Neuro Flashcards
(322 cards)
1
Q
CN arising from spinal cord
A
CNXI (accessory nucleus found at C1-C4 spinal cord levels)
2
Q
CN arising from the medulla oblongata
A
CN IX, X, XII
3
Q
CN arising from pontomedullary junction
A
CN VI, VII, VIII
4
Q
CN arising from pontocerebellar angle
A
CN VII and VIII
5
Q
CN arising from the pons
A
CN V, VII
6
Q
CN arising from midbrain
A
CN II, IV
7
Q
CN arising from the posterior aspect of the midbrain
A
CN IV
8
Q
CN arising from diencephalon
A
CN II
9
Q
CN arising from telencephalon
A
CN I
10
Q
Signs of Foster Kennedy Syndrome
A
olfactory groove meningioma, IL anosmia, IL optic atrophy, CL papilledema
11
Q
CN sensory ganglia
A
TGIS9+10
Trigeminal (CNV), Geniculate (CNVII), inferior and cuperior ganglia (CN IX, X)
12
Q
CN motor ganglia
A
COPS ciliary (CN III) Otic (CN IX) Pterygopalatine (CN VII) Submandibular (CN VII) Intramural (CN X)
13
Q
Nerves traversing the jugular foramen
A
CN IX, X, XI
14
Q
Nerves traversing the supraorbital fissure
A
CN III, IV, V1 (ophthalmic)
15
Q
Nerves traversing cavernous sinus
A
CN III, IV, VI, V1 (opthalmic) and V2 (maxillary) + internal carotid plexus (sympathetic)
16
Q
Nerve through foramen rotundum
A
CN V2 (maxillary)
17
Q
Nerve through foramen ovale
A
CN V3, (mandibular)
18
Q
Nerve through foramen magnum
A
CN XI + sympathetic plexus on vertebral artery
19
Q
Nerves through internal auditory meatus
A
CN VII, VIII
20
Q
nerves through stylomastoid foramen
A
CN VII
21
Q
Brainstem Nuclei for CN III
A
oculomotor, Edinger-Westphal
22
Q
Brainstem Nucleus for CN IV
A
Trochlear Nerve
23
Q
What CN decussates before exiting the brainstem?
A
CN IV
24
Q
Brainstem nuclei for CN V
A
chief sensory nucleus, mesencephalic, spinal trigeminal, trigeminal motor nucleus
25
Brainstem Nucleus for CN VI
Abducens
26
Brainstem Nucleus for CN VII
Facial, Superior Salivatory, Spinal Trigeminal, Solitary
27
Brainstem Nuclei for CN IX?
nucleus ambiguous, inferior salivatory, spinal trigeminal, solitary
28
Brainstem nuclei for CN X
Nucleus Ambiguis, dorsal vagal, spinal trigeminal, solitary
29
Nucleus for CN XI
acessory nucleus (cervical spinal cord)
30
Brainstem Nucleus for CN XII
Hypoglossal
31
two smooth muscles innervated by CN III
sphincter/constrictor pupillae + ciliary body
32
5 skeletal muscles innervated by CN III
levator palpebrae, superior rectus, medial rectus, inferior oblique, inferior rectus
33
Three components of the near triad
3 by III, convergence of eyes, pupilary constriction, contraction of ciliary muscle
34
muscle innervated by CN IV
superior oblique
35
action of muscle innervated by CN IV
intorsion, abduction and depression (turns pupil down and out)
36
Action to test muscle innervated by CN IV
Adduct and depress [in and then down]
37
Muscle innervated by CN VI
Lateral rectus
38
Signs of compressive injury to CN III
dilated pupil with normal eye movements
39
Aneurysm of what artery compresses CN III
Posterior Communicating Artery
40
Signs fo Diabetic Infarct in CN III
Oculomotor Palsy with normal pupil
41
Signs of Injury to CN IV
Diplopia worse walking down stairs; improves with head tilt to opposite side
42
Sign of injury to CN VI
diplopia with head tilt towards paralyzed muscle
43
Location of horizontal gaze center
pons
44
Location of vertical gaze center
midbrain
45
Signs of Argyll-Robertson pupil
pupil accomadate but doesn't react (to light); tertiary syphilis; "prostitutes pupil"
46
Signs of internuclear ophthalmoplegia
injury to MLF (demyelination in MS): on leftward gaze, right eye does not adduct (convergence is still intact)
47
Structures injured in "one-and-a-half" syndrome
abducens nucleus and both MLF
48
Injury to right abducens nerve
IL CN VI palsy; cannot abduct eye
49
Injury to right abducens nucleus
ib rightward gaze, Right Eye does not ABduct, Left eye does not ADduct
50
Eye movement deficits in Right Medial Pontine Syndrome
On Rightwadr Gaze: Right eye does not ABduct, Left eye does not ADduct + on Leftward gaze Right eye does not ADduct
51
3 Causes of ptosis
CN III Palsy, Horner Syndrome, Myasthenia Gravis
52
Muscles innervated by CN V
temporalis, masseter, medial and lateral pterygoi, anterior digastric, tensor tympani, tensor veli palatinin, myelohyoid
53
Motor Signs with CN V injury
jaw closes to good side, atrophy of temporalis and masseter
54
Muscles innervated by CN VII
muscles of facial expression, poster digastric, stylohyoid, stapedius
55
Motor Signs with CN VII injury
Bell's Palsy: complete facial paralysis, can't smile or wrinkle forehead
56
Muscle Innervated by CN IX
Stylopharyngeus
57
Motor signs with CN IX injury
Dysphagia
58
Skeletal Muscles innervated by CN X
Levator veli palantini, palatoglossus, pharyngeal, laryngeal and esophageal
59
motor signs with CN X injury
dysphagia, hoarsenss, sagging palate, uvula deviated to opposite side
60
Muscles innervated by CN XI
Trapezius and SCM
61
Motor signs with CN XI injury
weakness shrugging shoulder, cannot abduct humerous beyond 90, weakness turning head to opposite side
62
Muscles innervated by CN XII
genioglossus, hyoglossus, styloglossus, intrinsic tongue muscles
63
Motor signs with CN XII injury
tongue deviates to side of lesion on protrusion, atrophy of tongue muscles
64
Skin innervated by CN V
V1 - forehead, upper eyelid and nose
V2 - cheek, lower eyelid, upper lip
V3 - jaw, lower lip
65
Skin innervated by CN VII, IX and X
small area around ear
66
What is Ramsay Hunt syndrome
Herpes infection in the geniculate ganglion = blisters in pinna
67
Signs of Ramsay Hunt Syndrome
IL facial paralysis, hyperacusis, loss of taste, herpes vesicles on external ear, canal
68
Viscera innervated by CN III
sphincter pupillae and ciliary muscle
69
Viscera innervated by CN VII
mucosa of nasal cavity, oral cavity, lacrimal, submandibular, sublingual glands
70
Viscera innervated by CN IX
parotid gland, mucosa of middle ear, mucosa of oropharynx
71
Viscera innervated by CN X
mucosa of larynx, pharynx, all viscera of foregut and midgut
72
CN/ganglia/nucleus for taste at the anterior 2/3 tongue
CN VII/ geniculate / solitary
73
General sensory innervation to anterior 2/3 tongue
CN V
74
CN/ganglia/nucleus for taste at posterior 1/3 tongue
CN IX/inferior ganglion of IX/ solitary
75
Signs of CN VII injury at the internal auditory meatus
IL complete facial paralysis, dry eye, dry mouth, hyperacusis, decreased taste on ant 2/3 of tongue (tinnitus/hearing loss if CN VIII affected)
76
Signs of CN VII injury in facial canal
IL complete facial paralysis, decreased taste on anterior 2/3 tongue
77
Signs of CN VII injury at the stylomastoid foramen
IL complete facial paralysis
78
Nerves for corneal reflex
In by CN V out by VII
79
Nerves for Pupillary Light Reflex
In by CN II, out by CN III
80
Nerves for Jaw Jerk
In by CN V, out by CN V
81
Nerves for Cough Reflex
In by CN X, out by CN X (also C3-T12 for diaphragm and intercostals)
82
Nerves for Gag Reflex
In by CN IX and out by CN X
83
Nerve most likely affected with aneurysm of Anterior Communicating/ACA
CN II
84
Nerve most likely affected with aneurysm of Posterior Communicating Artery
CN III
85
Nerve most likely affected with aneurysm at basilar bifurcation
CN III
86
Nerve most likely affected with aneurysm of ICA in cavernous sinus
CN VI
87
Nerves most likely affected with aneurysm of PICA
CN IX, X, XI, XII
88
What neurons (4 locations) are involved in discriminitive touch/proprioception/vibration pathway
posterior root ganglion, nucleus gracilis/cuneatus, VPL thalamus, postcentral gyrus
89
Where does the posterior column/medial lemniscus decussate?
rostral medulla (decussation of medial lemniscus as internal arcuate fibers)
90
Signs of injury to posterior columns in spinal cord
IL loss of discriminitive touch, proprioception and vibratory sense
91
Signs of injury to medial lemniscus
CL loss of discriminitive touch, proprioception and vibratory sense
92
What is Rombery test?
Test of Proprioceptive function, have patient stand upright with arms abducted eyes open and closed
93
3 sensory modalities that maintain stability of the trunk
vision, proprioception and vestibular
94
What is a positive Romberg test
a marked difference in the ability to maintain erect posture with eyes open and closed
95
What does a Romberg test look like in someone with cerebellar injury?
Patient cannot stand up even with eyes open
96
Neurons (4 locations) in pain/temperature pathway?
posterior root ganglia, posterior horn, VPL thalamus, postcentral gyrus
97
Where does the spinothalamic tract decussate?
Anteriori White Commissure, Spinal cord, at all levels
98
Deficits in Syringomyelia
BL dermatomal loss of pain and temperature (usually upper limbs)
99
Cause and signs of Dejerine-Roussy Syndrome
Extreme hypersensitivity to painful stimuli following posterior thalamic infarct
100
What is the function of lower motor neurons
innervate skeletal muscle
101
locatino of lower motor neurons
spinal cord + motor cranial nerve nuclei (III, IV, V, VI, VII, IX, X, XI, XII)
102
Location of upper motor neurons
cerebral cortex, red nuclear, reticular formation
103
Signs of injury to upper motor neuron
hemiparesis, increase muscle stretch reflexes (hyper-reflexia), spasiticty, clonus, +Babinski sign and Hoffman sign
104
Lower Motor Neuron (LMN) signs
paralysis, decreased muscular stretch reflexes (hyporeflexia), flaccid tone, atrophy
105
Motor tracts in the Posterior Limb of the internal capsule
Corticospinal (upper imb, lower limb)
106
What is spasticity?
a velocity-dependent increase in muscle tone (injury to UMNs)
107
What is rigidity?
A velocity-independent increase in muscle tone (damage to Basal Nuclei structures)
108
The corticospinal tract decussates at what level?
pyramidal decussation, caudal medulla
109
Motor tracts in the genu of the internal capsule
corticobulbar (to cranial nerve nuclei)
110
Signs of injury to the corticospinal tract in the right internal capsule
left UMN signs
111
Signs of injury to the corticospinal tract in the cervical spinal cord on the right
right, UMN signs
112
Signs of injury to the corticobulbar tract in the right internal capsule
Left, lower facial paralysis; tongue points away from lesion
113
Features of decorticate posture
UL flexed; LL extended
114
Location of lesion in decorticate posturing
rostral midbrain or thalamus (red nucleus intact)
115
Features of Decerebrate posturing
UL and LL extended
116
Location of lesion causing Decerebrate posturing
Midbrain - damage involving red nucleus or rubrospinal tract
117
Signs of Myopathy
Proximal Symmetric weakness, no sensory loss
118
What are the 2 most common causes of peripheral neuropathies?
Diabetes and Alcoholism
119
Signs of polyneuropathy
Stocking/Glove sensory loss
120
neurons in auditory pathway (at least 6)
Spiral ganglion, Cochlear Nucleus, Superior Olive, Inferior Colliculus, Medial Geniculate, Primary Auditory Cortex
121
Normal human frequency hearing range
20Hz to 20kHz --> decreases with age
122
Result of Rinne test in normal ear
air conduction > bone conduction
123
Result of Rinne test in Conductive Hearing Loss
Air Conduction < Bone Conduction
124
Result of Rinne test in Sensorineural Hearing Loss
Air Conduction > Bone Conduction
125
Weber in Normal Hearing
Localize to Midline
126
Weber test with Sensorineural hearing loss in Right Ear
Localize to the Left
127
Weber test with Conductive Hearing Loss in Right Ear
Localize to the RIght
128
Deficits with injury to CN VIII
IL deafness, dizziness, CL nystagmus
129
Deficits with injury to brainstem auditory pathways
BL hearing loss (greater on CL side)
130
What is presbycusis?
age-related hearing loss, high frequencies lost first
131
Neurons in visual pathway (3 Neurons)
Retinal Ganglion Cells, Lateral Geniculate, Primary Visual Cortex
132
Signs of injury to optic nerve/retina
IL visual loss, can affect both temporal and nasal hemifield
133
Signs of injury to optic chiasm
bitemporal hemianopsia
134
signs of injury to optic tract
CL homonymous hemianopsia
135
signs of injury to Meyer's loop
Upper quadrant homonymous hemianopsia
136
Visual deficits in PCA stroke affecting calcarine sulcus
CL homonymous hemianopsia, with macular sparring
137
What is Marcus Gunn pupil?
Optic Nerve Lesion, when light is shown into bad eye, pupil dilates
138
What Structures comprise the basal nuclei (ganglia)?
Caudate, Putamen, Globus Pallidus, Subthalamic nucleus, Basal Nucleus of Meynert
139
Brain region affected in Parkinson disease
substantia nigra, pars compacta (dopamine)
140
Signs of Parkinson Disease
Bradykinesia, Pill-rolling tremor, masked facies, postural instability
141
Pathological Sign of Parkinson Disease
Loss of Dopaminergic neurons in substantia nigra + Lewy bodies in SN
142
Brain region affected in Huntington disease
Caudate Nucleus
143
Signs of Huntington Disease
Choreioform movements, dementia
144
Brain region injured in right hemiballismus
Left subthalamic nucleus
145
Signs of Essential Tremor
Chronic, Progressive tremor in arms, neck, larynx, chin; reduced with alcohol consumption
146
What is Wilson Disease?
Inborn error of Copper metabolism; Kayser-Fleischer rings; wing-beating tremor, rigidity
147
Structures most susceptible to cerebral hypoxia (CO poisoning, drowning, strangulation)
Globus pallidus and putamen
148
What are the signs of Cerebellar Injury?
Ataxia, Dysmetria, Dysdiadokinesia, Nystagmus, Dysarthria
149
Signs of injury to vestibulocerebellum (flocculonodular lobe)?
truncal atazia, nystagmus
150
Signs of injury to lateral hemisphere of cerebellum/dentate nucleus
IL limb ataxia, intention tremor, dysarthria
151
Signs of injury to middle cerebellar peduncle
IL limb ataxia
152
Results of caloric testing in normal individual
COWS
Cold - nystagmus to opposite side
Warm - nystagmus to same side
153
Signs of Arnold Chiari I malformation
extension of cerebellar tonsil below foramen magnum
154
Signs of Arnold Chiari II malformation
displaced vermis - myelomeningiocele
155
Signs of Dandy-Walker
Enlarged posterior Fossa, small cerebellum, absent vermis, cystic dilation of 4th ventricle, hydrocephalus
156
Signs of injury to corticospinal tract in spinal cord
UMN signs below lesion
157
Signs of injury to anterior horn of spinal cord
LMN signs AT level
158
Signs of injury to posterior columns
IL loss of discriminitive touch, proprioception and vibrator sense
159
Signs of injury to spinothalamic tract
CL loss of pain and temperature sensation
160
Signs of Intramedullary Tumor/Central Cord Syndrome
Sensory Loss, Sacral sparing of motor function, maybe bowel/bladder disturbances
161
Deficits in Anterior Spinal Syndrome
UMN signs below lesion, LMN signs at level, loss of pain and temperature below lesion, discriminitive touch, proprioception and vibration are intact
162
Deficits in Tabes Dorsalis
loss of disc touch, proprioception and vibration below lesion, Romberg sign
163
Deficits in Brown-Sequard Injury
IL loss of discriminitive touch, CL loss of pain/temp, UMN signs below lesion, LMN signs at level
164
Deficits in Friedreich's Ataxia
loss of disc touch, proprioception and vibration below lesion, Romberg sign, ataxia and UMN signs below lesion
165
Deficits in Subacute Combined Degeneration
B12 deficiency; loss of disc touch, proprioception and vibration below lesion, UMN signs below lesion
166
Signs of Conus Medullaris Syndrome
sudden, bilateral onset; decrease calcaneal reflex, perianal sensory loss, impotence, urinary and fecal incontinence
167
Signs of Cauda Equina Syndrome
gradual, unilateral onset, calcaneal and patellar reflexes decreased, saddle sensory loss
168
Signs of tethered cord syndrome
commonly associated with spina bifida, pain, weakness, sexual dysfunction
169
Signs of Spinal Cord Transection at C6
LMN signs at C6 (brachioradialis), UMN signs below; complete sensory loss below C6
170
Signs of Spinal Cord transection at L4
LMN signs at L4 (quads), UMN signs below; complete sensory loss below L4
171
Deficits in medial medullary syndrome
CL loss of discriminitive rouch, CL UMN signs, tongue deviates to lesion on protrusion (w/ fasciculations)
172
Artery involved in medial medullary syndrome
Alternating branches of anterior spinal artery
173
Deficits in lateral medullary syndrome
IL loss of pain and temp on face, CL loss of pain and temp on body, dysphagia, hoarseness
174
Artery involved in lateral medullary syndrome
PICA
175
Deficits in medial pontine syndrome
CL loss of discriminitive rouch, CL UMN signs, IL CN VI palsy + INO…maybe 1 1/2 syndrome
176
Artery involved in medial pontine syndrome
basilar, paramedian branches
177
Deficits in lateral pontine syndrome
IL loss of pain and temp on face, CL loss of pain and temp on body, CN VII or V palsy
178
Artery involved in lateral pontine syndrome
basilar and circumferential branches
179
Deficits in Weber Syndrome
IL CN III palsy, CL UMN sign, CL lower facial paralysis
180
Deficits in Benedikt Syndrome
IL CN III palsy, CL ataxia [superior cerebellar peduncle]
181
Deficits in Claude Syndrome
IL CN III palsy, CL UMN sign, CL lower facial paralysis, CL ataxia
182
Arteries involved in midbrain syndromes
Paramedian branches from PCA
183
Strokes that can lead to Horner Syndrome
Lateral Medullary, Cervical Spinal
184
Signs/ Symptoms of basilar artery thrombosis
hemi or tetraparesis (corticospinal tract), dysarthria (nuc. Amg/corticonuclear tract), lower facial paralysis (corticonuclear tract), altered consciousness (reticular formation), visual disturbances (med geniculate/optic tract)
185
What signs/symptoms are characteristic of cortical injury?
aphasia, agnosia, anosognosia, primitive reflexes: grasp, snout, suck, root, magnetic gate, astereognosia, apraxia, contralateral neglect
186
Deficits in left inferior division MCA stroke
receptive aphasia, CL homonymous hemianopsia
187
Deficits in left superior division MCA stroke
expressive aphasia, CL UMN signs [face + UL], CL sensory loss [face + UL]
188
Deficits in right MCA main stem stroke
CL UMN signs [face, UL + LL], CL sensory loss [face, UL + LL]
189
Deficits in left PCA stroke
CL homonymous hemianopsia with macular sparring
190
Deficits in left ACA stroke
CL UMN signs [LL], frontal lobe signs
191
Deficits in Parinaud Syndrome
vertical gaze palsy, obstructuve hydrocephalus
192
Deficits in Anterior Choroidal Artery Stroke
CL UMN signs, CL homonymous hemianopsia
193
Deficits in lenticulostriate artery hemorrhage
CL UMN signs, CL lower facial paralysis, tongue deviates away from lesion
194
Blood supply to thalamus
posterior cerebral [thalamogeniculate + thalamoperforating]
195
Signs of thalamic hemorrhage
CL sensory loss, CL homonymous hemianopsia
196
Signs of tonsillar herniation
respiratory and cardiovascular arrest
197
Signs of uncal herniation
CN III palsy, UMN signs, papilledema
198
Structure injured in CL neglect
Right parietal lobe
199
Signs of Gerstman's syndrome
acalulia, left-right confusion, finger agnosia; left parietal lobe
200
Structure damaged in alexia without agraphia
left splenium of corpus callosum
201
Where is Broca's area? Function?
left inferior frontal gyrus; expressive speech
202
Where is Wernicke's area? Function?
left supramarginal, angular, superior temporal gyri; receptive speech
203
Signs of Conduction Aphasia
normal comprehension and fluent speech; impaired repetition
204
Aphasia type in a patient who is fluent, cannot comprehend or repeat?
Wernicke's
205
Aphasia type in a patient who is not fluent, can comprehend but cannot repeat?
Broca's
206
Aphasia type in a patient who is fluent, can comprehend but cannot repeat?
Conduction
207
Aphasia type in a patient who is not fluent, cannot comprehend or repeat?
Global
208
Structures implicated in obsessive compulsive disorder?
Basal nuclei, cingulate gyrus, orbitofrontal cortex, raphe nuclei
209
Structures implicated in Schizophrenia
Limbic System, Frontal Lobe, Basal Nuclei
210
Cause of Cushing's Disease
ACTH-secreting pituitary adenoma
211
Signs of LH or FSH secreting adenoma
hypogonadism and infertility
212
Signs of prolactin-secreting adenoma
amenorrhea in females, hypogonadism in men, galactorrhea, infertility, hair loss, decreased libido, weight gain
213
Signs of Diabetes Insipidus
Polyuria, Polydipsia
214
Signs of SIADH
concentrated urine with osmolality >300mOsm/L
215
SIADH treated with rapid infusion of hyperotnic saline will cause
central pontine myelolysis
216
Signs of craniopharyngioma
visual deficits, diabetes insipidus, adiposity, developmental delay, HA, papilledema
217
Craniopharyngioma derived from
remnant of Rathke's pouch
218
Bladder problems in cortical lesions (paracentral lobule)
uninhibited, spastic bladder
219
Bladder problems in brainstem/high spinal cord injury
flaccid paralysis that becomes spastic (urge incontinence, hyperactive, empties too frequently)
220
Bladder Problems in Sacral spinal cord injury
overflow incontinence
221
Disturbances of erection/ejaculation with spinal cord injury above T12
loss of psychogenic erections, reflex erections intact, only reflex ejaculation
222
Disturbances of erection/ejaculation with sacral spinal cord injury
loss of reflex erection, psychogenic may be preserved, ejaculation is abolished
223
Signs of Horner Syndrome
Constricted pupil, ptosis, red face, anhydrosis
224
Site of injury in patient with miosis, ptosis and CN VI palsy
cavernous sinus - ICA aneurysm (sympathetics follow ICA and CN VI is riding on ICA)
225
Why no red face/anhydrosis in previous patient?
External Carotid Nerve is intact
226
Components of the Limbic System
parahippocampal gyrus, uncus, hippocampus, amygdala
227
Structures in the Papez circuit
hippocampus, mamillary body (via fornix), anterior nucleus of thalamus, cingulate cortex
228
Function of hippocampus
consolidation of short term memory
229
Part of hippocampus most vulnerable to seizure activity
CA4
230
Part of hippocampus most susceptible to anoxia
CA1
231
Structure affected in Korsakoff Syndrome
mammillary bodies, dorsomedial thalamus
232
Metabolic deficiency in Korsakoff Syndrome
Thiamine
233
Signs of Korsakoff Syndrome
amnesia, confabulation with short term memory intact
234
Signs of Wernicke-Korsakoff syndrome
ophthalmoplegia, ataxia and disturbances of mentation and consciousness
235
Signs of injury in akinetic mutism
immobile, mute and unresponsive but awake; BL lesion of cingulate gyrus
236
Signs of Kluvy-Bucy syndrome
Placid, visual agnosia, hyperorality
237
Brain region injured in Kluver-Bucy syndrome
BL temporal lobe
238
Signs of normal pressure hydrocephalus
wet, wacky, wobbly
239
structure damaged in epidural hematoma
middle meningeal artery
240
Structure damaged in subdural hematoma
"bridging" beins (cerebral beins emptying into superior sagittal sinus)
241
How do you age subdural hematomas?
acute bleed is white (hyperdense) on CT; isodense in 1-2weeks and hypodense after that
242
Structure damaged in subarachnoid hemorrhage
vessels in or around the circle of willis
243
contents of cisterna magna
vertebral artery, CN IX, X, XI and XII, choroid plexus
244
Contents of prepontine cistern
basilar artery, CN VI
245
Contents of cerebellopontine cistern
CN V, VII, VIII
246
Contents of Interpeduncular cistern
CN III
247
Contents of the ambient cistern
CN IV
248
Structure comprising the lateral wall of the lateral ventricle?
caudate nucleus
249
Structure(s) comprising the lateral wall of the 3rd ventricle?
thalamus, hypothalamus
250
Structure at floor of 4th ventricle?
pons [facial colliculus], medulla [hypoglossal trigone]
251
Signs of injury to facial colliculus?
facial colliculus (genu of facial nerve and abducens nucleus) = IL facial paralysis + IL CN
252
Signs of injury to the reticular formation?
Coma
253
Components of the diencephalon?
thalamus, hypothalamus, epithalamus (pineal), subthalamus
254
Deficits in ALS?
UMN and LMN signs, sensation intact
255
Deficits in MS?
multiple (motor, sensory, special sensory, cognitive) deficits in time and lesions in space
256
Deficits in Guillan-Barre?
typically follows viral illness or vaccination, ascending paralysis (LE then UE), some
257
Signs of radiculopathy?
pain/sensory loss in a dermatomal pattern
258
What is tabes dorsalis?
demyelination of posterior columns from syphillis
259
Signs/symptoms of tabes dorsalis?
decreased muscle stretch reflexes, loss of discriminitve touch, proprioception and vibratory sense, + Romberg, ataxia (not from cerebellum)
260
Structures innervated by posterior rami?
deep back muscles and overlying skin
261
Dermatome for C2?
back of the scalp; greater occipital nerve [posterior ramus of C2]
262
Signs of injury to musculocutaneous nerve in axilla?
decreased biceps reflex, weakness in flexion at elbow, supination, sonsory loss along
263
Signs of injury to median nerve at elbow?
severe weakness in forearm flexion, paralysis of thenar muscles, sensory loss over
264
Signs of injury to median nerve at carpal tunnel?
paralysis of thenar muscles, sensory loss over palmar aspect and tips of digits 1 - 3, lateral half of digit 4
265
Signs of injury to ulnar nerve at cubital tunnel?
weakness in flexion of digits 4 and 5, sensory loss in 5th digit (palmar and dorsal), weakness in ab/adduction of fingers, hypothenar muscles, adductor pollicis , Froments sign, slight ulnar claw
266
Signs of ulnar nerve injury at Guyon's tunnel?
sensory loss in 5th digit (palmar only), weakness in ab/adduction of fingers, hypothenar muscles, adductor pollicis , Froments sign, ulnar claw
267
Signs of injury to radial nerve with midshaft humeral fracture?
wrist drop, weak supination, sensory loss on dorsum of hand, triceps normal
268
Signs of injury to radial nerve in axilla?
paralyzed triceps, decreased triceps reflex, decreased brachioradialis reflex, wrist drop, weak supination, sensory loss on dorsum of hand
269
Signs of lesion to upper roots of brachial plexus?
Erb-Duchenne palsy, decreased biceps + brachioradialis reflexes; arm is medial rotated and extended [cant abduct, laterally rotate of flex at elbow], sensory loss over lateral arm
270
Signs of lesion to lower roots of brachial plexus?
Klumpke palsy, complete claw, sensory loss over 5th digit and medial arm, forearm
271
Signs of thoracic outlet syndrome?
weakness in intrinsic hand muscles, sensory loss over 5th digit and medial arm, forearm
272
Signs of injury to C5 nerve root?
weakness in abduction, lateral rotation and flexion at elbow, decreased bicep reflex, sensory loss over lateral arm
273
Signs of injury to C6 nerve root?
weakness in wrist extension, flexion at elbow, decreased brachioradialis reflex, sensory loss over lateral forearm
274
Signs of injury to C7 nerve root?
weakness in finger extension, elbow extension, wrist flexion, decreased tricep reflex, sensory loss over middle finger
275
Signs of injury to C8 nerve root?
weakness in finger flexion, sensory loss over 4th + 5th digit, medial forearm
276
Signs of injury to T1 nerve root?
weakness in finger ab/adduction, sensory loss over medial forearm/arm
277
Signs of injury to lateral femoral cutaneous nerve?
sensory loss over anterior and lateral thigh; aka meralgia paresthetica
278
Signs of entrapment/injury to saphenous nerve?
sensory loss along anterior and medial leg, medial malleolus and foot
279
Signs of injury to femoral nerve?
paralysis of quadriceps, decreased patellar reflex, sensory loss along anterior and medial thigh, leg, medial malleolus and foot
280
Signs of piriformis syndrome?
decreased achilles reflex, weakness in knee flexors, dorsiflexors, plantar flexors, sensory loss over lateral leg, lateral malleolus, dorsum of foot
281
Signs of injury to common fibular nerve?
foot drop, weakness in dorsiflexion, eversion, sensory loss over lateral leg and dorsum of the foot
282
Signs of injury to superficial fibular nerve?
weakness in eversion, sensory loss over dorsum of foot
283
Signs of injury to deep fibular nerve?
foot drop, weakness in dorsiflexion, eversion, sensory loss in the web between 1st and 2nd toes
284
Signs of injury to tibial nerve in popliteal fossa?
weakness in plantar flexion, toe flexion, weakness in intrinsic foot muscle, sensory loss on plantar surface of foot
285
Signs of injury to the tibial nerve in tarsal tunnel?
weakness in intrinsic foot muscles, sensory loss on plantar surface of foot
286
Signs of injury to superior gluteal nerve?
Trendelenburg sign: pelvis drops to good side during gait, paralysis of gluteus medius, minimus and tensor fascia lata
287
Signs of injury to inferior gluteal nerve?
Paralysis of gluteus maximus, weakness in extension and lateral rotation of thigh
288
Signs of injury to L2 nerve root?
weakness in leg flexion, knee extension, adduction, sensory loss over anterior thigh
289
Signs of injury to L4 nerve root?
weakness in knee extension, decreased patellar reflex, sensory loss over anterior medial leg, medial malleolus
290
Signs of injury to L5 nerve root?
weakness in dorsiflexion, toe extension, abduction of thigh, sensory loss over anterior leg, dorsum of foot, digits 1 and 2
291
Signs of injury to S1 nerve root?
weakness in plantar flexion, eversion, hip extension, decreased achilles reflex, sensory loss over posterior leg, digits 3-5
292
Signs of injury to S2 nerve root?
weakness in toe flexion, decreased anal wink, sensory loss over posterior thigh, perineum
293
Structure infected in herpes zoster?
posterior root ganglion
294
Reflex for C5?
biceps [via musculocutaenous n]
295
Reflex for C6?
brachioradialis [via radial n]
296
Reflex for C7?
triceps [via radial n]
297
Reflex for L1?
cremaster [ilioinguinal and genitofemoral ns.]
298
Reflex for L4?
patellar tendon [quadriceps, via femoral n]
299
Reflex for S1?
Achilles/calcaneal tendon [gastroc, via tibial n]
300
Levels of sympathetic innervation of the eye?
T1 - T4
301
Levels of sympathetic innervation of the heart?
T1 - T4
302
Levels of sympathetic innervation of the lungs?
T2 - T7
303
Levels of sympathetic innervation of the foregut?
T5 - T9
304
Levels of sympathetic innervation of the small intestine?
T9 - T10
305
Levels of sympathetic innervation of the large instestine to splenic flexure?
T11 - L1
306
Levels of sympathetic innervation of the descending colon to rectum?
L1 - 2
307
Levels of sympathetic innervation of the kidney?
T10 - L1
308
Levels of sympathetic innervation of the testes/ovary?
T10 - 11
309
Levels of sympathetic innervation of the pelvic organs?
T11 - L2
310
Levels of sympathetic innervation of the upper limb?
T2 - 7
311
Levels of sympathetic innervation of the lower limb?
T10 - L2
312
Parasympathetic innervation of the eye?
CN III, Edinger-Westphal
313
Signs of Adie's pupil?
tonically dilated pupil that constricts with low dose pilocarpine
314
Structure injured in Adie's pupil?
ciliary ganglion
315
Parasympathetic innervation of the lacrimal, submandibular and sublingual glands?
CN VII, superior salivatory
316
Parasympathetic innervation of the parotid gland?
CN IX, inferior salivatory
317
Parasympathetic innervation of the thoracic organs?
CN X, dorsal vagal
318
Parasympathetic innervation of midgut?
CN X, dorsal vagal
319
Parasympathetic innervation of the kidney?
CN X, dorsal vagal
320
Parasympathetic innervation of the testes/ovaries?
S2 - 4 + dorsal vagal
321
Parasympathetic innervation of the hindgut?
S2 - 4
322
Parasympathetic innervation of pelvic organs?
S2 - 4
