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LCK STEP > CHAPTER: Neuro > Flashcards

CHAPTER: Neuro Flashcards

1
Q

Where is ACh made - diseases with altered levels

A

Basal nucleus Meyner

↓ - Alz

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2
Q

Where is dopamine made - diseases w/ altered levels

A

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

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3
Q

Where is GABA made - diseases w/ altered levels

A

Nucleus accumbens

↓Anxiety

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4
Q

Where is NE made - diseases w/ altered levels

A

Locus ceruleus
↑ Anxiety
↓ Depression

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5
Q

Where is serotonin made - diseases w/ altered levels

A

Raphe nucleus

↓ Anxiety, depression

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6
Q

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

A

Spina bifida occulta

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7
Q

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

A

Holopros (SHH)

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8
Q

Describe the 3 areas that syringomyelia can compress aka presentation

A 
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
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9
Q

Sensory innervation of the 3 parts of the tongue

A 
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
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10
Q

Motor innervation of the tongue

A

CN 10 = back to raise the tongue (say ah)

CN 12 = all other muscles (wiggle tongue s2s)

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11
Q

Fxns astrocytes + stain

A 
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
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12
Q

Appearance of HIV infected microglia

A

Multinucleated giant cells in CNS

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13
Q

What is space vs time constants

A 
Space = length = ↓LC means lose more charge as you go down axon
Time = ↓TC = ↑conduction (demyelin ↑TC)
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14
Q

Histo of oligodendrocytes

A

Fried egg

Perinuclear halos

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15
Q

What 2 nerves serve as pain + temp @ skin

A
  1. C = slow, unmyelin (dull, lasting pain)

2. A delta = fast, myelin

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16
Q

Where are Meissner’s corpuscles - signals they transmit

A

Hairless skin
Fine touch + position sense
Large, myelinated

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17
Q

Where are Pacinican corpuscles - signals they transmit

A

Large myelin - vibration + P

Joints, deep skin

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18
Q

Where are Merkel discs - what signals do they transmit

A

Superficial skin, fingers

Large myelin - P, deep touch, position

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19
Q

Where are Ruffini corpuscles - what signals do they transmit

A

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

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20
Q

What part of the nerve does inflam GB attack

A

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

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21
Q

How does an infarct change the BBB

A

X endothelial tight junctions = layer that faces blood

Vasogenic edema

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22
Q

Which hypothalamic nuc makes ADH vs oxytocin

A

ADH from supraoptic nuc

Oxytocin from paravent nuc

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23
Q

What happens if you damage the lateral or VM hypothalamic nuc

A

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

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24
Q

Fxns of ant vs post hypothalamus

A

Ant: cool + para (A/C please!)

Post = heat + sympa

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25
Q

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

A 
Suprachiasmatic nucleus (hypothal) -> NE 
Binds pineal gland -> melatonin (drowsiness)
Vs dorsal raphe -> serotonin (initiating sleep)
26
Q

6 stages of the sleep cycle and impt events in each

A
  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
Q

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

A

Paramedian pontine reticular formation

28
Q

Which thalamic nucleus sends input to the motor cortex?

A

VL

Vs VPL + VML -> somatosensory

29
Q

Famous 5 fxns of the limbic system

A 
Mam bodies + fornix + hippo + amyg + hypothalamus + cingulate gyrus
Feeding
Fleeing
Fighting
Feeling
Fucking = sex
30
Q

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

A 
SCHIZO - dopamine pathways
Mesocortical = ↓activity = neg symptoms
VTA -> prefrontal cortex
Mesolimbic = ↑activity = positive symp
Better pharm target: VTA -> nuc accumb
31
Q

3 nuclei of the cerebellum

A

Dentate
Interposed = globose + emboliform
Fastigial

32
Q

Lesion of the lateral cerebullem causes what

A

Fall towards injured side = ipsi

33
Q

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

A
  1. Excite = D1 = ↑motion
  2. Inhibitory = D2 binds to inhibit the inhibitory path
    Net ↑motion
34
Q

Aphasia with damage to articulate fasiculus (connector)

A

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

35
Q

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

A
  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
Q

Disease + presentation of amygdala damage

A

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

37
Q

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

A 
Bilat mamm bodies 
1. Confusion // memory loss
2. Ataxia
3. Horizontal nystagmus
B1 def - alcoholics
38
Q

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

A

Chronic HTN -> intracerebral hemm

39
Q

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

A

Ant comm - bitemporal hemianopia

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

40
Q

What is central post stroke pain syndrome?

A

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

41
Q

Complication of untreated subarach hemm

A

Hydrocephalus

42
Q

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

A 
Hypoxic signs 5 mins post-stroke 
#1 = hippocampus
Cortex
Cerebellum
Watershed
43
Q

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

A 
Thrombotic = pale infarct @ peripheral cortex
Embolic = hemm infarct " "
44
Q

Walk through ventricular system

A 
Lat vent
Monro
3rd
Aqueduct
4th 
Central canal - lateral Luschka - medial Magendie
45
Q

Main complication of normal pressure hydrocephalus that ↓fxn micturition centers

A

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

46
Q

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

A

BELOW

47
Q

Spinal cord lesion presenting with:

  1. Floppy baby (hypotonia) + tongue fasiculations
  2. Only LMN signs
A

Degen ant horn (where UMN synpases onto LMN)

  1. Werdnig Hoffman disease = AR, symmetric weakness
  2. Polio = asymmetric weakness
48
Q

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

A

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

49
Q

Symptoms if you completely occlude the ant spinal artery

A

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
Q

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

A

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

51
Q

Neuro presentation of B12 def

A 
Subacute combined degen
Demyelin:
1. Spinocerebellar - ataxia
2. Corticospinal - parasthesia
3. Dorsal columns - X position, vibration
52
Q

What is Parinaud syndrome

A

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

53
Q

Name the 2 auditory centers in the brain

A

MGN + inf colliculi

54
Q

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

A

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

55
Q

Describe all the actions of trigeminal CN 5

A

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
Q

All actions of CN 7 facial

A

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
Q

What are the fxns of the 3 vagal nuclei:

  1. Nucleus solitarius
  2. Nucleus ambiguus
  3. Dorsal motor nucleus
A
  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
Q 
Ipsi or contra for lesion to :
CN 5
CN 10
CN 11
CN 12
A 
POINTS TO:
5 - jaw ipsi
10 - uvula contra 
11 - shoulder droop on ipsi
12 - tongue ipsi
59
Q

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

A

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
Q

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?

A

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
Q

Describe noise induced hearing loss

A

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

62
Q

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

A

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!!!

LCK STEP (27 decks)

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