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Flashcards in DIT Neuro 2 Deck (44):
1

Lower motor neuron lesion symptom vs upper?

Lower: flaccid paralysis, atrophy and fasciculations (b/c anticipate signal) (hyporeflexive b/c no ark)

Upper lesions: spastic paralysis and hyperreflexive

2

How does signal get to the deep cerebellar nuclei?

inputs from Mossy and Climbing fibers

to other stuff

To PURKINJE (know those three cells)

To deep nuclei of cerebellum

3

Where is the major output pathway of cerebellum going?

Ventral Lateral nucleus of thalamus (via superior cerebellar peduncle)

4

What side of body is affected by left side of cerebellum?

Left side (ipsilateral)

(path is to right thalamus, cortex, corticospinal tract which decussates to the left body again)

5

What does Romberg test?

Proprioception (Tabes dorsalis)

6

What are the three input to cerebellum? What nuclei do they go through?

Nuclei: D E G F (F is in middle)

Vestibulocerebellum is F (middle)
Spinocerebellum is EG and F
Cerebroccerebellum is D

7

Vermis and peravermis issue causes what?

Postural instability (core of body affected), slurred and slow speech

Spinocerebellum

8

3 kinds of tremors? Cause for each?

Essential (fam history and always tremor)

Resting: parkinsons and gone with movement

Intention: cerebellar damage with involuntary movement (cerbrocerebellum issue (lateral hemisphere)

9

Lesion of substantia pars compact?

Lesion of subthalamic nucleus?

Parkinsons

Hemibalismus

10

Mnemnoic for parkinson drugs?

BALSA

Bromocriptine (ergot, vasoconstrict) pramiproxal and ropinerol

Amantadine more dopa release
Levadopa/carbidopa

Selegiline: stopes monoamine oxidase (pref dopamine)

Antimuscarinic (Benztropine Park my Benz)

11

Huntington mnemonic? 2 of them

CAG. Caudate loses ACh and GABA

C's

CAG repeat
Chromsome Cuatro
Chorea
Cognitive decline
Caudate

12

Huntington Tx? 2 types of drugs

tetrabenazine and reserpine (inhibit monoamine transport)

Haloperidol and clozapine

13

What causes:

Hemiballismus?

Chorea

Athetosis?

Hemiballismus: one half body jerks out: contralateral subthal nucleus (lacunar stroke, its a contralateral lesion)

Chorea: huntington

Athetosis: slow writhing movements in hands and fingers: Huntington again

14

What does polio hit? What is werdnig hoffmann disease?

LMN b/c destroy anterior horns

15

What does MS affect in spinal cord?

Random demyelination.

Scanning speech, inanition tremor, internuclear opthalgia (MLF lesion: adduction paralysis ipsilateral and abduction nystagmus)

16

What does amyotrophic lateral sclerosis affect on spinal cord?

Cause?

Tx?

ALS is upper and motor neuron lesion.

IN TACT sensory and not dumb

Lateral spinal tract
Anterior horn

So lots of symptoms: eventually can't breath.

Caused by superoxide Dismutase 1 defect.

Tx is riLOUzole for Lou Gerig (not curative, but dampens affect)

17

Describe Friedrich ataxia?

trinucleotide repeat

Freidriech is Fratastic (fratazxin): FRAT bro always STAGGERINg, FALLINg, but has BIG HEART

Sensory loss b/c iron binding issues in mitochondria. Presents in kids. Chromosome 9

18

Mnemonic for Ataxia telangiectasia?

A disease
ATM gene (double strand break repair)

Ataxia, Angiomas, igA deficiency Afp is high

Ataxia from cerebellar defect

19

Erb duchenne palsy?

Erber (upper trunk: C5-6) from babies being born who are too big and stretches roots.

Waiter tip.

suprascapular, musculocutaneous, axillary

Will get function back if just distocia.

20

Klumpke palsy?

KLumpke cause KLaw hand

21

Look at more brachial plexus

ok

22

How do you injure femoral nerve? What is consequence?

Pelvic fracture (L2-4)

Loww of hip flexion and extension (loss of sensation to anterior thigh and medial leg)

23

How do you injure obturator? What is consequence?

Anteriorhip displasion, loss of

Medial thigh sensation
loss of adduction

24

How do you injure superior gluteal nerve?
Consequence?

Posterior dislocation
Hip abduction and medial rotation of thigh

Polio can do it
Tradelenberg gate (Teri Ache) and hip drop when standing on injured leg (THE NONINJURED SIDE DROPS b/c gluts can't keep body level)

25

How do you hurt inferior gluteal nerve?
What do you see?

Gluteus maximus is out, so can't stand up or extend hip

26

Sciatic is lost? what happens?
How does it happen?

Intervertebral disc herniation, spinal stenosis, spondylolisthesis

Hammis out

Sensation to posterior thigh and lower leg

27

How do you diagnose which nerves are out for branches of sciatic?

PED: Perioneal Everts and Dorsiflexes, if injured, foot is dropPED (deep perioneal)

TIP: Tibial Inverts and Plantarflexes; if injured: can't stand on TIPtoes

28

Type 1 muscle vs type 2? mnemonic

Type 1: 1 slow red ox
slow twitch are red and lots of mitochondria so great at ox phosph

Type2 is fast twitch, white muscle building muscle

29

Bilateral facial paralysis: consider what?

CSF findings with one of the diseases? (nothing was mentioned for the other disease)

Guillain barre: Elevated CSF protein with normal cell count

Lyme disease

30

What is progressive multifocal leukoenephalopathy presentation?

any associations?

Demylenation b/c oligodendrocyte destruction

JC virus association (AIDs) and usually rapidly progressive and fatal

31

What is metachromatic leukodystrophy?

Findings?

Autosomal rec lysosomal storage from arylsulfatase A def.

Sulfatides build up and impair myelin sheath production.

Central and peripheral demyelination with ataxia/dementia

32

What is charcot marie tooth disease?

Findings?

hereditary motor and sensory neuropathy b/c defective protein production or sheath production.

Autosomal dominant

Various parts of body affected but LOOK FOR HIGH or FLAT foot arches

33

If you have a pic on the test of a retina with an optic disk having a big ring in it, what is it showing?

Optic cup >50% of optic disk diameter is glaucoma

34

What are the two kinds of macular degeneration? What happens?

How do you treat it?

Loss of macula vision (central fields)

Dry: STOP FUCKING SMOKING deposition of drusen in eye. Multivitamin and antioxidants slow progression

Wet: rapid loses from vascularization and treat with antiVEGF

35

Glaucoma tx? 5 classes

Increase outflow:
Alpha agonists
Prostaglindins
Cholinergic agonists


Reduce production:
beta blockers
acetazolamide

36

What is a risk of chronic middle ear infection? How do you treat what we are worried about?

Cholestatoma. Overgrowth of keratin debris that erodes ossicles and mastoid air cells.

Gray white pearly lesion behind TM and remove it!!!

37

WHAT IS MENIERE DISEASE? (ACCIDENTAL CAPS LOCK, SORY)

ENDOLYMPHATIC HYDROPS. IMBALANCE OF FLUID AND ELECTROLYTE COMP IN ENDOLYMPH CAUSE TRIAD OF:

INTERMITTENT VERTIGO
HEARING LOSS
TINITIS

38

What are findings of alzheimer intracellularilyh and extracellularily?

intracellular tau proteins

Extracellular beta amyloid

Neurofibrillary tangles have intracellular tau

Depletion of acetylcholine

39

Why are down syndrome higher risk for dimensia?

Extra chromosome 21

Code for amyloid precursor protein

40

Alzheimer tx?

Cholinest inhib: Donepezil, galantamine, rivastigmine

Memantine: NMDA (NMDgay) receptor antag (glutamate receptor which would otherwise be overstim)

41

What is dementia with Lewy bodies?

VISUAL hallucinations, parkinsonian features, repeated syncope

Lew bodies are in the cortex instead of substantial nigra

42

What do you see with pick disease?

Pick bodies are spherical tau protein aggregates. They may PICK ON YOU b/c personality change

Frontotemporal atrophy

dimentia, aphasia, parkinsoinan aspects with change in personality. THEY GET CRABBY.

Pariatal lobe is spared and superior 2/3 of temporal features.

43

Rapid on course of dementia with change in personality?

Creutzfeldt jakob. May have startle clonus

Prion disease (beta pleated sheets)

Brain starts to make vacuoles (spongioform encephalopathy)

44

Intracellular spherical aggregates of tau on silver stain?

Silver means Pick.