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121

Most vulnerable areas of the brain for hypoxia?

Hippocampus, neocortex, cerebellum, watershed.

122

Histologic features of ischemia in brain.

NOTHING from 3-6h. Red neurons 12-48 hrs. Necrosis + neutrophils from 24-72h. Macrophages from 3-5 days. Reactive gliosis + vascular proliferation from 1-2 weeks. >2 weeks is a glial scar.

123

TIA definition?

Brief, reversible focal neurologic dysfunction lasting <24 hrs with NEG MRI findings of infarction.

124

Superior sagittal sinus vs. inferior saggital sinus

Superior on top. Inferior is inside off of the straight sinus as a branch (other being Great cerebral vein of Galen)

125

Phenytoin vs. phenobarbital SE's?

Generalized lymphadenopathy w/ hirsuitsm, coarsened features, gingival hyperplasia vs. acute intermittent porphyria, sedation

126

Neurofibromatosis-1

AD (Chromosome 17). Cafe-au-lait. Neurofibromas. Lisch nodules (hamartomas of iris). Pseudoarthrosis.

127

CN's in medulla

CN IX-XII

128

CN's in Pons

CN V-VIII

129

CN's above the Pons

CN I-IV

130

Restless legs syndrome treatment

First nonpharm (limit aggravating factors), Fe supplement, Dopamine agonists (pramipexole, ropinirole)

131

Valproic acid pregnancy risk?

NEURAL tube defects. 1-3%

132

By what age should a child be able to play cooperatively?

Age 4

133

By what age able to copy circle and use utensils?

Age 3

134

By what age have friends?

Age 5

135

Steps for hearing from TM

Stapes to TM -> oval window (amplification) -> fluid displacement of endolymph of scala media -> bending of cilia of hair cells (basilar vs. tectorial membranes) -> inc. OR dec. K+ conductance = dpol. or repol. -> dpol to Ca2+ release of repol to no Ca2 -< release of neurotransmitter or not -> CN VIII; Higher frequency closer to stapes (stiff) while lower frequency at compliant near apex.

136

Purpose of the foramina of Luschka and Magendie?

Connect 4th ventricle to the subarachnoid space. Luschka = Lateral. Magendie = Medial.

137

NPH

Expansion fo ventricles distorts fibers of the CORONA RADIATA -> urinary incontinence, ataxia, cognitive dysfunction

138

Communicating hydrocephalus

Decreased CSF absorption by arachnoid graduation lead to inc. ICP, papilledema, herniation

139

Hydrocephalus ex vacuo

Apparent increase of CSF 2/2 atrophy. ICP is normal. (e.g. Alzheimer's, adv. HIV, Pick)

140

Noncommunicating hydrocephalus

Due to a structural blockage within the CSF system

141

How many spinal nerves are there?

31 spinal nerves. "Have the spine of a man walking outside on January 31st."

142

Which nerves exit above their corresponding vertebra?

C1-C7.

143

To what vertebrae does the spinal cord extend to? And where do you do a LP?

Lower border of L1-L2. LP usu. between L3-L4 or L4-L5. Subarachnoid space down to S2.

144

Dorsal column body organization

Fasciculus gracilis (lower body and legs) are inside. Fasciculus ceunatus (upper body, and arms)

145

Anterolateral system body organization

Lateral spinothalamic tract. Sacral outside to cervical inside.

146

Corticospinal tract body organization

Sacral lateral. Cervical medial.

147

Anterolateral system pathway

Free nerve endings synapse in ipsilateral gray matter and decussates within 2-3 levels in anterior white commisure, ascending CONTRlaterally, synapsing at VPL -> sensory cortex

148

Dorsal column pathway

Fine touch, vibration, pressure, propioception enter spinal cord and ascend ipsilaterally until it synapses at the nucleus cuneatus (lateral) or gracilis (medial) -> decussates at the MEDULLA and ascends contralaterally up the medial lemniscus -> synapses at VPL -> sensory cortex

149

Spastic paralysis vs. flaccid paralysis

UMN vs. LMN signs

150

ALS

Combined UMN and LMN w/ NO sensory, cognitive, or oucular motor deficits. Some etio = defective superoxide dismutase I. Riluozole tx modest (dec. presynaptic glutamate release).