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Flashcards in Neuro Deck (258):
1

Branchial Clefts are derived from

Ectoderm

2

Branchial Pouches are derived from

Endoderm

3

Branchial Arches are derived from

Mesoderm

4

1st Branchial Cleft produces

External auditory meatus

5

2-4 Branchial Clefts produce

temporary cervical sinuses

6

If the temporary cervical sinuses persists -->

Branchial Cleft cyst on the lateral neck (doesn't move w/ swallowing)

7

What other cyst may be confused w/ a Branchial Cleft cyst?

Thyroglossal cyst (midline, moves w/ swallowing)

8

1st Branchial Pouch produces

middle ear cavity, eustachian tubes, mastoid air cells

9

2nd Branchial Pouch produces

epithelial lining of the tonsils

10

3rd Branchial Pouch produces

thyroid & inferior parathyroid glands

11

4th Branchial Pouch produces

superior parathyroid glands

12

DiGeorge Syndrome

failure of the 3 & 4 branchial pouches to develop --> absent thymus & parathyroid glands --> T-cell immunodeficiency & hypocalcemia

13

1st Branchial Arch produces what cartilage

Meckel's cartilage: mandible, mandible ligament, malleus, incus

14

1st Branchial Arch produces what muscles

mm of mastication: masseter, medial/lateral pterygoids, temporalis, mylohyoid, Tensor tympani, Tensor veli palatini, ant. 2/3 of tongue

15

1st Branchial Arch produces what nerve

CN V2 & V3

16

Failure of Branchial Arch 1 cells to migrate

Treacher-Collins Syndrome

17

2nd Branchial Arch produces what cartilage

stapes, styloid process, stylohyoid ligament, lesser horn of hyoid

18

2nd Branchial Arch produces what muscles

mm. of facial expression: stapedius, stylohyoid

19

2nd Branchial Arch produces what nerve

CN 7

20

3rd Branchial Arch produces what muscle

stylopharyngeal m.

21

3rd Branchial Arch produces what nerve

glossopharyngeal n.

22

Failure of the 2nd Branchial Arch cells to migrate

Pharyngocutaneous Fistula

23

4-6 Branchial Arch produces what cartilage

Criocoid & Thyroid cartilages, & cartilage of the larynx

24

4-6 Branchial Arch produces what muscle

Cricothyroid, pharyngeal, laryngeal

25

4-6 Branchial Arch produces what nerve

CN 10

26

Prosencephalon develops into

telencephalon & diencephalon

27

Mesencephalon develops into

Midbrain

28

Rhombencephalon develops into

metencephalon & myelencephalon

29

Telencephalon develops into

Cerebral hemispheres

30

Diencephalon develops into

Thalamus

31

Metencephalon develops into

Cerebellum & pons

32

Myelencephalon develops into

Medulla

33

What week does the developing brain begin to form

week 4 - dilation

34

Anencephaly is increased risk w/

maternal diabetes

35

Holoprosencephaly is increased risk w/

Trisomy 13, FAS, SHH mutation (fx during weeks 5-6)

36

Dandy-Walker

Agenesis of the cerebellar vermis -> 4th ventricle/posterior fossa enlargement

37

Dandy-Walker is associated w/

spina bifida and hydrocephalus

38

Chiari I

mild cerebellar tonsil herniation through foramen magnum

39

Chiari I may cause

syringomyelia

40

Chiari II

significant cerebellar tonsils & vermis herniation through foramen magnum

41

Chiarir II is associated w/

lumbosacral myelomeningocele

42

Chiari II may cause

aqueductal stenosis & hydrocepahlus

43

Syringomyelia

cavitary lesion in the spine filled w/ CSF
Compresses STT spinal commissural fibers -> b/l loss of pain&temp in UEs (cape-like distribution)
Severe -> compress ant. horn motor neurons -> hand mm. weakness & atrophy

44

Most common location of Syringomyelia

C8-T1

45

Syringomyelia is associated w/

Chiari I

46

Reactive Gliosis

astrocytes form scar tissue in response to injury

47

Nissl Bodies

RER in neuronal dendrites

48

BBB

Non-fenestrated endothelial tight junctions
BM capillary
Astrocyte foot processes

49

Astrocyte marker

GFAP

50

Astrocyte tumor

Glioblastoma

51

CNS phagocytes

microglia

52

HIV infection in the CNS

microglia giant cell formation

53

Cell destroyed in Multiple sclerosis

Oligodendrocyte

54

"Fried egg" Appearance

Oligodendrocyte (large clear cytoplasm)

55

Myelin producing cell in the CNS

Oligodendrocyte

56

Myelin producing cell in the PNS

Schwann Cells

57

Acoustic Neuroma

Schwanoma in the internal acoustic meatus

58

B/L Acoustic Neuroma

Neurofibromatosis type II

59

Cell destroyed in Guillain-Barre

Schwann Cells

60

Microglia are derived from

Mesoderm

61

Oligodendrocytes are derived from

neuroectoderm

62

Astrocytes are derived from

neuroectoderm

63

What substances cross the BBB?

glucose & a.a. w/ transporter
non-polar, lipid-soluble
ADH & Oxytocin (fenestrated area)

64

Acute Tx for high ICP

Mannitol

65

Alzheimers Disease

Degeneration of basal nucleus of Meynert -> low Choline Acetyltransferase -> low ACh

66

Site of GABA production

Nucleus Accumbens

67

Site of ACh production

Raphe nucleus

68

Site of NE production

Locus ceruleus, reticular formation, solitary tract

69

Reticular Activation System components

Reticular formation, Locus ceruleus, Raphe nucleus

70

Gerstmann Lesion

lesion to dominant angular gyrus

71

lesion to dominant angular gyrus Sx

agraphia, acalculia, R/L disorientation, finger agnosia

72

Hemispatial neglect - lesion to the

non-dominant parietal lobe

73

Frontal lesion Sx

disinhibition, poor judgment, primitive reflexes

74

Prefrontal lesion Sx

inability to complete complex functions

75

Frontal Eye Field lesion

eyes deviate toward side of lesion

76

PPRF lesion

eyes deviate away from side of lesion

77

Superior Colliculus lesion

inability to gaze upward

78

Parinaud's Syndrome

Superior Colliculus lesion

79

RAS Lesion

stupor & coma

80

B/L Hippocamous Lesion

Anterograde amnesia

81

Destruction of mammillary bodies is seen in what disorder

Wernicke-Korsakoff - thiamine deficiency

82

Destruction of mammillary bodies Sx

nystagmus, opthalmoplegia, ataxia, encephalopathy, anterograde & retrograde amnesia, confabulation

83

Poor repetition is seen with a lesion to

arcuate fasciculus

84

Poor comprehension is seen w/ a lesion to

Wernicke's area

85

Poor verbal expression is seen w/ a lesion to

Broca's area

86

Personality changes & disinhibition is seen w/ a lesion to

Frontal cortex

87

Dysarthria is seen w/ a lesion to

Cerebellar vermis

88

Kluver Bucy Syndrome

B/L amygdala lesion

89

Hemibalism is seen w/ a lesion to

the sub thalamic nucleus of the basal ganglia

90

Parkinson Sx may be seen w/ a lesion to

Basal ganglia

91

Expressive dysprosody is seen w/ a lesion to
(inability to express emotion)

Non-dominant Broca area

92

Receptive dysprosody is seen w/ a lesion to
(inability to comprehend emotion)

Non-dominant Wernicke's area

93

Hemispheric cerebellar lession

Ipsilateral limb ataxia & intention tremors are seen w/ a lesion to

94

Cerebellar vermis lesion

affects midline structures -> truncal ataxia & dysarthria

95

Fracture to the cribiform plate is most likely to lesion

CN 1

96

Lesion to an optic n. would result in

Anopsia (blindness in effected eye)

97

Lesion to the optic chiasm (pituitary tumor)

bitemporal hemianopsia

98

Lesion to an optic tract

homonymous hemianopsia

99

Homonymous hemianopsia w/ macular sparing is likely to result from

PCA infarct (macula receives collateral circulation from the MCA)

100

Bilateral hemianopsia

lesion to the optic chiasm

101

Homonymous hemianopsia

lesion to the optic tract

102

Wallerian Degeneration

axonal injury resulting in degeneration distal to the injury& axonal retraction proximally

103

Each oligodendrocyte myelinates x number of axons

~30

104

Which cell type is injured in Multifocal Leukoencephalopathy?

Oligodendrocyte

105

Which cell type is injured in Leukodystrophies?

Oligodendrocyte

106

Which cell type is injured in Guillain-Barre?

Schwann Cell (endoneurium)

107

Each Schwann cell myelinates x number of axons

1 PNS axon

108

In limb reattachment, what investing structure of the nerve must be rejoined?

Perineurium

109

GABA is produced where?

Nucleus accumbens

110

ACh is produced where?

Basal nucleus of Meynert

111

5-HT is produced where?

Raphe nucleus

112

Dopamine is produced where?

ventral tegmentum & SNc

113

NE is produced where?

Locus ceruleus

114

NT imbalance in Anxiety

High NE, Low 5-HT, Low GABA

115

NT imbalance in Parkinsons

Low DA, High 5-HT, High ACh

116

NT imbalance in Huntingtons

High DA, Low ACh, Low GABA

117

NT imbalance in Depression

Low NE, DA, & 5-HT

118

Mesocortical Pathway

Ventral Tegmental of midbrain -> cortex

119

Results of blocking the Mesocortical Pathway

Increased negative Sx of schizophrenia

120

Mesolimbic Pathway

Ventral Tegmental of midbrain -> limbic system

121

Results of blocking the Mesolimbic Pathway

Relieve positive Sx of Schizophrenia

122

Nigrostriatal Pathway

Substantia nigra pars compacta -> neostriatum

123

Results of blocking the Nigrostriatal Pathway

Parkinson Disease

124

Tuberoinfundibular Pathway

Arcuate nucleus of hypothalamus -> pituitary

125

Results of blocking the Tuberoinfundibular Pathway

increased prolactin secretion from ant. pituitary
(hypogonadism -> amenorrhea, low libido & gynecomastia in men)

126

Bilateral acoustic neuroma

Neurofibromatosis type II

127

Degeneration of the Basal nucleus of Meynart?

Alzheimers (low ACh)

128

Decreased DA in the substantial nigra pars compacta?

Parkinsons

129

3 areas w/ fenestrated capillaries in the brain

area postrema - vomiting d/t emetics
Organum Vasculosum Lamina Terminalis - osmotic sensing
Neurohypophysis - ADH release

130

Meissner's Corpuscles

hairless skin for fine touch & position

131

Pacinian Corpuscles

deep skin, ligaments for vibration & pressure

132

Merkel Corpuscles

hair follicles, basal epidermis - for pressure, position, deep static touch

133

Ischemia to CN3 is likely to cause

injury to the motor neurons -> deviation of the eye down & out

134

Mass effect/compression to CN3 is likely to cause

injury to the parasympathetic fibers traveling in on CN3 -> pupillary defects

135

Efferent pupillary defect

lesions to the oculomotor n. so that 1 eye is unable to constrict (no response to direct or consensual light)

136

Afferent pupillary defect

lesion to the optic n. such that light is not perceived by 1 eye resulting in no direct constriction in effected eye or consensual constriction in the opposite (effected eye will constrict to consensual light)

137

CN4 lesion

eye drifts upward when looking away from lesion (tilt head AWAY from lesion)

138

CN3 lesion

eye points down & out, pupil dilation

139

CN6 lesion

eye deviates medially, inability to abduct

140

Function of Anterior Hypothalamic Nuclei

Cooling (thermoregulation)

141

Damage to the Anterior Hypothalamic Nuclei

HYPERthermia

142

Function of Suprachiasmatic Hypothalamic Nuclei

circadian rhythm

143

Function of Preoptic Hypothalamic Nuclei

Secrete GnRH

144

Function of Supraoptic Hypothalamic Nuclei

Secretes ADH

145

Function of Paraventricular Hypothalamic Nuclei

Secretes Oxytocin, CRH, TRH

146

Damage to the Supraoptic Hypothalamic Nuclei

Central Diabetes Insipidus

147

Function of Arcuate Hypothalamic Nuclei

Secretes GnRH, Pulsatile GnRH
Secretes DA
Regulates appetite

148

Function of Lateral Hypothalamic Nuclei

regulates hunger, inhibited by Leptin

149

Function of Ventromedial Hypothalamic Nuclei

Regulates satiety, stimulated by Leptin

150

Damage to the Lateral Hypothalamic Nuclei

anorexia, weight loss

151

Damage to the Ventromedial Hypothalamic Nuclei

obesity & savage behavior

152

Function of Dorsomedial Hypothalamic Nuclei

regulates hunger

153

Stimulation to the Dorsomedial Hypothalamic Nuclei

obesity & savage behavior

154

Function of Posterior Hypothalamic Nuclei

warming (thermoregulation)

155

Function of Mammillary Hypothalamic Nuclei

Memory

156

Damage to the Posterior Hypothalamic Nuclei

HYPOthermia

157

Damage to the Mammillary Hypothalamic Nuclei

Wernicke-Korsakoff (thiamine def --> periventricular hemorrhage/necrosis)

158

Wernicke-Korsakoff syndrome presents with a triad of

confusion, ophthalmoplegia, and ataxia

159

Korsakoff’s Psychosis is a progression from Wernicke’s encephalopathy which consists of

irreversible memory loss, confabulation, and personality changes

160

Hemiballismus is d/t

contralateral lesion of the sub thalamic nucleus

161

Chorea is d/t

Caudate atrophy seen in Huntington (basal ganglia)

162

Athetosis

slow, writhing, snake-like movement

163

Athetosis is d/t

Caudate atrophy seen in Huntington (basal ganglia)

164

Essential Tremor

tremor at rest & w/ movement; 50% FHx

165

Intentional Tremor

tremor w/ movement (cerebellar dysfunction)

166

Resting Tremor

tremor at rest & relieved by movement (Parkinson)

167

Dominant parietal lobe lesion

agraphia, acalculia, finger agnosia, L-to-R disorientation

168

Non-dominant parietal lobe lesion

Hemispatial neglect

169

Nerve injured w/ anterior hip dislocation?

Obturator n.

170

Nerve injured w/ disc herniation

sciatic n.

171

Nerve injured w/ pelvic fracture

femoral n.

172

Nerve injured w/ posterior hip dislocation

Superior & Inferior gluteal n.

173

Nerve injured w/ knee injury

tibial n.

174

Nerve injured w/ lateral knee injury

Deep fibular n.

175

Nerve providing sensation to the lower leg?

Sciatic n.

176

Nerve injury resulting in foot drop?

common fibular n. or deep fibular n.

177

Nerve injury resulting in trendelenburg gait

Superior gluteal n.

178

Nerve required for foot plantar flexion?

tibial n.

179

Nerve required for hip extension

Inferior gluteal n.

180

Nerve required for thigh adduction

Obturator n.

181

Nerve required for thigh flexion

Femoral n.

182

Nerve required for sensation to the anterior thigh

Femoral n.

183

Nerve required for sensation to the medial thigh

Obturator n.

184

Nerve required for thigh extension

Sciatic n.

185

Meckel nerve ending

slow adaptation, static pressure, superficial (fingertips, hair follicles)

186

Meissner nerve ending

rapid adaptation, light touch, fingertips, superficial

187

Raffinian nerve ending

slow, position sense, deep (SQ), spindle-shape

188

Pacinian nerve ending

vibration, rapid, deeper (onion-shaped)

189

A-delta

rapid, myelinated, sharp pain, cold

190

C-fibers

slow, unmyelinated, dull warm pain

191

B/L Bell's Palsy

Guillain-Barre or Lyme's Disease

192

Neurotransmitter changes that occur in anxiety include

increased norepinephrine, decreased GABA, and decreased serotonin

193

Neurotransmitter changes that occur in depression include

decreased norepinephrine, decreased serotonin, and decreased dopamine

194

Neurotransmitter changes that occur in Alzheimer's dementia include

decreased acetylcholine and increased glutamate.

195

Neurotransmitter changes that occur in Huntington's disease include

increased dopamine, decreased GABA, and decreased acetylcholine

196

In schizophrenia, there is increased dopamine in the

mesolimbic pathway (positive symptoms)

197

In schizophrenia, there is decreased dopamine in the

mesocortical pathway (negative symptoms)

198

Neurotransmitter changes that occur in Parkinson's disease include

decreased dopamine, decreased serotonin, and increased acetylcholine

199

Glutamate

excitatory NT

200

GABA

inhibitory NT

201

Substantia Nigra pars compacta -> indirect pathway

inhibits Neostriatum (->inhibits Globus Pallidus ext. ->inhibits Subthalamic Nuclei-> stimulates Globus Pallidus int. -> inhibits thalamus -> stimulates Cortex) ----> MOVEMENT STIMULATED

202

Substantia Nigra pars compacta -> direct pathway

stimulate Neostriatum (-> inhibit globus pallidus int. -> inhibit thalamus -> stimulates cortex) ------> MOVEMENT STIMULATED

203

Eosinophilic inclusion in the cytoplasm of neurons

Lew Body (Parkinsons ds & Lewy Body Dementia)

204

Norepinephrine (NE) is a catecholamine and the primary neurotransmitter of

postganglionic sympathetic neurons.

205

Dopamine (DA) plays a role in:

Cognition
Motor Functions
Neuroendocrine Functions

206

Serotonin (5-HT) plays a role in the following functions:

Arousal
Sensory Perception
Emotion
Higher Cognition

207

Acetylcholine (ACh) is the major neurotransmitter of the:

Peripheral nervous system
Parasympathetic nervous system
Preganglionic sympathetic fibers

208

γ-Aminobutyric acid (GABA) is the major

inhibitory neurotransmitter of the central nervous system.

209

Glutamate is the major

excitatory neurotransmitter of the central nervous system and makes up 60% of brain synapses.

210

Frontal lobe function

Motor function, Problem solving, Spontaneity, Memory, Language, Initiation, Judgement
Impulse control, Social and sexual behavior

211

Parietal lobe function

integrates sensory information from different modalities
dominant - language and mathematics
non-dominant - imagery and spatial relationships

212

Temporal lobe function

auditory perception

213

Occipital lobe function

visual processing

214

Unilateral Occipital lobe destruction causes

contralateral hemianopia or quadrantopia and bilateral lesions cause cortical blindness

215

Bilateral destruction of the mammillary bodies

(Wernicke-Korsakoff syndrome) leads to confusion, anterograde and retrograde amnesia, confabulation, and personality changes.

216

Reticular activating system/reticular formation function

arousal and sleep-wake transitions

217

Extreme damage of the reticular formation can cause

coma

218

Kluver-Bucy syndrome

B/L anygdala lesion --> hyerphagia, hypersexuality, anterograde amnesia

219

Hippocampus function

crucial for learning and consolidation of memories

220

Intrafusal mm. fibers

send 1a signal to spinal cord conveying information about the length of the mm. fiber
--> increased mm. contraction

221

Golgi tendon

send 1b signal to spinal cord conveying information about the tension of the mm. fiber
--> inhibits mm. contraction

222

What sensory receptor communicates pricking pain (fast, myelinated)

A-delta

223

What sensory receptor communicates burning, dull pain?

C fiber

224

What sensory receptor communicates vibration & pressure?

Pacinian

225

What sensory receptor communicates dynamic/changing light, discriminatory touch?

Meissners

226

What sensory receptor communicates static/unchanging light touch

Meckel

227

What sensory receptor communicates proprioception of mm. length

Intrafusal

228

What sensory receptor communicates proprioception of mm. tension

Golgi tendon

229

Guillain-Barre pathogenesis

Autoimmune Disease – molecular mimicry; often following Campylobacter jejuni infection

230

Guillain-Barre results in destruction of

Schwann cells

231

Progressive Multifocal Leukoencephalopathy results in destruction of

oligodendrocytes

232

Progressive Multifocal Leukoencephalopathy is seen after

JC viral infection (AIDs)

233

Guillain-Barre Sx

ascending mm. weakness, B/L facial mm. paralysis, respiratory mm. weakness (w/o sensory loss)

234

Common causes of otitis externa

Pseudomonas aeruginosa > S. aureus

235

Tx for otitis externa

topical Abx & irrigation

236

Common causes of otitis media

S. pneumo, ntHi, M. catarrhalis

237

Tx for otitis media

Amoxicillin +/- Clavulanic acid, Cephalosporin, T-tubes

238

Meniere Ds Sx

intermittent vertigo, tinnitus, hearing loss

239

Meniere Ds pathogenesis

imbalance of fluid & electrolytes in the endolymph

240

Cholesteatoma

cystic lesion (grayish & pearly) lined by keratinizing squamous epithelium filled w/ amorphous debris

241

Dementia + visual hallucinations

Lewy Body Dementia

242

Dementia + progressive aphasia

Frontotemporal dementia/Pick Disease

243

Dementia + ataxia & loss of pupillary light reflex

Tertiary Syphilis

244

Dementia + megaloblastic anemia & peripheral neuropathy

Vitamin B12 def.

245

Dementia + resting tremor & bradykinesia

Parkinson Ds

246

Dementia + uninhibited social behavior

Frontotemporal dementia/Pick Disease

247

Dementia + urinary incontinence & magnetic gait

Normal pressure hydrocephalus

248

Dementia + syncopal episodes

Lewy Body Dementia

249

Dementia + dysarthria & liver disease

Wilson ds

250

Dementia + myoclonus

Creutzfeldt-Jakob Ds

251

Normal Pressure Hydrocephalus is what type of hydrocephalus

Communicating hydrocephalus (most common)

252

Communicating hydrocephalus is caused by

decreased resorption of CSF by the arachnoid granulations

253

Normal Pressure Hydrocephalus Sx are a result of

enlarged ventricles compressing the corona radiata

254

Normal Pressure Hydrocephalus Sx

urinary incontinence, ataxia, and cognitive dysfunction (often reversible)

255

Cingulate (subfalcine) herniation

cerebral hemisphere displaces the cingulate gyrus under the falx cerebri.

256

A downward transtentorial (central) herniation occurs when the

diencephalon and the medial aspects of the temporal lobe are squeezed through a notch in the tentorium cerebelli.

257

A descending transtentorial uncal herniation

the uncus, the most medial aspect of the temporal lobe, puts pressure on the brainstem (particularly the midbrain).

258

Cerebellar tonsillar herniation occurs when the

cerebellar tonsils are displaced through the foramen magnum.