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Flashcards in CHAPTER: Neuro Deck (62):
1

Where is ACh made - diseases with altered levels

Basal nucleus Meyner
↓ - Alz

2

Where is dopamine made - diseases w/ altered levels

Ventral tegmentum, substantia nigra pars compacta
↑ Schizo, Huntington
↓ Park

3

Where is GABA made - diseases w/ altered levels

Nucleus accumbens
↓Anxiety

4

Where is NE made - diseases w/ altered levels

Locus ceruleus
↑ Anxiety
↓ Depression

5

Where is serotonin made - diseases w/ altered levels

Raphe nucleus
↓ Anxiety, depression

6

Which neural tube defect is unique because it has normal AFP?

Spina bifida occulta

7

Patau syndrome (trisomy 13) and fetal alcohol syndrome both present with what forebrain abnormality

Holopros (SHH)

8

Describe the 3 areas that syringomyelia can compress aka presentation

1. Ant white comm - bilat pain + temp
Keep fine touch
2. Ant horn invasion - LE muscle atrophy + ↓reflexes
3. Lat hypothalamospinal tract = Horners
Associated with Chiari 1

9

Sensory innervation of the 3 parts of the tongue

Ant 2/3
1. CN 5(1) via chorda tympani = sensation
2. CN 7 = taste
Post 1/3 = CN 9
All way back = CN 10

10

Motor innervation of the tongue

CN 10 = back to raise the tongue (say ah)
CN 12 = all other muscles (wiggle tongue s2s)

11

Fxns astrocytes + stain

BBB + reactive gliosis to injury
Remove excess NT
K metab
Glycogen fuel reserve - so brain can use glucose as long as it can
GFAP + // neuroectoderm

12

Appearance of HIV infected microglia

Multinucleated giant cells in CNS

13

What is space vs time constants

Space = length = ↓LC means lose more charge as you go down axon
Time = ↓TC = ↑conduction (demyelin ↑TC)

14

Histo of oligodendrocytes

Fried egg
Perinuclear halos

15

What 2 nerves serve as pain + temp @ skin

1. C = slow, unmyelin (dull, lasting pain)
2. A delta = fast, myelin

16

Where are Meissner's corpuscles - signals they transmit

Hairless skin
Fine touch + position sense
Large, myelinated

17

Where are Pacinican corpuscles - signals they transmit

Large myelin - vibration + P
Joints, deep skin

18

Where are Merkel discs - what signals do they transmit

Superficial skin, fingers
Large myelin - P, deep touch, position

19

Where are Ruffini corpuscles - what signals do they transmit

Fingers + joints
Dendritic endings that adapt slowly
Slipping of objects (holding something)
Joint angle change

20

What part of the nerve does inflam GB attack

Endoneurium - surrounds 1 individual nerve fiber
Vs peri = fasicle
Vs epi = entire nerve

21

How does an infarct change the BBB

X endothelial tight junctions = layer that faces blood
Vasogenic edema

22

Which hypothalamic nuc makes ADH vs oxytocin

ADH from supraoptic nuc
Oxytocin from paravent nuc

23

What happens if you damage the lateral or VM hypothalamic nuc

Lat ↑s hunger - damage = shrink laterally
Lose hypocretin neurons in lat hypothal -> narcolepsy
VM ↑satiety - damage = grow ventrally + medally
Think how grehlin (hunger) and leptin (satiety from fat) affects these two areas at baseline

24

Fxns of ant vs post hypothalamus

Ant: cool + para (A/C please!)
Post = heat + sympa

25

Pathway to releasing melatonin vs serotonin - what does each do for the sleep cycle?

Suprachiasmatic nucleus (hypothal) -> NE
Binds pineal gland -> melatonin (drowsiness)
Vs dorsal raphe -> serotonin (initiating sleep)

26

6 stages of the sleep cycle and impt events in each

1. Awake + eyes open = beta = ↑freq, ↓amp
2. Awake + eyes closed = alpha
3. Light sleep = theta
4. Sleep spindles (short jagged bursts) + K complexes
5. Delta = ↑amp, ↓freq - sleep walking, night tremors, bed wetting
6. REM = beta = ↑ACh = paradoxical sleep = no motor tone, ↑brain O2 use, dreaming/nightmares, memory processing, sex

27

What area of the brain controls the conjugate gaze during REM?

Paramedian pontine reticular formation

28

Which thalamic nucleus sends input to the motor cortex?

VL
Vs VPL + VML -> somatosensory

29

Famous 5 fxns of the limbic system

Mam bodies + fornix + hippo + amyg + hypothalamus + cingulate gyrus
Feeding
Fleeing
Fighting
Feeling
Fucking = sex

30

Fxn of the mesocortical and mesolimbic pathways - what disease are the pathways symptomatic for?

SCHIZO - dopamine pathways
Mesocortical = ↓activity = neg symptoms
VTA -> prefrontal cortex
Mesolimbic = ↑activity = positive symp
Better pharm target: VTA -> nuc accumb

31

3 nuclei of the cerebellum

Dentate
Interposed = globose + emboliform
Fastigial

32

Lesion of the lateral cerebullem causes what

Fall towards injured side = ipsi

33

Describe the excitatory vs inhibitory pathway in basal ganglia to ↑motion

1. Excite = D1 = ↑motion
2. Inhibitory = D2 binds to inhibit the inhibitory path
Net ↑motion

34

Aphasia with damage to articulate fasiculus (connector)

Conduction aphasia
"1, 2, 3, boy, 6, dog, 8, 12, peanut"
But pt knows this is wrong - often get fustrated

35

What happens if you areas around Broca + Wernicke are damage but these sites are spared (3 types of aphasia)

1. Transcortical motor = spare Broca which closer to motor cortex = nonfluent
2. Transcortical sensory = spare W which closer to sensory cortex = impaired comprehension
3. Mixed = nonfluent + impaired comp

36

Disease + presentation of amygdala damage

HSV 1 encephalitis
Disinhibition: food, sex, big mouth
Amygdala normally uses fear to control impulses

37

What area of the brain is damaged + presentation of Wernicke Korsakoff

Bilat mamm bodies
1. Confusion // memory loss
2. Ataxia
3. Horizontal nystagmus
B1 def - alcoholics

38

Cause of a Charcot Bouchard microaneurysm + the hem it causes if rupture

Chronic HTN -> intracerebral hemm

39

Describe what symptoms a large aneurysm of the ant + post comm arteries could cause (if don't rupture to cause subarach hemm)

Ant comm - bitemporal hemianopia
Post comm - ipsi CN 3 palsy (down + out, blown pup)

40

What is central post stroke pain syndrome?

If injury thalamus in stroke - ↑pain sensation on the CL side from stroke (same a how the sensory would change)

41

Complication of untreated subarach hemm

Hydrocephalus

42

What are the 4 areas of brain most vulnerable to hypoxic injury

Hypoxic signs 5 mins post-stroke
#1 = hippocampus
Cortex
Cerebellum
Watershed

43

Describe the type of infarct you'd see in a thrombotic vs embolic stroke?

Thrombotic = pale infarct @ peripheral cortex
Embolic = hemm infarct " "

44

Walk through ventricular system

Lat vent
Monro
3rd
Aqueduct
4th
Central canal - lateral Luschka - medial Magendie

45

Main complication of normal pressure hydrocephalus that ↓fxn micturition centers

Stretching corona radiata causes:
"Wet, whacky, wobbly"
Reversible cause of dementia

46

Does a slipped disc affect the nerve root above or below it?

BELOW

47

Spinal cord lesion presenting with:
1. Floppy baby (hypotonia) + tongue fasiculations
2. Only LMN signs

Degen ant horn (where UMN synpases onto LMN)
1. Werdnig Hoffman disease = AR, symmetric weakness
2. Polio = asymmetric weakness

48

Spinal cord lesion presenting with: combo U+LMN w/o sensory or bladder/bowel defects
UMN: spastic + hyperreflexia
LMN: muscle weak, atrophy, fasiculations

ALS
Lose 1. ant horn (LMN) + 2. lateral corticospinal (UMN coming down)
Defective SOD
Treat: riluzole

49

Symptoms if you completely occlude the ant spinal artery

Lose all white matter before horns and all horns
X pain, temp // weakness
Intact sensory b/c dorsal columns spased
Most susceptible above T8 b/c no collat BF

50

Spinal cord lesion presenting with: X vibration or position sense -> poor coordination -> ataxia
No DTRs, + Romberg

Tabes dorsalis
Could have present this if gives pen G for syph early
+ Charcot joints, prostitute pupils

51

Neuro presentation of B12 def

Subacute combined degen
Demyelin:
1. Spinocerebellar - ataxia
2. Corticospinal - parasthesia
3. Dorsal columns - X position, vibration

52

What is Parinaud syndrome

Lesion in superior colliculus (brain stem) - stroke, hydrocephalus, pinealoma
Eyes can't to veritcal gaze together

53

Name the 2 auditory centers in the brain

MGN + inf colliculi

54

Primitive reflexes may return with a lesion to what part of the brain? Name the reflexes

Frontal lobe lesion
Moro, rooting, sucking, palmar, plantar
Galant - face down, stroke spike, LE go to that side

55

Describe all the actions of trigeminal CN 5

Each branch covers part of FACE SENSATION
V1 - opthalmic
V2 - maxillary - sensory ant 2/3 tongue, muscle of mastication
V3 - mandibular - tensor tympani to dampen sound, muscle mastication, muscles floor mouth

56

All actions of CN 7 facial

Motor to muscles facial expression
Taste ant 2/3 (vs CN 5, 2 sensory from same area)
Lacrimation
Salivation - submand + subling (parotid CN 9)
Close eye lid
Change volume via stapedius
Ipsi Bell's palsy if injured

57

What are the fxns of the 3 vagal nuclei:
1. Nucleus solitarius
2. Nucleus ambiguus
3. Dorsal motor nucleus

1. Sensory from int organs - taste, gut distention (CN7, 9, 10)
2. Motor innervation for swallowing + palate (CN 9-11)
3. Parasympa to heart, lungs, GI

58

Ipsi or contra for lesion to :
CN 5
CN 10
CN 11
CN 12

POINTS TO:
5 - jaw ipsi
10 - uvula contra
11 - shoulder droop on ipsi
12 - tongue ipsi

59

What is the presentation if you damage an UMN vs LMN of the facial nerve

UMN - CL lower muscles facial express paralyzed, forehead spared
Damage is between the motor cortex -> facial nucleus in pons
LMN - ipsi Bell's palsy: lose all muscle facial express, things sound loud, lose taste on ant half of tongue on that side

60

Which CNs run in the cavernous sinus? Which runs with the internal carotid art? Which is most likely to get injured if cavernous sinus syndrome?

3, 4, 5 (1), 6 - sometimes 5 (2)
5 (1) runs with ICA branch
4 at ↑est injury risk
Cavernous sinus syndrome: opthamopledia, ↓corneal sensation (no V1 afferent of reflex arch)

61

Describe noise induced hearing loss

Damage hair cells in organ of Corti
Lose high freq hearing 1st
Vs 1 time very loud noise (bomb) - tympanic membrane rupture

62

Describe R + W test findings for conductive vs SN hearing loss

SN: normal R (duh), W on forehead localizes to normal ear
C: abnormal R, W to the affected ear - all the tests go to the bad ear!!!