Neuro Final - From Quizlet - 53+

Question 1

vitamin A deficiency

Answer 1

causes loss of rods =

loss of nocturnal activity

Question 2

loss of color vision

Answer 2

lesion:
optic nerve
visual association - cortical

congenital

Question 3

eye movement: look right

Answer 3

right eye: lateral rectus

left eye: medial rectus

Question 4

eye movement: look up & right

Answer 4

right eye: superior rectus

left eye: inferior oblique

Question 5

eye movement: look down & right

Answer 5

right eye: inferior rectus

left eye: superior oblique

Question 6

innervation of eye muscles: [LR6 - SO4 ]3

Answer 6

lateral rectus = CN6 =abducens nerve

superior oblique = CN 4 /trochlear nerve

the rest = CN 3 = oculomotor nerve

Question 7

lesion in anterior hypothalamus

Answer 7

hyperthermia

anterior hypothalamus function = heat loss
vasodilation + sweating

Question 8

lesion in posterior hypothalamus

Answer 8

decrease in temperature regulation

posterior hypothalamus function = heat production: vasoconstriction

Question 9

lesion in amygdala

Answer 9

lack of fear (can be lethal!)

Question 10

pseudobulbar affect - TX

Answer 10

dextromethorphan + quinidine

reduces laughing, crying episodes in ALS/MS patients

Question 11

performance anxiety - TX

Answer 11

propranolol

Question 12

reward system & projections

Answer 12

ventral tegmental projections - DA fibers to mesolimbic system

nucleus accumbens
amygdala
prefrontal cortex
basal forebrain
hippocampus
hypothalamus

Question 13

lesion of the labyrinth

Answer 13

affect vestibular eye movements

Question 14

lesion of the vestibular nuclei disrupts what?

Answer 14

disrupt vestibular and smooth pursuit eye movements

Sedative drugs often disrupt smooth pursuit

Question 15

Dopamine agonists - lead to?

Answer 15

lead to compulsive gambling, compulsive shopping, binge eating or hypersexuality in up to 10-20 % of patients with Parkinson’s disease

Question 16

treat impulsive behavior

Answer 16

Dopamine antagonists

Question 17

Treatment of alcohol addition (3)

Answer 17

(NAB)
Naltrexone - long acting opioid receptor antagonist, block reward and decreases craving of alcohol (for Pt already off alcohol)

Acamprosate - GABA analog, prevent drinking relapses

benzos prevent & treat alcohol withdrawal

Question 18

Treatment of opioid addiction (3 drugs)

Answer 18

methadone: mu agonist - long duration = suppress withdrawal
naltrexone: opioid antagonist = block reward experience of opioid drugs

buprenorphine (sounds like morphine): partial mu agonist = maintenance drug for opioid dependent Pts

Question 19

partial /focal seizures (3)

Answer 19

secondarily generalized - start focal, spreads to entire brain

simple partial - no abnormal consciousness

complex partial- consciousness impaired. Has aura & post-ictal sleepiness -often in temporal lobe

Question 20

generalized seizures (2)

Answer 20

absence - kids, no post-ictal confusion

tonic-clonic (grand mal) - 
sudden loss of consciousness
tonic = stiff muscle contraction
clonic = jerking
post-ictal confusion, sleepiness

Question 21

lesion of basis pontis (pons)

Answer 21

locked-in state

normal consciousness but paralyzed,
some preservation of eye movements

Question 22

severe diffuse cerebral cortical lesion

Answer 22

Vegetative state

normal arousal, sleep-wake cycle and vegetative functions,

but no higher brain functions

Question 23

Stupor and Coma - Where is the Lesion?

Answer 23

Supratentorial mass lesion = herniation syndrome with secondary “pressure” effect on the RAS (reticular activating system)

(or) Focal lesion directly involving the RAS in the pontine midbrain tegmentum or in the thalami (mostly subtentorial)
(or) usually Diffuse/multifocal lesion of bilateral cerebral hemispheres

Question 24

Aprosodia

loss of intonation - speaks like robot

Answer 24

due to

Parkinson’s Disease (most likely) ; or

lesion in right hemisphere (resp for speech intonation)

Question 25

bilateral lesions of occipital temporal projection (visual system)

Answer 25

Visual Agnosia good visual acuity BUT unable to recognize object "what / recognition system" = occipital temporal projection "where system" =occipital parietal projection

Question 26

Constructional Apraxia

Answer 26

lesion= left or right cerebral hemisphere or thalamus (not localizing) Inability to put the parts together into a whole, as in drawing or copyin

Question 27

Prefrontal Lobe Syndrome - medial lesion

Answer 27

difficulty with initiation and continuation of motor acts (akinetic) ("medial = cannot "mediate" motor)

Question 28

Prefrontal Lobe Syndrome - orbital lesion

Answer 28

inappropriate and disinhibited behavior | "orbital"= "see" what you want and do it w/o regard to consequence

Question 29

Prefrontal Lobe Syndromes - | Dorsolateral lesion

Answer 29

difficulty with abstraction, problem solving, changing strategies (hard word= no hard thinking)

Question 30

transient global amnesia

Answer 30

lesion= bilateral medial temporal lobe structures important for memory (transient dysfunction)

Question 31

left sided neglect (hemi-attention) | where is the lesion?

Answer 31

right brain lesion in cerebral hemisphere or thalamus (not localized)

Question 32

chronic + focal | category?

Answer 32

neoplasm

Question 33

memory problem - 2 places lesion could be

Answer 33

``` medial temporal lobe (in cortex - only cortex can have seizures) medial diencephalon (NOT in cortex) ```

Question 34

cannot form new verbal memory | where is the lesion?

Answer 34

lesion in left brain either in medial temporal lobe or medial diencephalon if also seizures = left medial temporal lobe

Question 35

cannot form new verbal or non-verbal memory | where is the lesion?

Answer 35

bilateral medial temporal lobe or bilateral medial diencephalon lesion if previous MI/stroke - hippocampus is affected = lesion is in bilateral medial temporal lobe

Question 36

100% isolated retrograde amnesia | Where is the lesion?

Answer 36

``` isolated retrograde amnesia Where is the lesion? Conversion syndrome! Not neurological problem. Mind distressed = self-hypnotized brain into amnesia (wow!) ```

Question 37

problem with language comprehension | abnormal with word/noun finding difficulties and paraphasic errors

Answer 37

Wernicke's aphasia Lots of output, bad comprehension cannot follow commands lesion = left superior temporal gyrus -posterior portion

Question 38

problem with language output | language comp is ok

Answer 38

Broca's aphasia lesion = left inferior frontal gyrus - posterior part

Question 39

anterograde amnesia for verbal info

Answer 39

left hippocampus formation | Or left diencephalon

Question 40

anterograde amnesia of non-verbal info

Answer 40

right hippocampus formation

Question 41

bipolar disorder - meds (4)

Answer 41

1. lithium = unknown MOA 2. quetiapine = D2/5HT2 antagonist 3. divalproex = Ca and Na blocker 4. carbamezepine = Na blocker (L-Q-D-C)

Question 42

anxiety - meds (3)

Answer 42

(BBB) 1. benzo/diazepam (GABA-A agonist) 2. beta blocker/propanol 3. busprione = non-benzo anxiolytic; agonist at 5HT1a and D2 receptors

Question 43

what drug can be used for depression and smoking cessation?

Answer 43

buproprion = increase DA & NE

Question 44

lesion in left vestibular portion of CN8

Answer 44

left head tilt | right linear acceleration

Question 45

left semi-circular canal

Answer 45

left head rotation

Question 46

Pt has shooting pain on right side, decreased sensation and weakness on right sensation loss is severe in center and less at margins. Where is the lesion?

Answer 46

graded margins = lesion at roots (not peripheral nerve bc peripheral = sharp margins) hyporeflexia = LMN lesion lesion = LMN lesion at roots

Question 47

UMN issue in legs but not in arms | where is the lesion?

Answer 47

Spinal cord lesion

Question 48

Epileptic Seizure with Impaired Awareness | where is the lesion?

Answer 48

temporal lobe (70-80%)

Question 49

lesion in left frontal eye field

Answer 49

saccades to the right | fast phase of nystagmus

Question 50

mirtazepine

Answer 50

Antidepressant increase NE and Serotinin release inhibit pre-synaptic alpha-2 and 5HT2A no effect on reuptake

Question 51

buspirone

Answer 51

non-benzo anxiolytic partial 5HT agonist partially block D2

Question 52

lesion in intralaminal nuclei of thalamus

Answer 52

stupor and coma

Question 53

Ondansetron - not effective for?

Answer 53

vestibular, D2 or opioid induced N/V | no 5HT receptors in vestibular system

Question 54

Pontine Micturation Center - Pathway

Answer 54

PMC descends in lateral spinal cord - starts the void and coordinates it (ParaNS reflex keeps it going)