Exam 3 Flashcards
(160 cards)
1
Q
brain localization - motor aprosody
A
fronta - broca’s on right.
inflect speech with emotion
2
Q
CN VIII Action
A
Vestibular N.
Sensory: Hearing, Balance
3
Q
CN VII Action
A
Facial N.
Motor: Facial Muscles, stapedius m., orbicularis occuli
Sensory: Taste (Ant 2/3 of tongue), salivation (submandibular, sublingual), lacrimation
4
Q
Which cranial nuclei have pre-ganglionic parasympatheic output
A
3, 7, 9, 10
5
Q
Most common mvmt disorder of adults
A
RLS, ET, PD
6
Q
Rebound reflex
A
increase ROM with lack of normal recoil
cerebellar dz
7
Q
Corneal Blink Reflex
A
A: Spinal cord nuc of V E: motor nuc of VII 1st: skin near eye --> spinal nuc of V with body in trigeminal ganglion 2nd: to VPM of thalamus 3rd: to post central gyrus
8
Q
brain localization - Vision
A
Occiptial
Occipitotemporal - what
Occipotparietal - where
9
Q
IV lesion
A
Eyes gazed upward
head tilt
10
Q
Weber Test
A
Conduction: Louder in affected
SN: louder in unaffected
11
Q
V nulcei
A
Mesencephalic - upper pons - lateral
Motor nuclei - mid pons (medial)
Sensory nuclei - mid pons - lateral
Spinal - lower pons - from sensory nuc.
12
Q
CN IX Action
A
Glossopharyngeal N. - BOTH
Motor: Stylopharyngeus (swallowing) - nucleus ambiguous)
Sensory: Posterior 2/3 of tongue (taste - n. solitary; P/T - spinal Nuc V), Carotid Bodies (n. Solitary)
13
Q
Conduction aphasia
A
damage of arcuate fasciculus
repetition defecit
14
Q
Dysiadochokinesia
A
impairment of rapid alt. movement
pronation/supination, tapping fingers
15
Q
XII lesion
A
if LMN deviates to side with lesion
if UMN away from lesion
both atrophy
16
Q
VII nuclei
A
lower pons - anterior lateral to VI, wraps around and exits more laterally to VI.
17
Q
Hemineglect
A
ignore one side of the body. Right - surveys both sides of the body left only surveys right. Left hemisphere lesion is more severe but Right - leads to left hemineglect
18
Q
brain localization - Writing
A
Left Parietal
19
Q
Corneal Reflex A/E
A
A: Spinal Nuc V
E: Motor Nuc VII
20
Q
Selegiline
A
MAO inhibitor to promote packaging of NT in vesicles
21
Q
Gag Reflex
A
Sensory/Afferent IX to spinal trigeminal nuc to nucleus ambiguous to motor loop
Output/motor - X
22
Q
Pathway of CN III
A
Middle cranial fossa through superior orbital fissure
23
Q
which aphasia has poor naming
A
all
24
Q
how to treat open angle glaucoma
A
Pilocarpine + Apartonidine + timolol
Acetazolamide
Mannitol or Glycerol
25
pathway of CN IX
Posterior cranial fossa through jugular foramen
26
Pramipexole
D2 Receptor Agonist
27
Brocas area
inferior frontal lobe
44 and 45
language fluency - full comprehension
28
Ageusia
total loss of taste
29
which aphasia have poor comprehension
wernickes and global
30
Cholinergic Agonists
contract ciliary M. to increase outflow of aqeuous humor
31
brain localization - Visuospacial function
Right parietal
32
Beta blockers action
reduces aqueous humor production at epithelium
| used in open angle glaucoma
33
Simulatenagonisa
inability to visualize stimulus simultaneously
| due to lesion in occipital lobe
34
Basal Ganglia lesion
resting tremor
| Hypo/hyperkinetic
35
brain localization - Audition
Temporal
36
brain localization - voluntary movement
frontal
37
Spinal Nucleus of V is equivalent to
Substantia Gelatinosa - pain and temperature
38
global aphasia
descruction of entire parayslvian zone
| no language and right hemiplegia
39
Movement of Superior Oblique
down and inward
40
X Lesion
Uvula deviation away from side of lesion
| vocal cord paralysis
41
Brimonidine
alpha 2 antagonist to increase aqueous outflow in open angle glaucoma
sounds like clonidine
42
CN XI Action
Accessory
| Motor: SCM and Trapezius (head turn and shoulder shrug)
43
V2
maxillary
44
Hemiparetic gait
unilateral UMN injury.
affected side has arm flexed, adducted and internally rotated.
circumduction, foot drop, hypotonia
45
Pilocarpine
cholinergic agonists used to treat open angle glaucoma
| contract ciliary M. to increase outflow of aqeuous humor
46
What is Ataxia
Dysmetria
Dysiadochokinesia
Decomposition of movement
47
V3
mandibular
| Afferent and Efferent jaw reflex
48
Carbonic Anhydrase Inhibitors
reduce formation of bicarbonate to reduce fluid trasnport
| used to treat open angle glaucoma
49
Diplegic Gait
LE spasticity is worse than UE
narrow base, dragging, scissoring gait
due to cereberal palsy
50
brain localization - Sensory Prosody
comprehension of emotion in speech
| Equivalent of Wernicke's on right (temporal)
51
Neuropathic gait
foot drop, lift leg high
Unilatera - peroneal palsy
BL: seen in ALS, CMT
52
VI nuclei
lower pons - medial to VII
53
brain localization -Attention to CL side of space
Parietal
54
what part of brain is language production
Brocas - frontal left
55
Pathway of CN XI
posterior cranial fossa through jugular foramen and foramen magnum
56
Dorzolamide
topical CA inhibitor used to treat open angle glaucoma
| reduce formation of bicarbonate to reduce fluid trasnport.
57
Executive function brain localization -
Frontal - dorsolateral prefrontal cortex
| plan, carry out goal directed
58
brain localization - Visual Perception
occipital
59
Solitary Nucleus
Special sensory - taste from 7, 9, and 10
60
Comportment - brain localization -
frontal orbitofrontal cortex
| maintain appropraite behavior during strong emotions
61
pathway of CN II
Middle cranial fossa through optic canal
62
Gag Reflex A/E
A: glossopharyngeal IX
E: nucleus ambuguous X
63
Gag Reflex Afferent and Efferent
```
IX sensory
X motor (nucleus ambiguous)
```
64
Progressive Supranuclear Palsy
>50
downward gaze, scared look, early onset postural instability, retrocollis - neck extension
Basal ganglia, brainstem, cortex, dentate nucleus, spinal cord are affected with neurofibrillary tangles, lewy bodies,
65
Agraphia
acquired writing disorder
66
Abnormal check reflex
when you pull on arm and unable to stop
| sign of cerebellar dz
67
Agnosia
impaired visual, auditory, tactile recognition
68
CN nuclei in midbrain
III and IV
69
Choreiform gait
hyperkinetic gait - disorders, jerky,
70
Internuclear Ophthalmoplegia
conjugate gaze palsy
lesion in MLF that coordinates horizontal gaze
Ipsilateral: impaired adduction
Contralateral: nystagmus due to overstimualtion of CN VI
normal convergence
71
Alpha 2 antagonists action
mainly increases aqueous humor outflow (some decrease in formation)
72
Sensory vs. mesencephalic vs Spinal Nuc of V
Sensory: touch and vibration of face
Spinal: pain and tmeperature of face
Mesencephalic: proprioception of face
73
CN VI Action
Abducens
| MOTOR: Lateral Rectus
74
Dysosmia
altered or distorted sense of smell
75
Pronator drift is due to..
pyramidal tract dysunction, parietal bloce, ipsilatera cerebellar dz
76
Ataxic gait
cerebellar disorder, wide base, drunken, staggering, no tandem gait.
77
VIII nuclei
lower pons and upper medulla
78
Memory brain localization -
Temporal - hippocampus
79
dysarthria
speed disorder due to motor impairment
80
which aphasia are fluent
Wernickes and conduction
81
Movement of Inferior oblique
up and outward
82
Apraxia
impaired ability to learn movements
83
Rinne Test
Air >Bone Conudction: Bone>Air; SN Air=Bone
84
Alexia
acquired reading disorder
85
XI lesion
```
Weakness in head turn to CL side of lesion
Shoulder drop (IPS)
```
86
Ventricular system in midbrain
Cerebral aquaduct
87
Pathway of CN IV
Middel cranial fossa through superior orbital fissure
88
Most Common mvmt disorder of kidsq
tourrettes
89
where does CN III emerge?
Midbrain
| interpeduncular fossa
90
which aphasia have poor repetition
all
91
V1
ophthalmic
| Afferent input for corneal blink and lacrimation
92
Pathway of CN VIII
posterior cranial fossa through internal auditory meatus
93
types of paraphasic speech
1) literal - phonemic - switches was sounds like
2) verbal - semantic - switches things
3) neologism - meaningless words
94
Visual Recognition - brain localization -
Occipital lobe
| prosopagnosia - ability to recognize faces
95
Hyposmia
diminished sense of smell
96
Cogwheel
sign of muscle rigidity
97
check speech ataxia
La - 12
Pa 7
Ka 10
98
brain localization - Reading
Left parietal
99
brain localization - Calculation
Parietal
100
Parosmia
altered perception of smell in presence of odor - unplesant odor
101
Carbidopa
blocks dopamine decarboxylase in periphery
| extends life of L-dopa
102
CN XII Action
Hypoglossal
| Motor: tongue movement.
103
Pathway of CN VII
posterior cranial fossa through internal auditory meatus
104
Phantosmia
altered perception of smell in absence of odor
105
CN II - Action
Optic - sight (sensory)
106
Jaw Jerk Relfex
downward tapping of jaw - bilteral contraction of masseter muscles.
Afferent: stretch receptors to mesencephalic Nuclues of V
Efferent: main motor nuclei of V
107
Basic emotions - brain localization -
Temporal - papex circuit
108
Cerebellar Lesions
Ipsilateral
Syngergy, Equilibrium, hypotonia
HANDS Tremor
Hypotonia, Ataxia, Nystagmus, dysarthria (cant speak), Stance and Gait problems and Action Tremor
109
III N. Palsy
due to vascular defects usually
Ptosis (levator palpebrae)
down and out eye (due to only functional lateral rectus and superior oblique)
Blown Pupil
110
Ropinirole
D2 Receptor agonist
111
which aphasias have good comprehension?
Brocas and conduction
112
Cavernous sinus nerves
3, 4, 5, 6
| All the nerves that control eye movement plus V
113
visual agnosia
failure of recognize an object
| lesion in occipital lobe
114
Latanoprost
prostaglandin analog to treat open angle glaucoma
115
dyphonia
laryngeal disease
116
brain localization - Language comprehension
Wernicke's (left temporal)
| Posterior superiortemporal gyrus
117
prosopagnosia
ability to recognize faces, in occipital lobe.
118
Nucleus Ambiguous
Motor output to pharynx and larynx (X)
| motor to sytolpharyngeus (IX)
119
Forced vs tandem gait
forced - walking funny
tandem - heel to toe
both signs of truncal ataxia
120
brain localization - motivation
medial prefrontal
121
Dopamine Receptor Agonists
act on D2 receptor to inhibit indirect pathway
produces not as severe of the On-off Ldopa response.
Decreased Dyskinesia
Causes hallucinations, sudden onset of sleep!
122
brain localization - Tactile sensation
Parietal
123
Pathway of CN VI
middle cranial fossa through superior orbital fissure
124
Wernicke's area
posterior superior lobe
22
language comprehension
125
Main sensory nucleus of V is equivalent to
Nucleus gracilis or cuneatus - touch, vibration, pressure
126
CN IV Action
Trochlear - MOTOR
| Superior Oblique
127
Timolol
Beta blocker used to treat open angle glaucoma
| reduces aqueous humor production at epithelium
128
Anosmia
loss of smell
129
Muscles of Mastification
Face from prefrontal gyrus to motor nuc of V.
| 2nd order from motor Nuc of V to muscle.
130
Benztropine
Anticholindergic drug to balance ACh overactivity in striatum.
Side Effects of confusion, drowsiness, constipation, urinary retention
used to limit tremors
131
spasticity
gives a clasp-knife feeling
132
Sensory gait
loss of proprioceptive input - slams food down
| VB12 def, tabes dorsalis, peripheral neuropathy
133
CN X Action
Vagus BOTH
Motor: Swallowing, soft palate, midline uvula, parasympathetic to Viscera
Sensory: Epiglottis, soft palate - taste, aortic arch chemoreceptors
134
CN III Action
```
Oculomotor
Motor - SR, IR, MR, IO
pupil constriction
Accomodation
Eye opening - levator palpebrae
```
135
Dorsal Motor Nucleus of X
holds Pregangionic Parasympathetic to heart, thorax and abdominal viscera
136
Entacapone
COMT Inhibitior to extend life of LDOPA
137
Psychogenic Mvmt Disorders
Abrupt onset, no response to meds or psychotherapy, static or variable course, selective disability.
presents with a combo of mvmt disorders, increases with attention and decreases with distractability. suggestible and entertainment
138
Multiple Systems Atrophy
MSA- Parkinsonism - striatonigral degeneration
MSA-Autonomic systems - sky-drager syndrome
MSA-cerebellar - ataxia due to olivopontocerebellar degeneration
139
CN V Action
Trigeminal N. Both
Motor: muscles of mastification
Sensation: facial sensation (Touch, vib, pain, Temp, proprioception)
140
Pathway of CN X
posterior cranial fossa through jugular foramen
141
what drugs increase aqueous humor outflow
Prostaglandins
Alpha 2 agonists
Cholinergic agonists
142
what drugs decrease aqueous humor production
Beta Blocker
| Carbonic Anydrase Inhibitiors
143
Pathway of CN XII
Posterior cranial fossa through hypogossal canal
144
which aphasia are nonfluent
Brocas and Global
145
Echothlophate
Indirect cholinergic agonists used to treat open angle glaucoma
contract ciliary M. to increase outflow of aqeuous humor
146
Amantiadine
D2 Receptor Agonist
147
Parkinson Plus diseases
parkinonism - slowness of movement but with atypical variants. more serious and less treatable
1)Multiple systems atrophy
2)Progressive supranuclear palsy
3) corticobasal degneration
4) Lewy Body Dimentia
Present with rapid progression, early onset dementia, autonomic instability, early onset postural instability, downgaze, poor response to Ldopa.
Worse Prognosis, and not good tx.
148
VI lesion
medial deviation with normal vergence
149
Pupillary Reflex A/E
A; optic N II
| E: Parasympathetic to ciliary Ganglion
150
Prostaglandins
increase Aqueous Humor Outflow
151
Where does CN IV emerge?
midbrain
dorsal side inferior to inferior colliculi
wraps to contralteral side.
152
Pathway of CN I
cribriform plate
153
DBS in PD
Thalamus, Internal Pallidium, STN
154
what nuclei do MLF act on?
3, 4, 6, 8
155
Main motor nucleus of V is equivalent to
alpha motor nuerons - voluntary control
156
Where does V exit the brainstem
in middle of MCP
157
Pathway of CN V
Middle Cranial Fossa
V1: superior obrital fissure
V2: foramen rotundum
V3: foramen ovale
158
Dysgeusia
Altered perception of taste (persistent salty or bad)
159
CN Nuclei in the pons
V - Mesencephalic, motor, sensory, upper spinal
VI
VII
160
CNI - action
Olfactory - smell (sensory)
