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Flashcards in "Neuro Gold" Deck (69)
1

3 components of blood-brain barrier

Endothelial cells, basement membrane, astrocytic end feet

2

Conditions associated with proximal symmetric weakness but no sensory loss

Myopathies

3

Symptoms associated with peripheral neuropathies

Distal asymmetric weakness with atrophy, fasciculations, sensory loss and pain

4

Two most common conditions that result in peripheral neuropathies

Diabetes and alcoholism

5

Distribution of sensory loss in polyneuropathies

Stocking/glove pattern

6

Symptoms of Guillan-Barre syndrome

Ascending symmetric muscle weakness, areflexia and paresthesias in hands and feet 1-3 weeks following a viral respiratory or GI infection

7

CSF findings in Guillan-Barre syndrome

CSF has elevated protein without elevated WBC

8

Motor neuron disease characterized by UMN and LMN lesions

Amyotrophic lateral sclerosis

9

MRI and CSF findings of MS

MRI: white matter lesions

CSF: oligoclonal bands on electrophoresis

10

Conditions that cause pain/loss in a dermatomal pattern

Radiculopathies

11

Signs of UMN lesions

Spastic paralysis, hyper-reflexia, positive Babinksi, Hoffman sign, and clonus

With an acute UMN lesion, there may be hyporeactive reflexes and flaccid paralysis

12

Cause of lower facial paralysis (can wrinkle their forehead but cannot smile)

Sign of damage to the corticobulbar tract in the pons or higher (internal capsule or crus cerebri)

13

Signs of LMN lesions

Flaccid paralysis, hyporeflexia, fasciculations, atrophy

14

Symptoms of spinal shock

Temporary flaccid paralysis, hyporeflexia, sensory loss and loss of bladder tone

Hyper-reflexia develops over a period of days to weeks

15

Cause and symptoms of anterior spinal artery syndrome

Cause: occlusion of the artery of Adamkiewicz

Symptoms: bilateral weakness, loss of pain and temperature and hyper-reflexia below the lesion

16

Symptoms of cauda equina syndrome

Weakness and sensory loss in the lower extremities, radicular pain, saddle anesthesia, and urinary incontinence

17

Cause and symptoms of syringomyleia/hyromelia

Cause: cavitation of the central spinal cord

Symptoms: impinges the anterior white commissure producing bilateral loss of pain and temperature in a dermatomal pattern

18

Cause and symptoms of Brown-Sequard syndrome

Cause: hemisection of the spinal cord

Symptoms: ipsilateral UMN paralysis and loss of discriminative touch and contralateral loss of pain and temperature

19

Cause and symptoms of anterior cord syndrome

Cause: compression of anterior spinal artery

Symptoms: affects the neurons of the anterior horn, spinothalamic tract and lateral corticospinal tract

20

Symptoms of tabes dorsalis

Loss of posterior columns (discriminative touch, proprioception, and vibration)

21

Cause and symptoms of subacute combined degeneration

Cause: B12 deficiency

Symptoms: peripheral neuropathy that can progress to cord (posterior columns and lateral corticospinal tracts)

22

Cause and symptoms of medial medullary syndrome

Cause: infarct within anterior spinal artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), ipsilateral deviation of the tongue on protrusion (hypoglossal nucleus or nerve) and contralateral loss of discriminative touch, proprioception and vibration (medial lemniscus)

23

Cause and symptoms of lateral medullary syndrome

Cause: infarct within posterior inferior cerebellar artery

Symptoms: ipsilateral loss of pain and temperature on face (spinal trigeminal tract), contralateral loss of pain and temperature on body (spinothalamic tract), nystagmus, dizziness, nausea (vestibular nuclei), hoarseness, ipsilateral sagging palate, dysphagia (nucleus ambiguous), loss of taste (solitary nucleus), ataxia (restiform body, inferior cerebellar peduncle), Horner syndrome (hypothalamospinal fibers)

24

Cause and symptoms of Foville syndrome

Cause: infarct within paramedian branches of basilar artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), diplopia, paralysis of abduction (CN VI; maybe also intranuclear ophthalmoplegia), ataxia (middle cerebellar peduncle), contralateral loss of discriminative touch, proprioception, and vibration (medial lemniscus)

25

Cause and symptoms of Gubler syndrome

Cause: infarct within paramedian branches of basilar artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), ipsilateral facial paralysis (facial nerve or nucleus), ipsilateral loss of pain and temperature on face (CN V), contralateral loss of pain and temperature on body (spinothalamic tract)

26

Cause and syndrome of midpontine base syndrome

Cause: infarct within paramedian or short circumferential branches of basilar artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), paralysis of jaw muscles (CN V), loss of sensation on face (CN V), ataxia (middle cerebral peduncle)

27

Symptoms of tonsillar herniation

Central apnea, hypertension, hyperventilation, loss of consciousness

28

Injury to the facial nerve (or nucleus) results in complete or lower facial paralysis

COMPLETE facial paralysis

29

Corticonuclear lesions (at pons or above) results in complete or lower facial paralysis

Lower facial paralysis

30

Cause and symptoms of Parinaud syndrome

Cause: lesion of the midbrain

Symptoms: paralysis of vertical gaze (vertical gaze center), obstructive hydrocephalus (pinealoma)

31

Cause and symptoms of Weber syndrome

Cause: infarct within branches of the posterior cerebral artery within the midbrain

Symptoms: contralateral spastic hemiparesis (corticospinal tract), diplopia, dilated pupil (CN III), paralysis of lower face, deviation of tongue to contralateral side, weakness of ipsilateral SCM and trapezius (corticonuclear tract), tremor (substantia nigra)

32

Cause and symptoms of Claude syndrome

Cause: infarct within branches of the posterior cerebral artery within the midbrain

Symptoms: diplopia, dilated pupil (CN III), tremor, hyperkinesia (red nucleus), ataxia (cerebellothalamic fibers)

33

Symptoms of an uncal herniation

Diplopia, dilated pupil (CN III), contralateral hemiparesis (corticospinal tract), paralysis of lower face, deviation of tongue to contralateral side, weakness of SCM and trapezius (corticonuclear tract)

34

Findings for Weber test

Tests bone conduction

Normally localizes to midline

Sensorineuronal loss - localizes to good ear

Conductive loss - localizes to bad ear

35

Findings for Rinne test

Compares air and bone conduction; air conduction is normally better than bone conduction

Sensorineuronal loss - air > bone

Conductive loss - bone > air

36

Cause of anisocornia (unequal pupils)

Lesion to CN III or sympathetics

A dilated pupil indicates injury to CN III

37

Cause of ipsilateral blindess

Lesion to retina or optic nerve

38

Cause of bitemporal hemianopsia

Lesion to optic chiasm

39

Cause of contralateral homonymous hemianospia

Lesion to optic tract

40

Cause of contralateral homonymous hemianopsia, maybe quantrantopia

Lesion to optic radiations

41

Marcus-Gunn pupil

Pupil that appears to dilate with direct stimulation of light on a swinging light test

Indicates lesion to optic nerve

42

Cause and symptoms of intranuclear ophthalmoplegia

Cause: lesion of the medial longitudinal fasciculus (in the pons or caudal midbrain)

Symptoms: eye that fails to adduct on lateral gaze (but convergence is intact)

43

Cause and symptoms of one-and-a-half syndrome

Cause: lesion involving both the medial longitudinal fasciculus and abducens nucleus

Symptoms: on testing horizontal gaze, one eye can only abduct and other eye cannot abduct or adduct

44

Cause of Argyll-Robertson pupil

Tabes dorsalis

45

Decorticate posturing

UL flexed, LL extended (rubrospinal tract intact)

46

Decerebrate posturing

All limbs in extension (rubrospinal tract damaged)

47

Damage to what structure results in coma

Reticular formation

48

Cause and symptoms of Meniere's syndrome

Cause: excess endolymph in the scala media

Symptoms: episodic vertigo, tinnitus and hearing loss

49

Cause and symptoms of benign positional vertigo

Cause: free otoliths in the semicircular canals

Symptoms: outbursts of vertigo and nystagmus with particular positions of the head

50

Caloric testing

Cold=nystagmus to Opposite side
Warm=nystagmus to Same side

COWS

51

Cause of ballismus

Lesion to subthalamuc nucleus

52

Cause of hemiballismus

Lesion to subthalamic nucleus on opposite side

53

Differentiate between sensory vs cerebellar ataxia with the Romberg test

In sensory ataxia, the patient sways considerably when eyes are closed

In cerebellar ataxia, the patient sways with eyes open

54

Cause and symptoms of Friedreich's ataxia

Cause: autosomal recessive disorder, degeneration of posterior columns and spinocerebellar tracts

Symptoms: progressive limb and gait ataxia, dysarthria, loss of joint position and vibration senses, absent tendon reflexes in the lower extremity and Babinski sign

55

Symptoms resulting from blockage of anterior choroidal artery

Contralateral hemiparesis (corticospinal tract) and contralateral homonymous hemianopsia (optic tract)

56

Symptoms resulting from blockage of lenticulostriate arteries

Contralateral hemiparesis and hemianesthsia (posterior limb of internal capsule)

57

Symptoms resulting from blockage of MCA: superior division

Motor and sensory symptoms involving the contralateral face (lower facial paralysis), upper limb and trunk (lower extremity is spared); on the left will produce expressive (Broca's) aphasia

58

Symptoms resulting from blockage of MCA: inferior division

Contralateral homonymous hemianopsia; on left receptive (Wernicke's ) aphasia

59

Symptoms resulting from blockage of ACA

Motor and sensory symptoms involving the contralateral trunk and lower limb (upper limb and face are spared) with frontal lobe signs (magnetic gate, personality changes, release of primitive reflexes [grasp, root, suck])

60

Symptoms resulting from blockage of PCA

Produces visual symptoms - contralateral homonymous hemianopsia, macular sparring is possible; may infarct thalamus (thalmogeniculate and thalamoperforating) = contralateral homonymous hemianopsia/somoatosensory loss

61

Symptoms of Broca's aphasia

Impaired comprehension, repetition, naming and speech output

62

Symptoms of Wernicke's aphasia

Fluent speech full of nonsense words and phrases

63

Cause and symptoms of conductive aphasia

Cause: damage to the arcuate fasciculus

Symptoms: poor repetition

64

Symptoms of anterior watershed strokes

Expressive aphasia and lower limb affects

65

Symptoms of posterior watershed strokes

Receptive aphasia and visual loss

66

Definition of apraxia

Loss of the ability to perform a learned and familiar motor task

67

Definition of agnosia

Inability to recognize a familiar object regardless of intact sense

68

Cause and symptoms of Gerstmann syndrome

Cause: damage to the angular gyrus in the dominant hemisphere

Symptoms: acalculia, agraphia, finger agnosia, and left-right confusion

69

Cause and symptoms of Kluver-Bucy syndrome

Cause: bilateral lesions of the amygdala

Symptoms: docility, placidity, hypersexuality, hyperorality, and hypermetamorphosis