neuro exam 2 Flashcards
(183 cards)
1
Q
What is the function of the basal ganglia?
A
Predict the effects of actions and execute appropriate motor plans.
2
Q
Which structures make up the basal ganglia?
A
Caudate, Putamen, Globus Pallidus, Subthalamic Nucleus (STN), Substantia Nigra.
3
Q
What two nuclei form the Striatum?
A
Caudate + Putamen.
4
Q
What two nuclei form the Lentiform Nucleus?
A
Putamen + Globus Pallidus.
5
Q
What neurotransmitter excites the striatum from cortical motor areas?
A
Glutamate
6
Q
What is Disinhibition in the basal ganglia?
A
Inhibiting an inhibitor to facilitate movement of a target neuron.
7
Q
What motor symptoms characterize Parkinson’s Disease (PD)?
A
Bradykinesia, rigidity, resting tremor, postural instability, freezing of gait
8
Q
What are the two common PD subtypes?
A
Postural Instability Gait Difficulty (PIGD) and Tremor-Dominant (TD).
9
Q
What is Freezing of Gait (FOG)?
A
Sudden inability to move despite intent to walk.
10
Q
What causes Parkinson’s Disease at the cellular level?
A
Death of dopamine-producing cells in the substantia nigra compacta.
11
Q
Name two treatments for Parkinson’s Disease.
A
Dopamine replacement drugs and Deep Brain Stimulation (DBS).
12
Q
What is Atypical Parkinsonism?
A
Neurodegenerative conditions resembling PD (e.g., PSP, MSA, Lewy body dementia).
13
Q
What causes Secondary Parkinsonism?
A
Toxins, drugs (e.g., antipsychotics), infections, or trauma (e.g., CTE).
14
Q
What are signs of Huntington’s Disease?
A
Chorea and dementia due to degeneration of striatum and cortex.
15
Q
What is Dystonia?
A
Involuntary, sustained muscle contractions causing abnormal postures
16
Q
What is Focal Dystonia?
A
Dystonia affecting a specific area like the hand or neck.
17
Q
What is Tourette’s Disorder?
A
Neurological disorder with motor and vocal tics, often with sensory urges.
18
Q
What is Dyskinetic Cerebral Palsy?
A
Involuntary movements due to lesions in basal ganglia and thalamus.
19
Q
What is feedforward in motor control?
A
Anticipatory use of sensory information to prepare for movement.
20
Q
What is feedback in motor control?
A
Use of sensory information during or after movement to make corrections.
21
Q
What are the three types of movement?
A
Postural, locomotor (walking), and reaching/grasping.
22
Q
Which part of the brain primarily controls postural movement?
A
Brainstem mechanisms
23
Q
Which nervous system areas control locomotion?
A
Brainstem and spinal regions.
24
Q
What primarily controls reaching and grasping?
A
The cerebral cortex
25
What sensory systems contribute to postural control?
somatosensation, vision, and vestibular input.
26
What does the cerebral cortex contribute to walking?
Goal orientation and control of ankle movement.
27
What does the basal ganglia contribute to walking?
Start/stop stepping (via MLR), muscle tone in postural muscles (via PPN).
28
What does the cerebellum contribute to walking?
Timing, coordination, error correction, and balance control.
29
What spinal structure generates stepping patterns
Stepping pattern generators (SPGs).
30
What is the action stream in reaching/grasping?
visual cortex → Posterior parietal cortex → motor areas.
31
What role does vision play in reaching/grasping?
Provides object location, shape, and size; guides initial and corrective movements
32
What happens if you lose somatosensation?
Impaired limb positioning and movement accuracy.
33
What are the consequences of losing proprioception?
Loss of coordination, especially during multijoint movements.
34
What are signs of vestibular loss?
Balance issues that can be partially compensated with visual or tactile cues
35
What happens to walking during dual tasks in neurologic disorders?
Decreased gait speed, stride frequency, and consistency.
36
What motor symptoms are linked to Parkinson’s Disease posture control?
Rigidity, flexed posture, poor protective reactions, weak anticipatory adjustments.
37
What are signs of LMN pathology?
Flaccid paralysis, atrophy, fasciculations, hyporeflexia.
38
What are signs of UMN pathology?
Paresis, spasticity, hyperreflexia, impaired selective control.
39
What are signs of cerebellar dysfunction?
Ataxia, nystagmus, dysarthria.
40
What are signs of basal ganglia dysfunction?
Hypokinesia or hyperkinesia.
41
What are peripheral nerves composed of?
Axons, Schwann cells, and connective tissue.
42
What are the three layers of connective tissue in peripheral nerves?
Endoneurium, perineurium, and epineurium.
43
Name the four nerve plexuses.
Cervical, brachial, lumbar, and sacral.
44
What is the function of a nerve plexus?
To redistribute nerve fibers from different spinal nerves into peripheral nerves.
45
What is the neuromuscular junction?
The synapse between a motor neuron and a muscle fiber.
46
What are common sensory changes with peripheral nerve dysfunction?
Decreased or lost sensation, paresthesia, dysesthesia.
47
What autonomic changes might occur with peripheral neuropathy?
Lack of sweating, edema, and blood pressure dysregulation.
48
What motor changes are observed with peripheral nerve damage?
Paresis or paralysis and muscle atrophy.
49
What is traumatic myelinopathy?
Focal compression causing loss of myelin (e.g., carpal tunnel syndrome).
50
What is traumatic axonopathy?
Damage to axons with preserved connective tissue; wallerian degeneration occurs.
51
What is diabetic polyneuropathy?
A common metabolic neuropathy affecting sensory and autonomic nerves
52
What is Guillain-Barré Syndrome?
An autoimmune demyelinating polyneuropathy that causes rapid onset of weakness.
53
What is Charcot-Marie-Tooth disease?
A hereditary motor and sensory neuropathy (HMSN)
54
What do ventral roots carry?
Motor (efferent) signals from the spinal cord.
55
What do dorsal roots carry?
Sensory (afferent) information to the spinal cord.
56
What is found in the white matter of the spinal cord?
Ascending and descending tracts (axons).
57
What is found in the gray matter of the spinal cord?
Neuron cell bodies and interneurons.
58
What are meninges?
Three layers (dura, arachnoid, pia) that protect the spinal cord.
59
What are stepping pattern generators (SPGs)?
Neural circuits in the spinal cord that produce rhythmic movement like walking
60
What is segmental dysfunction?
Damage to a spinal segment affecting sensory and motor function at that level.
61
What is vertical tract dysfunction?
Damage to ascending or descending tracts affecting function below the lesion.
62
How can you differentiate spinal vs. peripheral lesions?
Peripheral lesions affect dermatomes/myotomes, spinal lesions show tract signs.
63
What is anterior cord syndrome?
Loss of motor and pain/temp below lesion, preserved proprioception.
64
What is spinal shock?
Temporary loss of all spinal cord function below the lesion.
65
What is autonomic dysreflexia?
Excessive sympathetic response in SCI above T6, triggered by harmful stimuli.
66
What is orthostatic hypotension?
Drop in blood pressure upon standing due to loss of sympathetic control.
67
What is meningomyelocele?
A neural tube defect with spinal cord and meninges protruding through the spine
68
What is syringomyelia?
A fluid-filled cavity within the spinal cord causing segmental signs.
69
what is vertebral canal stenosis?
Narrowing of the vertebral canal, possibly compressing the spinal cord or nerves.
70
What is the function of the Olfactory nerve (CN I)
Sense of smell.
71
What is the function of the Optic nerve (CN II)
Vision
72
What is the function of the Oculomotor nerve (CN III)?
Eye movement, pupil constriction.
73
What is the function of the Trochlear nerve (CN IV)?
Eye movement (superior oblique muscle
74
What is the function of the Trigeminal nerve (CN V)?
Facial sensation and chewing.
75
What is the function of the Abducens nerve (CN VI)
Eye movement (lateral rectus muscle).
76
What is the function of the Facial nerve (CN VII)?
Facial expression, taste (anterior 2/3 tongue), salivation.
77
What is the function of the Glossopharyngeal nerve (CN IX
Taste (posterior 1/3 tongue), swallowing, salivation
78
What is the function of the Vagus nerve (CN X)
Autonomic control of the heart, lungs, and digestive trac
79
How is CN II tested?
Visual acuity and field tests.
80
Which cranial nerves are involved in the pupillary light reflex
CN II (afferent), CN III (efferent)
81
What nerves are tested in the corneal reflex?
CN V (sensory), CN VII (motor).
82
What are the three main functions of the reticular formation?
regulate arousal, consciousness, and sleep-wake cycles
83
What are the four structures classified under the 'medial' category in the brainstem?
Motor nuclei of CNs, corticospinal tract, medial longitudinal fasciculus, and medial lemniscus.
84
What vertical pathways decussate in the lower medulla?
The corticospinal and dorsal column/medial lemniscus pathways
85
Can you identify the four major reticular nuclei and their respective functions?
VTA =dopamine
PPN = acetylcholine
Raphe nuclei =serotonion
locus coeruleus = norepinephrine influencing movement, mood, and arousal.
86
Where do cranial nerves 3 to 12 attach to the brainstem?
They attach at specific levels throughout the brainstem, with CN 3 and 4 in the midbrain, CN 5-8 in the pons, and CN 9, 10, and 12 in the medulla.
87
What role does the ventral tegmental area play in neurotransmitter production?
It produces dopamine and is involved in reward-seeking behavior.
88
What are the four primary functions of the medulla?
controls eye and head movements
swallowing coordination
regulates cardiovascular and respiratory activities.
89
What are the four Ds of brainstem region dysfunction?
Dysphagia, Dysarthria, Diplopia, Dysmetria
90
what is dysphagia
swallowing difficulty
91
what is dysarthria
speech difficulty
92
what is diplopia
double vison
93
what is dysmetria
inability to control distance of movements
94
What deficits are associated with lesions of cranial nerve 2 (optic nerve)?
Ipsilateral blindness and loss of direct pupillary light reflex.
95
What is the purpose of the optokinetic response, and how does it work?
Adjusts eye position during slow head movements by allowing eyes to follow large visual stimuli.
96
What are the contents of the medial longitudinal fasciculus (MLF)?
The MLF contains bilateral connections among vestibular and ocular motor nuclei in the brainstem.
97
How is visual information from the right visual field conveyed to the left visual cortex?
Information from the right visual field hits the nasal retina of the right eye and the temporal retina of the left eye, both of which project to the left visual cortex.
98
What is the difference between conjugate and vergence eye movements?
Conjugate movements involve both eyes moving in the same direction, while vergence movements involve both eyes moving towards or away from each other.
99
What deficits result from lesions of cranial nerve 6 (abducens nerve)?
Inability to abduct the eye, causing inward deviation and double vision.
100
What is cortical blindness and how is it characterized?
The person has no awareness of visual information due to a lesion in the brain.
101
How is pathologic nystagmus different from physiologic nystagmus?
Pathologic nystagmus indicates nervous system abnormalities, while physiologic nystagmus occurs normally in response to stimuli.
102
What defines saccadic movements in the visual system?
Quick, voluntary movements that switch the line of sight from one object to another.
103
What are the functions of the vestibulo-ocular reflex (VOR)?
Stabilizes visual images during head movements.
104
What is oscillopsia and what causes it in the context of bilateral vestibular lesions?
Oscillopsia is the perception of visual instability caused by decreased reflexive eye movements in response to head movement due to bilateral vestibular loss.
105
Describe the symptoms of vestibular neuritis and its typical causes.
Vestibular neuritis typically involves severe vertigo, nausea, and nystagmus, often following a viral infection.
106
What characterizes persistent postural-perceptual dizziness?
Persistent dizziness exacerbated by upright posture and visual stimuli, lasting over 3 months, often follows vestibular disorders or anxiety.
107
What are the distinguishing features of vestibular ataxia compared to cerebellar and sensory ataxia?
Vestibular ataxia is gravity-dependent; limb movements are normal when supine but ataxic during walking. Cerebellar ataxia remains constant in all positions, while sensory ataxia includes impaired sensation.
108
What are the two otolithic organs and their primary functions?
The utricle and saccule are the otolithic organs that detect head position relative to gravity and linear acceleration/deceleration.
109
What are the hallmark symptoms of Ménière’s disease?
Ménière’s disease is characterized by hearing loss, tinnitus, a sensation of fullness in the ear, severe vertigo, and nausea.
110
What are the differences between typical and atypical BPPV?
Atypical BPPV presents with intense dizziness and prolonged symptoms without latency, unlike typical BPPV, which has a brief, predictable onset.
111
What causes Benign Paroxysmal Positional Vertigo (BPPV) and how is it characterized?
BPPV is caused by the displacement of otoconia into semicircular canals, resulting in brief episodes of vertigo and nystagmus triggered by specific head positions.
112
What are the four factors used in the evidence-based approach to diagnosing dizziness?
Timing, triggers, oculomotor signs, and specific/provocative tests.
113
What is the HINTS exam used for?
To differentiate between central and peripheral causes of spontaneous continuous dizziness.
114
What defines triggered episodic dizziness?
Dizziness occurs only after a specific movement and is absent otherwise.
115
What defines spontaneous episodic dizziness?
Episodes occur without a specific trigger and there are symptom-free periods.
116
What are some provocative tests used in dizziness diagnosis?
dix-Hallpike maneuver, HINTS exam, orthostatic hypotension screening, and supine roll test.
117
Name five nonvestibular causes of dizziness.
Cardiovascular disorders, Parkinson’s disease, metabolic disorders, anemia, and psychologic disorders.
118
What are common signs of acute traumatic/toxic dizziness?
Spontaneous nystagmus, symptoms worsened by head motion, and history of trauma or toxin exposure.
119
What differentiates chronic triggered from chronic spontaneous dizziness?
Triggered: always provoked by a specific trigger; Spontaneous: no consistent trigger.
120
What are the main functions of the cerebrospinal fluid (CSF) system?
Regulates extracellular milieu, protects the CNS, supplies nutrients, and removes metabolites from the brain.
121
Where is CSF primarily formed?
In the choroid plexuses of the ventricles.
122
What structures are included in the lateral ventricles?
Body, atrium, and the anterior, posterior, and inferior horns.
123
Name the three meningeal layers.
Dura mater, arachnoid mater, and pia mater.
124
What space lies between the arachnoid and pia mater and is filled with CSF?
The subarachnoid space.
125
What is the glymphatic system responsible for?
Moving fluid from arteries, through brain tissue, and into lymphatic channels to remove waste.
126
What are two types of hematomas involving the meninges?
Epidural and subdural hematomas.
127
What causes hydrocephalus?
Blocked CSF circulation causing pressure buildup in ventricles.
128
What is the difference between communicating and noncommunicating hydrocephalus?
Communicating involves intact flow between ventricles; noncommunicating involves an obstruction.
129
What are signs of hydrocephalus in infants?
Enlarged head, large anterior fontanel, poor feeding, inactivity, and downward gaze.
130
What are common causes of congenital hydrocephalus?
Blockage of cerebral aqueduct, failure of ventricle foramina to open, cysts, and Arnold-Chiari malformation.
131
What is meningitis?
Inflammation of the meninges caused by bacterial or viral infections.
132
What are symptoms of meningitis?
Headache, fever, confusion, vomiting, and neck stiffness.
133
What differentiates a transient ischemic attack (TIA) from a stroke?
A TIA resolves within 24 hours without permanent deficits, whereas a stroke causes lasting neurologic damage.
134
What are the three patterns of stroke progression?
Transient ischemic attack, completed stroke, and progressive stroke
135
Define brain infarction.
Brain tissue death due to blocked blood supply from a thrombus or embolus.
136
What is a lacunar infarct?
A small, deep infarct resulting from occlusion of a small artery.
137
What characterizes a hemorrhagic stroke?
Bleeding into brain tissue, causing pressure and damage in surrounding areas.
138
What are common symptoms of vertebrobasilar artery stroke?
Ataxia, oculomotor dysfunction, dysarthria, vertigo, and nause
139
What are the effects of anterior cerebral artery stroke?
Personality changes, contralateral lower limb motor and sensory loss, and gait apraxia.
140
What symptoms are associated with middle cerebral artery stroke?
Contralateral hemiplegia (face and upper limb more than leg), aphasia, neglect, and hemisensory loss.
141
What is the significance of hemisphere lateralization in stroke?
Left hemisphere: aphasia; Right hemisphere: spatial neglect and nonverbal communication deficits.
142
What are the effects of posterior cerebral artery stroke?
Visual field loss (hemianopia), thalamic syndrome, and eye movement impairments.
143
What is an arteriovenous malformation?
A tangle of abnormal vessels connecting arteries and veins, which may rupture and cause bleeding.
144
What are common causes of cerebral edema?
Concussion, cardiac arrest, and high altitude.
145
What is an uncal herniation?
Temporal lobe pushes the uncus into the tentorium cerebelli, compressing the brainstem.
146
What are the major components of the cerebrum?
Diencephalon and cerebral hemispheres.
147
What are the four parts of the diencephalon?
Thalamus, hypothalamus, epithalamus, subthalamus.
148
What is the main function of the thalamus?
Relay and process sensory and motor signals to the cerebral cortex
149
What is Broca's area responsible for?
Motor programming of speech (usually in the left hemisphere).
150
What is Wernicke's area responsible for?
Language comprehension.
151
What happens with damage to the prefrontal cortex?
Impairments in executive functions like decision-making, judgment, and social behavior.
152
What is agnosia?
Inability to recognize objects when basic sensory modalities are intact.
153
What is apraxia?
Difficulty with motor planning to perform tasks or movements when asked.
154
What is neglect syndrome?
Inability to attend to stimuli on one side of the body or environment, often due to parietal lobe damage.
155
What is the result of a lesion in the dominant hemisphere (usually left)?
Aphasia, apraxia, and difficulties with logical/analytical tasks.
156
What is the result of a lesion in the non-dominant hemisphere?
Issues with spatial awareness, attention, and nonverbal communication.
157
What are the three main types of memory?
Working, declarative, and procedural memory.
158
What brain regions are involved in working memory?
Prefrontal cortex and temporoparietal association cortex.
159
What are the three stages of declarative memory?
Encoding, consolidation, retrieval.
160
What is the difference between episodic and semantic memory?
Episodic = personal events; Semantic = general knowledge.
161
What is procedural memory also called?
Skill, habit, or nonconscious memory.
162
What are the types of attention?
Orienting, divided, selective, sustained, and switching attention.
163
What limits attention?
Capacity, automaticity of tasks, and effort required.
164
What is ADHD characterized by?
Developmentally inappropriate inattention and impulsiveness.
165
What is amnesia?
Loss of declarative memory.
166
What is the difference between retrograde and anterograde amnesia?
Retrograde = loss of past memories; Anterograde = inability to form new memories.
167
What brain areas are key for intellect?
Lateral prefrontal cortex and posterior parietal lobes.
168
What are common causes of cognitive disability?
Trisomy 21 and untreated phenylketonuria.
169
What is the most common learning disability?
Dyslexia.
170
What are the three main areas of the prefrontal cortex?
Lateral prefrontal cortex, medial prefrontal cortex, and ventral prefrontal cortex.
171
What is the role of the lateral prefrontal cortex?
Goal-directed behavior, judgment, planning, and divergent thinking.
172
What does the medial prefrontal cortex regulate
Emotions, self-awareness, and motivation.
173
What can result from medial prefrontal cortex lesions?
apathy, lack of self-awareness, and social inappropriateness
174
What is the main function of the ventral prefrontal cortex?
Emotional regulation, impulse control, and socially appropriate behavior.
175
What are the three aspects of emotion?
Emotional experience, expression, and regulation.
176
What is the role of the amygdala?
Detects emotional salience and processes fear and threat.
177
Which areas are critical for decision making under ambiguity and risk?
Ventromedial and orbitofrontal cortices
178
What is somatic marker hypothesis?
Emotions guide decision-making by marking certain choices with positive or negative value.
179
Which brain region integrates personality traits?
Ventral prefrontal cortex.
180
What is acquired sociopathy?
Behavior changes following ventral prefrontal cortex damage—e.g., impulsivity, lack of empathy.
181
What is the role of the anterior insula in emotion?
Integrates interoceptive awareness and emotional experience
182
What syndrome is associated with profound behavior changes following prefrontal damage?
Prefrontal syndrome.
183
