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Flashcards in Neuro 2 Deck (63)
1

What neurons [4 locations] are involved in discriminitive touch/proprioception/vibration pathway?

posterior root ganglia, nucleus gracilis/cuneatus, VPL thalamus, postecentral gyrus

2

Where does the posterior column/medial lemniscus pathway decussate?

rostral medulla [internal arcuate fibers]

3

Signs of injury to posterior columns in spinal cord?

IL loss of discriminitive touch, proprioception and vibration

4

Signs of injury to medial lemniscus?

CL loss of discriminitive touch, proprioception and vibration

5

What is the Romberg test?

test of proprioceptive function [NOT cerebellum]; pt stands upright with arms abducted eyes open vs. eyes closed

6

What indicates a positive Romberg test indicate?

a marked difference in the ability to maintain erect posture with eyes open vs. eyes closed = + Romberg

7

What does a Romberg test look like in someone with cerebellar injury?

with cerebellar injury, pt cannot stand up even with eyes open - DON'T DO A ROMBERG TEST in a pt with cerebellar injury

8

Neurons [4 locations] in pain/temperature pathway?

posterior root ganglia, posterior horn, VPL thalamus, postcentral gyrus

9

Where does the spinothalamic tract decussate?

anterior white commissure, spinal cord, all levels

10

Deficits in syringomyelia?

BL dermatomal loss of pain and temperature [usually upper limbs]

11

Cause and signs of Dejerine-Roussy syndrome?

Extreme hypersensitivity to painful stimuli following posterior thalamic infarct

12

What is the function of lower motor neurons?

innervate skeletal muscle

13

Location of lower motor neurons?

spinal cord + motor cranial nerve nuclei (III, IV, V, VI, VII, IX, X, XI, XII)

14

Location of upper motor neurons?

cerebral cortex, red nucleus, reticular formation

15

Signs of injury to Upper Motor Neuron (UMN)?

hemiparesis, increase muscle stretch reflexes [hyper-reflexia], spasticity, clonus + Babinski sign, Hoffman sign

16

Lower motor neuron (LMN) signs?

paralysis, decreased muscles stretch reflexes [hyporeflexia], flaccid tone, atrophy

17

Motor tracts in the posterior limb of the internal capsule?

corticospinal [upper limb, trunk, lower limb]

18

What is spasticity?

a velocity-dependant increase in muscle tone [injury to UMNs]

19

What is rigidity?

a velocity-independant increase in muscle tone [damage to Basal Nuclei structures]

20

The corticospinal tract decussates at what level?

pyramidal decussation, caudal medulla

21

Motor tracts in the genu of the internal capsule?

corticobulbar [to cranial nerve nuclei]

22

Signs of injury to the corticospinal tract in the right internal capsule?

left, UMN signs

23

Signs of injury to the corticospinal tract in cervical spinal cord on the right?

right, UMN signs

24

Signs of injury to the corticobulbar tract in the right internal capsule?

left, lower facial paralysis; tongue points away from lesion

25

Location of lesion in decorticate posturing?

rostral midbrain or thalamus - red nucleus intact

26

Location of lesion in decerebrate posturing?

midbrain - damage involving red nucleus or rubrospinal tract

27

Signs of myopathy?

proximal symmetric weakness, no sensory loss

28

What are the 2 most common causes of peripheral neuropathies?

diabetes, alcoholism

29

Signs of polyneuropathy?

stocking/glove sensory loss

30

Neurons in auditory pathway [at least 6]?

spiral ganglion, cochlear nucleus, superior olive, inferior colliculus, medial geniculate, primary auditory cortex

31

Result of Rinne test in normal ear?

air conduction > bone conduction

32

Result of Rinne test in conductive hearing loss?

air conduction < bone conduction

33

Result of Rinne test in sensorineuronal hearing loss?

air conduction > bone conduction

34

Result of Weber test in normal hearing?

localize to midline

35

Result of Weber test with sensorineuronal hearing loss in R ear?

localize to left

36

Result of Weber test with conductive hearing loss R ear?

localize to right [You can verify this by sticking your finger in your ear and performing the Weber test on yourself.]

37

Deficits with injury to CN VIII?

IL deafness, dizziness, CL nystagmus

38

Deficits with injury to brainstem auditory pathways?

bilateral hearing loss

39

What is presbycusis?

age-related hearing loss, high frequencies lost first

40

Neurons in visual pathway [3 neurons]?

retinal ganglion cells, lateral geniculate, primary visual cortex

41

Signs of injury to optic nerve/retina?

IL visual loss, can affect both temporal and nasal hemifield

42

Signs of injury to optic chiasm?

bitemporal hemianopsia

43

Signs of injury to optic tract?

contralateral homonymous hemianopsia

44

Signs of injury to Meyer's loop?

upper quadrant homonymous hemianopsia

45

Visual deficits in PCA stroke affecting calcarine sulcus?

contralateral homonymous hemianopsia, with macular sparring

46

What is Marcus Gunn pupil?

optic nerve lesion, when light is shown into bad eye, pupil dilates (bad retina = no light)

47

What structures comprise the basal ganglia [nuclei]?

caudate, putamen, globus pallidus, subthalamic nucleus, basal nucleus of Meynert

48

Brain region affected in Parkinson disease?

substantia nigra, pars compacta [dopamine]

49

Signs of Parkinson disease?

bradykinesia, pill-rolling tremor, masked facies, postural instability

50

Pathological sign of Parkinson disease?

Loss of dopaminergic neurons in SN + Lewy bodies in SN

51

Brain region affected in Huntington disease?

caudate nucleus

52

Signs of Huntington disease?

choreioform movements, dementia

53

Brain region injured in right hemiballismus?

left subthalamic nucleus

54

Signs of essential tremor?

chronic, progressive tremor in arms, neck, larynx, chin; reduced with alcohol consumption

55

What is Wilson disease?

inborn error of copper metabolism; Kayser-Fleischer rings; wing-beating tremor, rigidity

56

What are signs of cerebellar injury?

ataxia, dysmetria, dysdiadokinesia, nystagmus, dysarthria

57

Signs of injury to vestibulocerebellum (flocculonodular lobe)?

truncal ataxia, nystagmus

58

Signs of injury to lateral hemisphere of cerebellum?

IL limb ataxia, intention tremor, dysarthria

59

Signs of injury to middle cerebellar peduncle?

IL limb ataxia

60

Results of caloric testing in normal individual?

COWS - cold = nystagmus to opposite side; warm = nystagmus to same side

61

Signs of Arnold-Chiari I malformation?

extension of cerebellar tonsil below foramen magnum

62

Signs of Arnold-Chiari II malformation?

displaced vermis + myelomeningiocele

63

Signs of Dandy-Walker?

enlarged posterior fossa, small cerebellum, absent vermis, cystic dilation of 4th ventricle, hydrocephalus