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1
Q

sensation with no thalamic relay

A

olfaction (CNI)

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2
Q

VPL nucleus

A

spinothalamic tract (pain and temperature) and medial lemniscus/dorsal columns (position and proprioception)

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3
Q

VPM nucleus

A

trigeminal and gustatory pathway

-FACE SENSATION, TASTE

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4
Q

LGN

A

relay nucleus for VISION

-receives impulses from the optic nerve and transmits via optic radiations to visual cortex (calcarine sulcus)

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5
Q

MGN

A

input from superior olivary nucleus and inferior colliculus of the pons-relay for HEARING

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6
Q

VL

A

input form basal ganglia, cerebellum

MOTOR info to motor cortex

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7
Q

opiods gen mech

A

G protein linked receptors that

open K, close ca2+ channels decreasing synaptic transmission and release of Ach, Ne, 5HT, glutamate, substance P

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8
Q

Benzos gen mech

A

allosterically bind and modulate GABA receptor-Cl channel in CNS-increasing frequency of opening
-influx of Cl–less excitable
anxiolytics, anticonvulsants, muscle relaxants, sedatives-hynotics
-benzo tolrance via downregulation of GABA receptors

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9
Q

barbituates gen mech

A

bind and increase GABA receptor-Cl channel opening in CNS (bind at different site than benzos do)

  • at high doses cause direct gating of the ion channels (ie channel opening without the need of GABA to bind as well)
  • cause more hangover
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10
Q

drugs to avoid with lithium use

A 
thiazide diuretics (working at DCT therefore not loop), ACEi, NSAIDs
increase lithium levels and more likely to cause lithium toxicity
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11
Q

triptans mech

A

serotonin 5ht agonists that lead to inhibition of vasoactive substance release (ie substance P and calcitonin gene related peptide (CGRP)) , vasoconstriction and block pain pathways

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12
Q

SSRIs

A

block presynaptic serotonin reuptake

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13
Q

TCAs/SNRIs

A

block serotonin/NE PREsynaptic reuptake

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14
Q

buproprion

A

blocks presynaptic dopamine and NE reuptake

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15
Q

phenytoin mech

A

reduces ability of Na channels to recover from inactivating, reducing overall firing

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16
Q

carbamezapine mech

A

increases Na refractory period making longer inactivation and decreasing AP firing

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17
Q

free nerve endings

A

pain/temperature
c-slow unmelyinated type
Adelta-fast, myelinated type
on all skin, some viscera

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18
Q

Meissner corpuscles

A

dynamic, fine/light touch, position sense
large myelinated fibers, adapt quickly
on glabrous (hairless) skin

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19
Q

Pacinian corpuscles

A

vibration/pressure
large myelinated fibers, adapt quickly
deep skin layers, ligaments, joints

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20
Q

Merkel discs

A

pressure, deep static touch (shapes/edges), position sense

large myelinated fibers adapt slowly, fingertips, superficial skin

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21
Q

RUffini corpuscles

A

pressure, slippage of objects along joint skin, joint angle change
dendritic endings with capsule, adapt slowly
fingertips, joints

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22
Q

nucleus accumbens

A

GABA

down in HD, anxiety

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23
Q

locus ceruleus

A

NE
up in anxiety
down in depression

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24
Q

ventral tegmentum and SN pars compacta

A

dopamine
up in HD
down in PD, depression

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25
Raphe nuclei (pons, medulla, midbrain)
serotonin | down in depression, anxiety
26
basal nuclei of myenert
ACh down in alzheimers, huntintons up in PD
27
tongue innervation
taste: ant 2/3 VII via chorda typmani, post 1/3 IX (glossopharyngeal) Pain: ant 2/3 via V3 mandibular, post 1/3 IX motor: styloglossus (taco) genoglossus, hypoglossus via XII hypoglossal, palatoglossal via X
28
organum vasculosum of the lamina terminalis
OVLT in hypothalamus -area not protected by BBB -senses change in osmolarity
29
area postrema
in hypothalamus not protected by BBB -responds to emetics
30
supraoptic nuclues
in hypothalamus | makes ADH
31
paraventricular nucleus
in hypothalamus | makes oxytocin
32
lateral hypothalamus
hunger | -if injured anorexia, FTT in infants
33
ventromedial area of hypothalamus
satiety (stimulated by leptin) | -if injured majes you fat
34
anterior hypothalamus
cooling, parasympathetic
35
posterior hypothalamus
heating, parasymptathetic | if injured-cold blooked "poikilotherm"
36
suprachiasmatic nucleus
circadian rhythmm | -causes NE release which acts on the pineal gland to release melatonin
37
At night, BATS Drink Blood
Sleep cycle EEG pattern: Awake (eyes open): Beta Awake (eyes closed): Alpha NREM stage 1: theta NREM stage 2: sleep spindles and K complexes NREM stage 3: delta (lowest frequency, high amp) REM: Beta
38
kluver bucy syndrome
damage to amygdala | disinhibted personality, hypersexual, hyperphagia, hyperorality
39
gerstmann syndrome
damage to dominant parietal-temporal lobe | -agraphia, acalcula, finger agnosia, left-right disorientation
40
wing beating tremor, psychosis, cirrhosis
wilsons dz | damage to lentiform nucleus -putamen, GP
41
clasp knife spasticity
damage to internal capsule-get initial resistance then release no upper motor block of spinal stretch reflex
42
central post stroke pain syndrome
after thalamic stroke, allodyina and dysesthesia (pain with things that would normally not cause any pain)
43
riluzole
treatment for ALS | glutamate antagonist
44
B12 vs tabes dorsalis
B12-demyelination of spinocerebellar, dorsal columns, corticospinal Tabes dorsalis-demyelination of dorsal columns
45
poliomyeltis csf
increase WBC slight increase in protein no change in glucose -damage to anterior horns (LMN)
46
SMA-werdnigg hoffman
AR LMN destruction of anterior horns death by 7 months floppy baby
47
parinaud syndrome
paralysis of conjugate verticla gaze due to lesion of superior colliculus (commonly pinealoma ie germinoma or aqeuductal compression-obstructive hydrocephalous
48
APP, prenisilin 1, presnisilin 2
increased risk for early onset AD | APP=amyloid precursor protein
49
Apoe4
increased risk of AD
50
Apoe2
decreased risk of AD
51
CSF in GBS
increased protein with normal cell count | albuminocytologic dissociation
52
Krabbe disease
AR lysosomal storage disorder due to deficiency of galactocerebrosidase leading to the buildup of galactocerebroside and psychosine which destroy myelin -p/w peripheral neuropathy, developmental delay, optic atrophy, globoid cells
53
metachromic leukodystrophy
AR lysosomal storage disorder due to deficiency of arylsulfatase A with resulting buildup of sulfatides, impaired production and destruciton of myelin sheath -central AND peripheral demylination with ataxia and dementia
54
progressive multifocal leukodystrophy PML
``` associated with JC virus CNS disruption of oligodendrocytes in AIDS pts rapidly progressive usually fatal increased risk with natalizumab rituximab ```
55
adrenoleukodystrophy
AR disruption of metabolism of long chain fatty acids leading to excess buildup in nervous system, adrenal glands, testes, can lead to long term coma/death and adrenal crisis
56
STURGE
``` Sporadic, port wine Stain Tram track calcification Unilateral Retardation Glaucoma, GNAQ gene Epilepsy ```
57
HAMARTOMAS
``` Hamartomas in CNS and skin Angiofibromas/angiomyolipomas (bilateral) Mitral regurgitation Ash leaf spots Rhabdomyoloma (cardiac) TUBEROUS SCLEROSIS dOminant (autosomal) Mental retardation Angiomyolipomas Seizures/shaggreen patches increased incidence of subependymal astrocytomas and ungual fibromas(growth under toes/fingernails) ```
58
von Hippel Lindau diseae
Autosomal Dominant hemangioblastomas (in retina, cerebellum, brainstem, spine) pheochromocytomas angiomatosis (cavernous hemangiomas in skin, mucosa, organs) bilateral renal cell carcinomas
59
Neurofibromatosis I
``` NFI gene on chromosome 17 cafe au lait lisch nodules(pigmented iris hamartomas) cutaneous neurofibromas optic gliomas pheochromocytoma ```
60
GBM
grade IV astrocytoma, highly malignant stain for GFAP -histo: pseudopalisading pleomorphic tumor cells-border central ares of necrosis and hemorrhage
61
Meningoma
near surfaces of brain, extra-axial, arises from arachnoid cells- +/- tail=dural attachment histo: spindle cell, concentrically in whorled pattern, psamomma bodies
62
oligodendroglioma
chicken wire pattern of capillaries - slow growing usually at frontal lobe - fried eggs-round nuclei with clear cytoplasm
63
pilocytic astrocytoma
low grade-usually in posterior fossa (ie cerebellum) GFAP +, low grade -histo: rosenthal fibers-eosinophilic corkscrew fibers, spindle cells with hairlike glial processes -cystic + solid (gross)
64
medulloblastoma
highly malignant cerebellar tumor possibility of drop mets, obstructive hydrocephalous -histo: homer wright rosettes, small blue cells (deeply basophilic with scant cytoplasm), sheets of primitive cells with many mitotic figures
65
ependymoma
``` usually in 4th ventricle causes obs hydrocephalous, GFAP poor prognosis histo: perivascular resettes, rod shaped blepharoplasts (basal ciliary bodies) found near nucleus ```
66
craniopharyngioma
causes bitemporal hemianopia HA, visual changes, growth failure, from rathke pouch remants -cystic calcification
67
uncal/transtentorial herniation
ipsi fixed/dilated pupil ipsi oculomotor paralysis (down and out) ispi hemiparesis-->contra corticospinal tract (contra crus cerebri) at Kernohan notch contra homonymous hemianopia with macular sparing (PCA)
68
cingulate (subfalcine) herniation under falx cerebri
can compress ACA (lower motor weakness)
69
cribiform plate
CNI
70
superior orbital fissure
CN III, IV, V1, VI
71
foramen rotundum
V2
72
foramen ovale
V3
73
optic canal
CN II
74
foramen spinosum
Middle meningeal artery
75
internal auditory meatus
CN VII, VIII
76
jugular foramen
CN IX, X, XI
77
foramen mangum
spinal roots of CN XI
78
hypoglossal canal
CN XII
79
varibale opthalmoplegia, decreased corneal sensation, Horner syndrome, occasional decreased maxillary sensation
cavernous sinus syndrome - 2/2 pituitary tumor, carotid cavernous fistula, cavernous sinus thrombosis related to infection - CN VI most susceptible

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