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Neuro 2 Flashcards

1
Q

What neurons [4 locations] are involved in discriminitive touch/proprioception/vibration pathway?

A

posterior root ganglia, nucleus gracilis/cuneatus, VPL thalamus, postecentral gyrus

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2
Q

Where does the posterior column/medial lemniscus pathway decussate?

A

rostral medulla [internal arcuate fibers]

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3
Q

Signs of injury to posterior columns in spinal cord?

A

IL loss of discriminitive touch, proprioception and vibration

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4
Q

Signs of injury to medial lemniscus?

A

CL loss of discriminitive touch, proprioception and vibration

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5
Q

What is the Romberg test?

A

test of proprioceptive function [NOT cerebellum]; pt stands upright with arms abducted eyes open vs. eyes closed

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6
Q

What indicates a positive Romberg test indicate?

A

a marked difference in the ability to maintain erect posture with eyes open vs. eyes closed = + Romberg

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7
Q

What does a Romberg test look like in someone with cerebellar injury?

A

with cerebellar injury, pt cannot stand up even with eyes open - DON’T DO A ROMBERG TEST in a pt with cerebellar injury

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8
Q

Neurons [4 locations] in pain/temperature pathway?

A

posterior root ganglia, posterior horn, VPL thalamus, postcentral gyrus

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9
Q

Where does the spinothalamic tract decussate?

A

anterior white commissure, spinal cord, all levels

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10
Q

Deficits in syringomyelia?

A

BL dermatomal loss of pain and temperature [usually upper limbs]

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11
Q

Cause and signs of Dejerine-Roussy syndrome?

A

Extreme hypersensitivity to painful stimuli following posterior thalamic infarct

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12
Q

What is the function of lower motor neurons?

A

innervate skeletal muscle

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13
Q

Location of lower motor neurons?

A

spinal cord + motor cranial nerve nuclei (III, IV, V, VI, VII, IX, X, XI, XII)

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14
Q

Location of upper motor neurons?

A

cerebral cortex, red nucleus, reticular formation

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15
Q

Signs of injury to Upper Motor Neuron (UMN)?

A

hemiparesis, increase muscle stretch reflexes [hyper-reflexia], spasticity, clonus + Babinski sign, Hoffman sign

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16
Q

Lower motor neuron (LMN) signs?

A

paralysis, decreased muscles stretch reflexes [hyporeflexia], flaccid tone, atrophy

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17
Q

Motor tracts in the posterior limb of the internal capsule?

A

corticospinal [upper limb, trunk, lower limb]

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18
Q

What is spasticity?

A

a velocity-dependant increase in muscle tone [injury to UMNs]

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19
Q

What is rigidity?

A

a velocity-independant increase in muscle tone [damage to Basal Nuclei structures]

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20
Q

The corticospinal tract decussates at what level?

A

pyramidal decussation, caudal medulla

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21
Q

Motor tracts in the genu of the internal capsule?

A

corticobulbar [to cranial nerve nuclei]

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22
Q

Signs of injury to the corticospinal tract in the right internal capsule?

A

left, UMN signs

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23
Q

Signs of injury to the corticospinal tract in cervical spinal cord on the right?

A

right, UMN signs

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24
Q

Signs of injury to the corticobulbar tract in the right internal capsule?

A

left, lower facial paralysis; tongue points away from lesion

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25
Q

Location of lesion in decorticate posturing?

A

rostral midbrain or thalamus - red nucleus intact

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26
Q

Location of lesion in decerebrate posturing?

A

midbrain - damage involving red nucleus or rubrospinal tract

27
Q

Signs of myopathy?

A

proximal symmetric weakness, no sensory loss

28
Q

What are the 2 most common causes of peripheral neuropathies?

A

diabetes, alcoholism

29
Q

Signs of polyneuropathy?

A

stocking/glove sensory loss

30
Q

Neurons in auditory pathway [at least 6]?

A

spiral ganglion, cochlear nucleus, superior olive, inferior colliculus, medial geniculate, primary auditory cortex

31
Q

Result of Rinne test in normal ear?

A

air conduction > bone conduction

32
Q

Result of Rinne test in conductive hearing loss?

A

air conduction < bone conduction

33
Q

Result of Rinne test in sensorineuronal hearing loss?

A

air conduction > bone conduction

34
Q

Result of Weber test in normal hearing?

A

localize to midline

35
Q

Result of Weber test with sensorineuronal hearing loss in R ear?

A

localize to left

36
Q

Result of Weber test with conductive hearing loss R ear?

A

localize to right [You can verify this by sticking your finger in your ear and performing the Weber test on yourself.]

37
Q

Deficits with injury to CN VIII?

A

IL deafness, dizziness, CL nystagmus

38
Q

Deficits with injury to brainstem auditory pathways?

A

bilateral hearing loss

39
Q

What is presbycusis?

A

age-related hearing loss, high frequencies lost first

40
Q

Neurons in visual pathway [3 neurons]?

A

retinal ganglion cells, lateral geniculate, primary visual cortex

41
Q

Signs of injury to optic nerve/retina?

A

IL visual loss, can affect both temporal and nasal hemifield

42
Q

Signs of injury to optic chiasm?

A

bitemporal hemianopsia

43
Q

Signs of injury to optic tract?

A

contralateral homonymous hemianopsia

44
Q

Signs of injury to Meyer’s loop?

A

upper quadrant homonymous hemianopsia

45
Q

Visual deficits in PCA stroke affecting calcarine sulcus?

A

contralateral homonymous hemianopsia, with macular sparring

46
Q

What is Marcus Gunn pupil?

A

optic nerve lesion, when light is shown into bad eye, pupil dilates (bad retina = no light)

47
Q

What structures comprise the basal ganglia [nuclei]?

A

caudate, putamen, globus pallidus, subthalamic nucleus, basal nucleus of Meynert

48
Q

Brain region affected in Parkinson disease?

A

substantia nigra, pars compacta [dopamine]

49
Q

Signs of Parkinson disease?

A

bradykinesia, pill-rolling tremor, masked facies, postural instability

50
Q

Pathological sign of Parkinson disease?

A

Loss of dopaminergic neurons in SN + Lewy bodies in SN

51
Q

Brain region affected in Huntington disease?

A

caudate nucleus

52
Q

Signs of Huntington disease?

A

choreioform movements, dementia

53
Q

Brain region injured in right hemiballismus?

A

left subthalamic nucleus

54
Q

Signs of essential tremor?

A

chronic, progressive tremor in arms, neck, larynx, chin; reduced with alcohol consumption

55
Q

What is Wilson disease?

A

inborn error of copper metabolism; Kayser-Fleischer rings; wing-beating tremor, rigidity

56
Q

What are signs of cerebellar injury?

A

ataxia, dysmetria, dysdiadokinesia, nystagmus, dysarthria

57
Q

Signs of injury to vestibulocerebellum (flocculonodular lobe)?

A

truncal ataxia, nystagmus

58
Q

Signs of injury to lateral hemisphere of cerebellum?

A

IL limb ataxia, intention tremor, dysarthria

59
Q

Signs of injury to middle cerebellar peduncle?

A

IL limb ataxia

60
Q

Results of caloric testing in normal individual?

A

COWS - cold = nystagmus to opposite side; warm = nystagmus to same side

61
Q

Signs of Arnold-Chiari I malformation?

A

extension of cerebellar tonsil below foramen magnum

62
Q

Signs of Arnold-Chiari II malformation?

A

displaced vermis + myelomeningiocele

63
Q

Signs of Dandy-Walker?

A

enlarged posterior fossa, small cerebellum, absent vermis, cystic dilation of 4th ventricle, hydrocephalus

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