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Maddy - First Aid > Neuro > Flashcards

Neuro Flashcards

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1
Q

frontal lobe lesion sx

A

disinhibition and deficits in concentration, orientation, judgement

may have reemergence of primitive reflexes

difficulty “describing the difference between a watch and a ruler”

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2
Q

front eye fields lesion sx

A

eyes look towards brain lesion (away from side of hemiplegia)

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3
Q

paramedian pontine reticular formation lesion sx

A

eyes look away from lesion (toward side of hemiplegia)

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4
Q

MLF lesion sx

A

internuclear ophthalmoplegia

  • impaired adduction of ipsilateral eye
  • nystagmus of contralateral eye w/ abduction

**MS

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5
Q

dominant parietal cortex lesion sx

A

agraphia (inability to write)

acalculia (loss of ability to do simple math)

finger agnosia (loss in the ability to distinguish, name, or recognize the fingers)

left-right disorientation

**Gerstmann syndrome

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6
Q

nondominant parietal cortex lesion sx

A

agnosia (inability to interpret sensations and hence to recognize things) of contralateral side of the world

**hemispatial neglect syndrome

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7
Q

bilateral hippocampus lesion sx

A

anterograde amnesia (inability to make new memories)

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8
Q

basal ganglia lesion sx

A

tremor at rest, chorea, athetosis

**parkinson, huntington, wilson’s disease

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9
Q

subthalamic nucleus sx

A

contralateral hemiballismus (intermittent flinging movements on one side)

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10
Q

bilateral mammillary bodies lesion sx

A

wernicke-korsakoff syndrome (confusion, ataxia, nystagmus, ophthalmoplegia), memory loss, congabulations, personality changes

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11
Q

bilateral amygdala lesion sx

A

kluver-bucy syndrome (disinhibited behavior - hyperphagia, hypersexuality, hyperorality)

**HSV-1 encephalitis

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12
Q

dorsal midbrain lesion sx

A

parinaud syndrome (vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus)

**pinealoma

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13
Q

reticular activating system (midbrain) lesion sx

A

reduced levels of arousal and wakefulness

**coma

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14
Q

cerebellar hemisphere lesion sx

A

intention tremor, limb ataxia, loss of balance

**cerebellar hemispheres are located laterally –> affect lateral limbs

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15
Q

cerebellar vermis lesion sx

A

truncal ataxia (wide-based, “drunken sailor” gait)

nystagmus

**vermis is located centrally –> affects central body

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16
Q

red nucleus (midbrain) lesion sx

A

decorticate (flexor) posturing - lesion above red nucleus

decerebrate (extensor) posturing - lesion at or below red nucleus

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17
Q

histologic features of brain 12-24 hours after ischemic event

24-72 hours

3-5 days

1-2 weeks

> 2 weeks

A

12-24: eosinophilic cytoplasm + lack of Nissl bodies + pyknotic nuclei (red neurons - shrunken)

24-72 hours: necrosis + neutrophils

3-5 days: macrophages

1-2 weeks: reactive gliosis (astrocytes) + vascular proliferation

> 2 weeks: glial scar

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18
Q

MCA stroke sx

A

contralateral paralysis and sensory loss in face and upper limb

dominant hemisphere: aphasia

nondominant hemisphere: hemineglect

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19
Q

ACA stroke sx

A

contralateral paralysis and sensory loss in lower limb

urinary incontinence

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20
Q

lenticulostriate artery stroke sx

A

contralateral paralysis

absence of cortical signs (neglect, aphasia, visual field loss)

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21
Q

ASA stroke sx

A

contralateral paralysis of upper and lower limbs

decreased contralateral proprioception

ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)

**medial medullary syndrome

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22
Q

PICA stroke sx

A

dysphagia, hoarseness, decreased gag reflex, hiccups

vomiting, vertigo, nystagmus

decreased pain and temp from contralateral body and ipsilateral face

ipsilateral horner, ataxia, dysmetria

**lateral medullary syndrome (wallenberg)

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23
Q

blood supply of medial medulla

A

ASA

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24
Q

blood supply of lateral medulla

A

PICA

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25
blood supply of medial pons
basilar
26
blood supply of lateral pons
AICA
27
blood supply of medial midbrain
PCA
28
blood supply of lateral midbrain
PCA
29
medial cranial nerves and where they come out of
3, 4 - midbrain 6 - pons 12 - medulla
30
lateral cranial nerves and where they come out of
5, 7, 8 - pons 9, 10, 11, 12 - medulla
31
AICA stroke sx
paralysis of face decreased lacrimation, salivation, taste from anterior 2/3 tongue decreased pain and temp contralateral body and ipsilateral face ipsilateral horner, ataxia, dysmetria **lateral pontine syndrome
32
basilar artery stroke sx
quadriplegia loss of horizontal eye movements **medial pontine syndrome ('locked in" syndrome)
33
PCA stroke sx
contralateral hemianopia (blindness in 1/2 visual field) with macular sparing
34
damage to the arcuate fasciculus causes what
conduction aphasia - fluent speech - good comprehension - poor repetition
35
transcortical motor transcortical sensory transcortical mixed
transcortical motor: affects frontal lobe around Broca but spares Broca transcortical sensory: affects temporal lobe around wernicke but spares wernicke transcortical mixed: broca, wernicke, arcuate fasciulus remain intact, surrounding watershed areas affected
36
what is a tonic-clonic (grand mal) seizure
alternating stiffening and movement postictal confusion, urinary incontinence, tongue biting
37
what is a myoclonic seizure
quick, repetitive jerks
38
patient with involuntary, rhythmic jerking of an extremity that lasts 1 minute, remains fully alert
simple focal (partial) onset seizure
39
dopamine, acetycholine, and GABA levels in huntington's
increased dopamine decreased Ach and GABA
40
histo and gross findings alzheimers
- AB amyloid plaques in gray matter - neurofibrillary tangles made of tau - hirano bodies (intracellular eosinophilic proteinaceous rods in hippocampus)
41
inclusions in frontotemporal dementia are made of what
hyperphosphorylated tau (pick bodies) or ubiquitinated TDP-43
42
sx CJD
rapidly progressive dementia with myoclonus (startle myoclonus) and ataxia
43
sx pseudotumor cerebri (idiopathic intracranial hypertension)
increased ICP with no obvious findings on imaging headache, tinnitus, diplopia, no change in mental status
44
what is charcot-marie-tooth disease sx mutation
defective production of proteins involved in structure and function of peripheral nerves or myelin sheath foot deformities (pes cavus, hammer toe) LE weakness (foot drop) sensory deficits PMP22 gene duplication
45
what is sturge weber syndrome sx
congenital nonhereditary anomaly of neural crest derivatives due to somatic mosaicism of activating mutation in one copy of GNAQ gene port-wine stain in CN V1/V2 distribution ipsilateral leptomeningeal angioma --> seizures intellectual disability early onset glaucoma
46
sx tuberous sclerosis
H: hamartomas in CNS and skin A: angiofibromas M: mitral regurgitation A: ash-leaf spots R: cardiac rhabdomyoma M: mental retardation A: renal angiomyolipoma S: seizures, shagreen patches
47
sx von hippel lindau dz
hemangioblastomas in retina, brainstem, cerebellum, spine angiomatosis bilateral renal cell carcinoma pheochromocytomas
48
sx NF1
cafe au lait spots intellectual disability cutaneous neurofibromas lisch nodules (pigmented iris hamartomas) optic gliomas pheochromocytomas seizures
49
treatment for ALS
rilouzole
50
sx brown sequard syndrome
1) ipsilateral loss of all sensation at level of lesion 2) ipsilateral LMN signs at level of lesion 3) ipsilateral UMN signs below level of lesion 4) ipsilateral loss of proprioception, vibration, light touch below level of lesion 5) contralateral loss of pain and temp below level of lesion
51
sx friedreich ataxia
staggering gait frequent falling nystagmus DM hypertrophic cardiopmyopathy
52
CN V motor lesion sx
jaw deviates towards side of lesion
53
CN X lesion sx
uvula deviates away from lesion
54
CN XI lesion sx
weakness turning head to contralateral side of lesion
55
CN XII lesion sx
tongue deviates toward side of lesion
56
compare upper and lower motor neuron facial nerve lesions
UMN: - lesion located in the connection between the motor cortex and the facial nucleus in the pons - affects contralateral lower muscles of facial expression - forehead is spared LMN: - lesion located anywhere along CN VII after facial nucleus in pons - affects ipsilateral upper and lower muscles of facial expression - forehead is affected
57
first line treatments for alzheimers
donepezil, rivastigmine, galantamine, memantine
58
first line treatment for huntington dz and moa
tetrabenazine inhibits vesicular monoamine transporter (VMAT) which decreases dopamine vesicle packaging and release
59
memantine MOA
NMDA receptor antagonist
60
first line treatment for ALS and moa
riluzole decreases neuron glutamate excitotoxicity
61
thiopental MOA and indications
barbiturate (facilitates GABAa) anesthesia induction, short surgical procedures
62
ketamine effect on cerebral blood flow
increased
63
MOA local anesthetics | lidocaine, mepivacaine, bupivacaine, ropivacain
block Na+ channels
64
what is the order of nerve blockade with local anesthetics
small diameter fibers > large diameter fibers myelinated fibers > unmyelinated fibers *size predominates over myelination* small myelinated fibers > small unmyelinated fibers > large myelinated fibers > large unmyelinated fibers
65
MOA succinylcholine
ACh receptor agonist --> produced sustained depolarization and prevents muscle contraction
66
MOA atracurium, cisatracurium, pancuronium, rocuronium, tubocurarine, vecuronium
competitive ACh antagonist
67
baclofen MOA and indication
GABA-B agonist in spinal cord muscle spasticity, dystonia, MS
68
cyclobenzaprine MOA and indication
acts within CNS mainly at brain stem muscle spasticity
69
dantrolene MOA and indications
prevents Ca2+ release from sarcoplasmic reticulum by inhibiting ryanidine receptor malignant hyperthermia and neuroleptic malignant syndrome
70
tizanidine MOA and indications
a2 agonist muscle spasticity, MS, ALS, cerebral palsy

Maddy - First Aid (23 decks)

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