Neuro 2 Flashcards by Nathan Hansen

Kinesin transports organelles toward __ end of microtubules, which are __ from the nucleus

toxic insult would impair __ transport, thus leading to a deficiency of __ at the nerve terminal

plus, distant

anterograde, vesicles

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__ is a disproportionate loss of pain/temp in arms and hands
formation of __ in cervical region of SC

most commonly has damage to ventral __ and __

this is decussation for fibers of __ tract for pain/temp from periperhy to somatosensory cortex

1st order neurons are in __
2nd order neurons in __

axons decussate in VWC, adn asced in contralateral __

3rd order neurons located in __ of thalamus

4th order neurons found in primary __ of parietal lobe

syringomyelia
cavity

white commisure, horn

lateral spinothlamic

dorsal root ganglia
dorsal horn

lateral funiculus

VPN

somatosensory cortex

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dextrxn of VWC leads to loss of __/__ bilaterally 1/2 levels below lesions and in dermatome

other senses are ___

ventral horns contain __ that receive impulses from lateral CS tract, responsible for voluntary __

damage can occur, but does not affect __/__
example of __ lesion

pain/temp

normal

motor neurons, motor activity

pain/temp
LMN

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__ transmits light touch/pressure

damage to __ cuases contralateral loss of pain/temp

__ recieves neurons of sensory input
ie __ and __ synapses

dorsal columns contain __/__ fasciculi
primary mediator for __/__/__ sensation

ventral ST

contralateral lateral funiculus

dorsal horn
lateral ST, ventral ST

cuneate/gracilis

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extrapyramidal symptom assc w recent antipsychotic meds is __ reaction
sudden __ of any muscle group
may have Oculogyric crisis, O__ or L

result from high potency __ blocking D2 in NS pathway (ie h/F)
excess __ results in extrapyramidal SE

tx w M1 receptor antags like B or antihistamine D

acute dystonic
contraction
opisthotnos, laryngospasm

1st gen antipsychotic
haloperidol, fluphenazine
cholingergic activity

benztropine, diphenhydramine

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Blockade of __ receptors leads to ortho hypoTN

Gaba receptor antags like __ tx benzo overdose

antagonism of __ causes sedation/weight gain

low potency antipsych like C/C/T can cause ___ SE

A1A

Flumenazil

chlorpromazine, clozapine, thioradizine

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long standing RA involves __ and causes joint dxn w vertebral __ subluxation

__ joint involved as atlas C1 has high degree of __

sx include neck __/__ and neuro findings
__ can worsen it, leading to __/__ compression

see __ paralysis w absent __
paralysis becomes __

cervical spine, malalignment

atlantoaxial, mobility

pain/stiffness
intubation, SC/arterial

flaccid, reflexes
spastic

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__ due to IE of left sided heart valve
see acute __ findings and __/__ finding

diffuse muscle rigidity w hyperthermia and myocyte breakdown dx ___

Cerebral septic emboli
neuro
murmur, cardio

Malignant hyperthermia

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__ tremor aka __
inherited __, look for family history
improves w __
tx w __ a nonslective B antag

__ anticholingergic to tx Parkinson, counterract EPSE

essential, familial
AD
alcohol
propanolol

benztropine

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__ contains optic nerve from temporal part of ipsi retina and nasal part of contra retina

Optic tract lesions result in __ homonyous hemaniopsia

frontal eye fields located in __ cortex
generates __ gaze movements
damage has eyes deviate __ side of lesion

contralateral homonyous hemaniopia w intact pupillary light reflexes may damage the __

lesion in __ producess contralateral upper quadrantopia

macula recieves collateral BF from __
not affected in __ infarct

optic tract

contralateral

prefrontal
conjugate
toward

LGN

Meyer loop

MCA
posterior cerebral artery

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at rest, membrane is permeable to ion w __ potential

opening of ligand gated ion channels causes __ in membrane potential

opening of voltage gated ion channels causes __ in membrane potential, meaning that membrane is permeable to __ potential ion

negative equilibrium

inc

dec, negative equilibrium

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Intraplerual pressure is __ at rest due to recoil of lungs/chest

w inspiration, diaphragm contracts to make IPP __, drawing air in

w no dec in phrenic nerve activity, pt shows progressively __ diaphragm contractions
thus, pt has excessive skeletal muscle __ (COPD/IPF) or impaired __

women in post partum period are at high risk of developing ___

negative

more negatve

weakening
weakness, NT release

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Fracture to the __ can be damaged w direct trauma
contains the __/__

__ nerve runs along orbital surfave, before leaving infraorbital foramen

damage can result in numbness to upper __/__/__

can also see E and impaired __ gaze (trapped IR muscle)

orbital floor
zygoma, maxilla

infraorbital

cheek/lip/gingiva

exopthalmos, vertical

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superior orbital fissure contains CN __/__/__/__
can lead to loss of __

hematoma over __ w periorbital eccymoses idicate fracture to __

fracture of __ can impair motor fxn of face

3/4/5/6

mastoid process, basilar skull

temporal bone

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infant w delyaed motor development and flaccid paralysis has __
caused by mutation in __ gene
affects __ in LMN, impairing __ fxn
thus, __ cells degenerate

collection of snRPs and pre mRNA form a __ to remove introns from pre MRNA

spinal muscular atrrophy
SMN1
snRPs, spliceosome
anterior horn

spliceosome

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first line tx of T gondii in HIV pt w ring enhancing lesions is P/S

Amphotercin and flucytosine can tx __ meningitis

Amphotercin can tx invasive ___
CNS aspergillosis presents w __ andd __ sx
this form, tx w __

__ tx listeria

CMV CNS involvement presents w P/transverse __, and E

pyrmethamine/sulfadiazine

cryptococcal

aspergillosis
abscess, pulm sx
voriconazole

listeria

polyneuro, myelitis, enceph

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HIV Pt w neg t gondii serology, think __
see large, solitary lesions

origin is ___ NHL of b cells
__ infection is identified in most cases
dx w __ PCR of CSF
definitive dx w __

usually do not have __ infiltration

T cells are malignant in __ T cell lymphoma

__ is primary cell in histiocytomas

__ is precursor to glioblastoma multiforme

primary CNS lymphoma

DLBCL
EBV
EBV
brain biopsy

T cells

AIDS assc

macros

astrocytomas

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varicella IgG ab and dermatome oriented, painful vesicular rash indicates __
this is a ___ w/in dorsal root ganglia

primary VZV occurs in __
typically resistant to __ later, but not __

varicella vacine induces __ for primary VZV but decreases over time

IgG is ineffective against __

herpes zoster
reactivation

childhood, chickenpox, zoster

immunity

dorsal root ganglion

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polysaccharide antigens on latex agglutination test w meningitis due to __ in AIDs indiv
should see round/oval __ w india ink stain
yeast obstructs CSF outflow, leading to inc __

nonseptate hyphae branch at __ angles
seen in M/R

__ forms spherules which rupture to release endospores

cryptococcus

budding yeast
opening pressure

wide
mucor/rhizpus

coccidioides

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__/__ transport Nitrogen throughout body

alanine fxn in the __/__ cycle to remove N2
alanine transported to __

there, converted to __ via ALT, as amino group trasnferred to __ to form glutamate

ammonia enters __ to form urea to get rid of N2

free ammonia then excreted in __

alanine, glutamine

glucose/alanine
liver

pyruvate, Aketoglutarate

urea cycle

urine

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residual neuropathic pain in later zoster is known as __
sensitization of affarent nerves in __
tx w __ (amytriptaline) or anticonvulsants G/P

Capsaicin causes activation of __ to cause buildup of Ca to defunctionaize nerves

also depletes __ important in pain

use as __ to dec pain

__/__ activate U and K opioid receptors respectively

post herpetic neuralgia
dorsal horn
TCA
gabapentin/pregabalin

TRPV1

Substance P

topical

endorphin/dynorphin

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FXS

PE finings include marco-__ and long/narrow __ w prominent __/__
N/P disorders like __ delay, A, and A develop

mutation in __ gene on long arm of X chromosome
expands during __ in oocytes
seen w >200 __ repeats, resulting in hyper__

this __ FMR1, inhibiting neural development

use __ to determine degree of methylation

orchidism, face
chin/forehead
develop, ADHD, ASD

FMR1
meiosis
CGG
methylation

inactivates
southern blot

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MG is caused by antibody/complement mediated destrxn of _ receptors on NMJ

long acting ACHe inhibs like P used for tx
__ Ach in NMJ

pt may be undertreated aka __
Tensilon test w short acting __
if positive, inc __ of pyridostigamine

too high AChE inhibitor causes __
leads to muscle weakness bc NMJ is __ to acetylcholine
does not respond to __
__ pyridostigmine

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nicotinic
pyridostigamine
inc

myasthenic
edrophonium
dose

cholinergic crisis
insensitive
edrophonium
discontinue

Fragile X cells will not stain in __ deficient medium
see small __ in long arm of chromosome X

Klinefelter syndrome has dec ___ secretion bc of fibrotic testes
causing __/__

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folate
gap

testosterone
oligospermia/infertility

Gingival hyperplasia in phenytoin is due to inc __ macrophages stimulate __/__ regresses w ___ Phenytoin is anticonvulsant for __ seizure, __ seizure and status __ inhibits abnormal __ in brain by blocking voltage gated __ in neurons SE A/N/H/__ anemia induces __ avoid in __

PDGF gingival cells, alveolar bone dscontinue grand mal, partial, epilepticus electrical activity Na channels ataxia/nystagmus/hirsutism/macrocytic p450 pregnancy

__ toxicity assc w coarse tremor, twitching, motor agitation, ataxia can cause NDI, hypo___ and __ defects __ withdrawal assc w sever depression Cocaine blocks reuptake of __/__/__ SE of clozapine A/S

lithium thyroid, cardiac cocaine, depression NE/dop/serotonin agranulocytosis/seizure

ADPKD assc w __ AMS, focal neuro defects can indivate ___ CCB like __ can prevent SAH

SAH/berry aneurysm cerebral vasospasm nimodipine

Pt w cardiogenic shock w evidence of watershed necrosis suffered from __/__ encephalopathy profound __ diminished blood flow to brain causing ischemia neurons do not store __ and are susceptible to ischemia Pyramidal cells of __ and perkinje cells of __ are most vulnerable cortical watershed infarcts present as bilateral __ strips of necrosis over convexity pt w severe carotid artery stenosis may have __ infarct

hyoxic/ischemic hypoTN glygogen hippocampus, cerebellum wedge shaped unilateral

__ aneurysm involves hemorrhage of __ structures cardaic embolism has __ infarcts in different territories HA/v/confusion indicates __ encephalopathy braid __/__ seen on autopsy

charcot bouchard deep multiple hyperTN enceph edema/hemorrhage

NF1 is mutation in __ tumor suppressor cutaneous neurofibromas are neoplasms of __ derived from __ pt at inc risk of __ neoplasm

NF1 schwann cells, NCC CNS

cystic degeneration of the putamen occurs in __ dz located lateral to __/__ __ mediates fear/SNS stimulation

wilsons dz globus pallidus/internal capsule

young woman w INO, episodes of ON should indicate __ demyelination of __ autoimmune response at __ myelin sheath aids in __ as impulse jumps between nodes of Ranvier where __ is concentrated aids in __ up impulses demyelination in MS results in ___ surviving oligodendrocytes partially __ neurons loss of axons/neurons over time indicates __ MS

MS CNS oligodendrocytes saltatory condxn sodium channels speeding up slowed condxn remyelinate chronic

right sided pure hemisensory loss has suffered a __ stroke VPLN receives input from __ tract and __ column and VPMN (info from __ pathway ) send __ projections to cortex damage leads to complete contralateral __ loss no pain/temp/vibration/proprioception may lead to __ gait

thalamic ST/dorsal trigeminal somatosensory sensory unsteady

injury to __ assc w contra weakness/ataxia due to descending motor tracts damage to __ seen w behavioral abnorms and chorea most lesions to internal capsule result in combined __ defects

base of pons caudate nucleus somatomotor

__ are small cavity infarcts of BG/internal capsule/pons/cerebellum result from occlusion of small __ supplying structures usually result of __/__ __ occurs w leakage of plasma proteins through damaged endothelium see __ thickening of vasc wall, collagen sclerosis, and __ macros __ result from accumulation of lipid laden macrophages both result in small vessel __ and __ necrosis w fluid filled cavity

lacunes penetrating arterioles, HTN/DM lipohyalinosis hyaline, foamy microatheromas occlusion, liq necrosis

__ is tumor of PNS from schwann cells appear __ w high/low cell areas Antoni A areas coposed of __ cells in palisading pattern nuclear free region known as __ body usually __ positive due to NCC origin __ is another S100 positive tumor Schwann cells are __ insulation of axons can occur in cranial __/spinal __

schwanomma biphasic spindle Verocay S100 melanoma PNS vault, canal

Schwannoma may arise in any CN except __ which is covered w oligodendrocytes most common site of involvement is __ angle CN8 known as __ w tinnitus/vertigo/hearing loss

2 cerebellopontine acoustic neuroma

__ is bizarre looking glial cells w mitotic figures, necrosis, hemorrhage seen in frontotemporal __ grows across ___ __ is a slow growing tumor arising in __ cells of arachnoid appear as cells in __ or __ may have __ L/S/B/R can metastasize to brain usually at __ jxn look for central __ w reactive __ and edema __ assc NF1, made of immature __ Microcystic __ and __ fibers

glioblastoma, white matter corpus callosum meningioma meningoethelial loules/whorls psmamomma bodies lung, skin, bone, renal G-W necrosis gliosis optic glioma astrocytes degen w Rosenthal fibers

__ is seizure lasting > 5 min or occurrence of multiple seizures w incomplete __ may be due to __ brain injury, I, __ abnorms, __ noncompliance IV __ potentiates GABA and is drug of choice IV __ is admin concurrently, anticonvulsant to prevent __ Phenytoin inhibits ___ __ is irreversible inhibitor of GABA transaminase used for __ resistant epilepsy

status epilepticus recovery structural, infection, met, med Lorazepam phenytoin, recurrence Na channels vigabitrim

__ blocks Na channels and inc Gaba Benzo/phenobarbitol inc __ action __ modulates gaba/glutamate release __ blocks Thalamic T type Ca channels

valproic acid GABA a levetiracetam ethosuxamide

__ is opioid analgesic for chronic pain all opioid receptors coupled to inhibitory __ proteins Morphine has high affinity for the __ receptor this reduces __ influx by closing presynaptic voltage gated channels and dec __ NT release from presynaptic terminal also bind to mu receptor on __ to open K channels allowing for __ thus producing __

morphine G proteins mu Ca excitatory postsynapse, efflux

Fluent aphasia that cannot understand language is due to lesion in __ area this is the posterior portion of superior temporal gyrus in __ lobe known as the __ cortex supplied by inferior terminal ___ superior terminal MCA supplies __ area

wernicke temporal auditory association MCA broca

__ nerve descends in obturator canal to supply __ muscle powers muscles for __ anterior division gives of terminal cutaneous branch for __ over distal medial thigh femoral nerve innervate __ for leg extension extension of thigh via __ and IGN innervation Psoas, iliacus, sartorius used to __ the thigh

obturator nerve obturator externus thigh adduction sensation quad femoris gluteus maximus flex

blurry vision, diplopia, weak/numb, bowel bladder dysfxn in woman <50 is __ __ is monocular visual loss w pain on eye movement and afferent light defect look for white matter lesions in __ region pathology is __ reacting to antigens in myelin B cells indicate __ Ig bands in CSF __ proliferate and form the scar after attack to oligodendrocytes

MS optic neuritis paraventricular Helper T cells oligoclonal astrocytes

__ cells found in choroid plexus and produce CSF __ are macrophages in CSF ___ targeted by peripheral demyelinating disorders

ependymal cells microglia schwann cells

loss of grey-white matter differentiation w sulcal effaceemnt indicates __ brain injury w cardiac arrest nonreactive pupils to light folllow cardiac rest means damage has occurred to __ optic nerve transmits light to midbrain and is received by __ nucleus bilateal occipital lesions lead to __ blindness __ lobes process signals from other brain areas Nondominant leads to __ and apraxia Dominant leads to L/R __

anoxic midbrain pretectal cortical parietal hemineglect confusion

pons used for __ gaze and doll eye reflex bilateral __ damage has pinpoint pupils due to lost descending symp fibers __ lobe injury can lead to memory/speech/vision/hearing problems

horizontal pontine temporal

nonrhythmic conj eye movements and involuntary jerking movements in young pt should be ___ arises from __ of AM/symp ganglion should see firm __ mass and const symptoms __ ecchymoses possible majority of pt have elevated __ metabolites biopsy shows small round blue __ and __ rosettes teset for __ amplification, which carries a poor prognosis

neuroblastoma NCC abdominal periorbital catecholamine cells, HW nMYC

Opsoclnus-myoclonus is paraneoplastic syndrome for __ is common in kids arises in __ causing ataxia may have __ rosettes as well

neuroblastoma medulloblastoma HW

Lacunar stroke seen w chronic H/D/S get hypertensive arteiolar __ and narrowing of lumen presents w pure motor hemiparesis w __ involvement pure sensory stroke w __/__ of thalamus ataxia hemiplegia syndrome w ___ usually not seen by __ can turn into __

HTN/DM/smoking sclerosis posterior internal capsule VPLN/VPM posterior internal capsule CT lacunes

spontaneous lobar/cortical hemorrhage is most commonly due to cerebral __ angiopathy __ aneurysm leads to intraparenchymal hemorrhage saccular aneurysm seen w __ hyperattenuation of __/__

amyloid CB SAH sulci/cisterns

__ modulates ataxia and truncal posture coordinates w __ descending motor systems lesion to this region results in truncal __ w unsteady/broad based gait pt can also get V/N w involvement of lower vermis/flocculonodular lobe limb dysmetria occurs w damage to __ and lateral descending motor system

vermis medial ataxia vertigo/nystagmus cerebellar hemispheres

optimal site for femoral nerve is the ___ anesthetize __/___ of anterior thigh/femur/knee __ is not in the femoral canal __ is a landmark for pudendal nerve block

inguinal crease skin/muscles femoral nerve

TCA like __ have strong __ properties like C and urinary __ __ is SNRI used for depression/anx/chronic pain SE is C

amitryptaline, anticholinergic retention duloxetine confusion

Putaminal hemorrhage involves ___ w contralateal hemiparesis/anesthesia disrupted __/__ in posterior limb leads to HA/N/V/AMS appears as __ on CT and can result in __ w midline shift most freq affected location is __, cerebellar nuclei, T/P basal ganglia supplied by __ arteries from the MCA

interenal capsule CS/somatosensory fibers hyperdense mass effect basal ganglia, thalamus, pons lenticulostriate

spontaneous deep intracerebral hemorrhage caused by __ vasculopathy

HTN

Neuro 2 Flashcards

(56 cards)