Neuro- 28A

Question 1

The four functions of the thalamus

Answer 1

• sensory relay
  - except for olfaction
  - preconscious perception of crude pain
• motor feedback relay
  - from the basal ganglia & cerebellum
  - nuanced and accurate control of movement
• reticular activating system array
• limbic relay- mammillary bodies to cingulate gyrus

Question 2

The job of the hypothalamus

Answer 2

• detector and controller of basic drives

- thirst, hunger, sex, temperature, circadian rhythm (SCN)

Question 3

Types of responses by the hypothalamus to maintain homeostasis

Answer 3

• neuroendocrine: control of the pituitary gland

- neurological: connections to limbic system and ANS

Question 4

Connect the hypothalamic hormone to pituitary hormone release

• corticotropin-releasing hormone
• gonadotropin-releasing hormone
• growth hormone-releasing hormone
• thyrotropin-releasing hormone

Answer 4

• adrenocorticotropic hormone ACTH
• FSH & LH
• GH
• TSH & Prolactin

Question 5

Which hypothalamic hormones are released from the posterior pituitary

Answer 5

• oxytocin

- vasopressin/ADH

Question 6

What is prolactin inhibiting hormone?

Answer 6

-dopamine: inhibits prolactin release

Question 7

What is Sheehan’s syndrome?

Answer 7

-postpartum anterior hypopituitarism

Question 8

Match the hormone deficiency with symptom

• cold intolerance
• polydipsia and polyuria
• erectile dysfunction with decreased testicular volume
• fatigue and anorexia

Answer 8

• TSH
• ADH
• LH/FSH
• TSH or ACTH

Question 9

What is Foster Kennedy Syndrome

Answer 9

Tumor that

• compresses one optic nerve- unilateral visual field loss
• increases intracranial pressure- papilledema in opposite eye (ICP)
• places pressure on olfactory bulb- anosmia

Question 10

Causes of anosmia

Answer 10

• tumors of the frontal lobe
• meningitis
• trauma

Question 11

Describe visual anatomy from eyes to visual cortex

Answer 11

optic nerves
=========optic chiasm================================
optic tracts
=======================lateral genicuate nuclei=========
optic radiations

Question 12

What is the thalamic relay for the optic tract?

Answer 12

lateral geniculate nucleus

Question 13

2 common causes of optic neuritis (visual loss)

Answer 13

• multiple sclerosis (adults)

- conversion disorder (adolescents)

Question 14

Match visual symptom with level of lesion:

• unilateral visual field loss
• bitemporal hemianopsia
• homonomous hemianopsia
• homonymous quandrantanopsia

Answer 14

• optic nerve (ipsilateral)
• optic chiasm
• optic tract (contralateral)
• optic radiations (contralateral)

Question 15

Which cranial nerves are responsible for extraocular movements?

Answer 15

-Cranial nerves 3 (medial), 4 (inferior), 6 (lateral)

Question 16

Characteristics of 3rd Nerve Palsy

Answer 16

“Third nerve palsy leaves you
BIG (dilated pupil)
DOWN (ipsilateral lid ptosis) &
OUT (abducted/pulled to the side)”

Question 17

Emergencies to consider with acute third nerve palsy

Answer 17

• ischemic stroke

- compression: aneurysm, herniation (between the posterior and superior cerebral artery)

Question 18

Signs of third nerve palsy with contralateral hemiparesis is indication of

Answer 18

-MIDBRAIN INFARCT (at level of cerebral peduncle)

Question 19

Characteristics of fourth nerve palsy

Answer 19

-head tilted away from the lesion to minimize diplopia
-diplopia is worse with reading or walking down stairs
“My neck is sore from cranial nerve 4”

Question 20

Characteristics of sixth nerve palsy

Answer 20

-limited abduction on the ipsilateral side (diplopia present upon ipsilateral lateral gaze)

Question 21

Signs of sixth nerve palsy with contralateral hemiparesis

Answer 21

-PONTINE INFARCT (at level of middle cerebellar peduncles)

Question 22

What is the clinical trial of Horner’s Syndrome

Answer 22

-miosis, ptosis, anhydrosis

Question 23

What is the other name for Horner’s Syndrome

Answer 23

-Oculosympathetic Paresis

Question 24

What is the concern about Horner’s Syndrome

Answer 24

• disruption of sympathetic innervation ipsilateral to signs
• etiologies (EXAM)
  
  • Pancoast tumor
  • internal carotid artery dissection

Question 25

Important step in the identification of Horner’s Syndrome

Answer 25

MRI/MRA of the head and neck