50
Q

Whats the only CN you cant get a schwannoma on?

A

CN2

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51
Q

Cranial nerves

-CNS or PNS?

A

PNS

-except CN2

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52
Q

Only CN w/o thalamic relay to cortex?

A

olfaction, CN1

53
Q

What inn. muscles of mastication?

A

CN 5

54
Q

what inn. lacrimation & salivation (submandibular & sublingual).

A

CN 7

55
Q

what inn. eyelids closing (orbicularis oculi)

A

CN 7

56
Q

CN 9

-whats the only muscle it innervates?

A

stylopharyngeus

-its “style” is one of a kind.

57
Q

what inn. parotid gland?

A

CN 9

58
Q

which nerve keeps uvula midline?

A

vagus n.

59
Q

CN 12

-inn. all intrinsic tongue muscles except:

A

palatoglossus (CN 10)

60
Q

Which intrinsic tongue muscle does CN 10 innervate?

A

palatoglossus

61
Q

what portion of brainstem are cranial nerve nuclei located?

A

tegmentum portion of brain stem

62
Q

Midbrain—nuclei of which CNs?

A

CN III, IV

63
Q

Pons—nuclei of which CNs?

A

CN V, VI, VII, VIII

64
Q

Medulla—nuclei of which CNs?

A

CN IX, X, XII

65
Q

Spinal cord—nucleus of which CNs?

A

CN XI

66
Q

Corneal reflex

  • afferent =
  • efferent =
A
  • afferent = V1 (ophthalmic)

- efferent = CN 7

67
Q

Lacrimation

  • afferent =
  • efferent =
A
  • afferent = V1 (ophthalmic)
  • loss of reflex does not preclude emotional tears.
  • efferent = CN 7
68
Q

Jaw Jerk

  • afferent =
  • efferent =
A
  • afferent = V3 (sensory—muscle spindle from masseter)

- efferent = V3 (motor—masseter)

69
Q

Pupillary reflex

  • afferent =
  • efferent =
A
  • afferent = CN 2

- efferent = CN 3

70
Q

Gag reflex

  • afferent =
  • efferent =
A
  • afferent = CN 9

- efferent = CN 10

71
Q

viral meningitis

-CSF: glucose, protein levels

A
  • normal glucose

- high protein

72
Q

Clasp knife spasticity

-UMN or LMN lesion?

A

UMN lesion

73
Q

Damage to external globus pallidus

-Sxs:

A

dec. movement

74
Q

Damage to internal globus pallidus

-Sxs:

A

inc. movement

75
Q

Basal nucleus of meynert

-what type of neurons

A

Houses the cell bodies of cholinergic neurons.

-ACh

76
Q

Who should obtain the informed consent?

A

The person performing the procedure!

77
Q

Which type of headache has pain behind the eye?

A

cluster headache

78
Q

Which type of headache has flushing, sweating, lacrimation, pupillary changes?

A

cluster headache

79
Q

Which type of headache is unilateral?

A

migraine

80
Q

Cluster headache

  • more common in men or women?
  • when do they usually occur?
  • Tx:
A
  • 7x more common in men.
  • at night, few hours after going to bed.
  • oxygen, sumatriptan
81
Q

Why is halothane rarely used in adults?

A

severely hepatotoxic

-can cause massive hepatic necrosis.

82
Q

Alzheimers

-whats the chemical imbalance?

A

dec ACh

83
Q

memantine

  • what is it?
  • what disease is it used for?
A

NMDA receptor antagonist

-used in alzheimers

84
Q

uncus =

uncal herniation =

A
  • uncus = medial temporal lobe

- uncal herniation = medial temporal lobe herniating through the tentorium cerebelli

85
Q

First sign of uncal herniation?

A

ipsilateral fixed and dilated pupil.

86
Q

What Sx is pathognomic for PCP intox?

A

vertical & horizontal nystagmus

87
Q

paraneoplastic subacute cerebellar degeneration:

  • which cells targeted?
  • after which cancers?
A 
-purkinje cells (output cells of cerebellum)
small cell carcinoma of lung
breast
ovarian
uterine
88
Q

Trigeminal nerve

  • which cranial foramina do each exit?
  • mnemonic?
A

Divisions of CN V exit owing to Standing Room Only.

  • Ophthalmic (V1) = Superior orbital fissure
  • Maxillary (V2) = foramen rotundum
  • Mandibular (V3) = foramen ovale
89
Q

Optic canal

-what goes thru?

A

-CN II, ophthalmic artery, central retinal vein.

90
Q

Superior orbital fissure

-what goes thru?

A
  • CN 3, 4, 5 (V1), 6
  • ophthalmic vein
  • sympathetic fibers
91
Q

Foramen spinosum

-what goes thru?

A
  • middle meningeal artery

* this is whats ruptured in epidural hematoma.

92
Q

Internal auditory meatus

-what goes thru?

A

CN VII, VIII

93
Q

Jugular foramen

-what goes thru?

A

-CN IX, X, XI, jugular vein.

94
Q

Foramen magnum)

-what goes thru?

A

-spinal roots of CN XI, brain stem, vertebral arteries.

95
Q

What drains into the cavernous sinus?

A

Blood from eye & superficial cortex.

96
Q

What passes thru the cavernous sinus?

A

CN III, IV, V1, V2, and VI and postganglionic sympathetic fibers en route to the orbit all pass through the cavernous sinus.
*3, 4, 6 all control eye movement.

97
Q

Cavernous sinus syndrome

A

(e.g., due to mass effect, fistula, thrombosis)—ophthalmoplegia and  corneal and maxillary sensation with normal visual acuity. CN VI commonly affected.

98
Q

CN V motor lesion

-does jaw deivate toward or away from lesion?

A
  • Toward lesion

- Jaw deviates toward side of lesion due to unopposed force from the opposite pterygoid muscle.

99
Q

CN X lesion

-does uvula point toward or away from lesion?

A

-away from lesion

Uvula deviates away from side of lesion. Weak side collapses and uvula points away.

100
Q

CN XI lesion

  • shoulder drop on which side?
  • troubling turning head to which side?
A
  • Shoulder drop on side of lesion (ipsi).

- Weakness turning head to contralateral side of lesion.

101
Q

CN XII lesion (LMN)

  • which way does tongue point?
  • mnemonic?
A
  • Tongue deviates toward side of lesion.

- “lick your wounds”

102
Q

Middle ear

-air or fluid filled?

A

-air filled

103
Q

Auditory nerve signaling goes to what brain structure?

A

brainstem

104
Q

Hearing thru bone conduction is abnormal, where must the disease process be?
-external, middle, or inner ear?

A

inner ear

105
Q

Pts w/sensorineural hearing loss

  • normal or abnormal rinne test?
  • where will weber test localize?
A
  • normal

- weber localizes to unaffected ear.

106
Q

Pts w/conductive hearing loss?

  • normal or abnormal rinne test?
  • where will weber test localize?
A
  • abnormal rinne test (bone>air).
  • weber localizes to the AFFECTED ear.

*affected ear won’t be hearing background noise from outside (bc you have conductive hearing loss) so the bone sound will sound louder there.

107
Q

Facial UMN lesion

  • ipsi or contra?
  • is any part spared?
A
  • contralateral paralysis

- forehead spared due to bilateral UMN inn.

108
Q

Facial LMN lesion

  • ipsi or contra?
  • is any part spared?
A
  • ipsi paralysis

- nope, nothing spared.

109
Q

Facial nerve palsy

  • wheres the lesion?
  • are Sxs ipsi or contra?
A
  • facial nucleus or facial nerve (so its a LMN lesion).
  • ipsilateral.

*inability to close eye on affected side.

110
Q

Bell’s Palsy

-associated w/

A
  • Lyme disease
  • herpes simplex
  • herpes zoster
  • sarcoidosis
  • tumors
  • diabetes.
111
Q

Corticobulbar tract

A

-a 2 neuron pathway connecting the cerebral cortex to the brainstem.
-primarily involved in carrying the motor function of the
non-oculomotor cranial nerves, like CN 7 for example.
-its one of the pyramidal tracts,in addition to corticospinal
tract.

112
Q

Which muscles close jaw?

-mnemonic?

A

3 muscles close jaw: Masseter, teMporalis, Medial pterygoid.

-M’s Munch.

113
Q

Which muscles open jaw?

-mnemonic

A
  • lateral pterygoid.

- Lateral Lowers

114
Q

Which nerve innervates all muscles of mastication?

A

V3

115
Q

neurofibromatosis

-derived from what?

A

neural crest cells

116
Q

Whats the most frequent CNS tumor in an immunosuppressed pt?

A

Primary CNS lymphoma

117
Q

Why are prostaglandins used in glaucoma?

A

they inc. outflow of aqeuous humor

-ie. latanoprost

118
Q

Latanoprost

  • use?
  • s/e:
A
  • inc. aqueous drainage in glaucoma.

- darkens color of iris (browning)

119
Q

neurofibromas are tumors of what cells which are derived from what tissue?

A

schwann cells (derived from neural crest)

120
Q

Area postrema

  • aka?
  • location?
  • is there BBB?
A
  • chemoreceptor trigger zone (CTZ)
  • dorsal medulla
  • no BBB - it has fenestrated caps.
121
Q

Myelination: will it increase or decrease:

-length constant:

A
  • increase

* length constant = how far can an impulse travel w/o being dissipated, so of course myelin will lengthen that.

122
Q

Myelination: will it inc or dec:

-time constant:

A
  • decrease
  • time constant = how fast a membrane can be depolarized. Myelin decreases membrane capacitance which reduces the time constant.
123
Q

Myelination: will it inc. or dec:

-membrane capacitance:

A

decrease

124
Q

Myelination: will it inc or dec:

-membrane resistance:

A

increase

125
Q

Length constant

-what is it?

A

How far down an axon an electrical impulse can propogate.

-myelination increases it.

126
Q

Blood in sulci & cisterns on CT

-what type of bleed?

A

subarachnoid hemorrhage

127
Q

Where is the first area damaged in global cerebral ischemia?

A

hippocampus

-pyramidal cells

128
Q

H1 vs H2

  • which is gastric one?
  • whats suffix?
A

H2

-“tidine”

129
Q

chlorpheniramine

-what is it?

A

1st gen H1 blocker

Final FA review (52 decks)

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