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CPD3 > Neuro1 > Flashcards

Neuro1 Flashcards

1
Q

In which lobe is the motor homunculus?

A

precentral gyrus of the Frontal lobe

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2
Q

In which lobe is the sensory homunculus?

A

postcentral gyrus, parietal lobe

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3
Q

Where is the auditory area of the brain?

A

superior temporal gyrus, Temporal lobe

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4
Q

What is Wernicke’s area primarily responsible for and where is it?

A

Sensory component of speech, language, Temporal lobe

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5
Q

What is the occipital lobe primarily responsible for?

A

vision

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6
Q

Do tract from the spinocerebellar tract cross?

A

NO- therefore injury is likely ipsilateral to side of Sxs

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7
Q

What is ataxia?

A

cerebellar disorder of awkward posture and gait

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8
Q

What is Asthenia?

A

cerebellar disorder in which muscles tire more easily than normal

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9
Q

Tremors and Nystagmus are likely disorders of the:

A

cerebellum

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10
Q

Central spinal cord is made of:

Peripheral spinal cord is made of:

A

Central: gray matter (cell bodies and synapses)
Peripheral: which matter (ascending and descending pathways)

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11
Q

What are the 3 main systems of the ascending tracts?

A

sensory: pain/temperature, proprioception, light touch

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12
Q

Lesions of the spinothalamic tract are more likely to be contralateral or ipsilateral?

A

contralateral- they cross at the spinal level of the lesion

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13
Q

Where do posterior column tract cross?

A

at the junction of the spinal cord and brainstem

for conscious proprioception

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14
Q

Lesions to a spinocerebellar tract are likely to be contralateral or ipsilateral to the side of symptoms?

A

ipsilateral- they do NOT cross

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15
Q

What is an upper motor neuron?

A

descending pathway neuron from brain to spinal cord before synapse

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16
Q

What is a lower motor neuron?

A

descending pathway postsynaptic from spinal cord to periphery

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17
Q

What structures are in the diencephalon?

A

thalamus (sensory relay), hypothalamus, epithalamus

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18
Q

What are four disorders of the basal ganglia?

A

Parkinsonism, Chorea, Athetosis, Hemiballismus

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19
Q

Multifocal neuro lesions often implies what kinds of diseases?

A

metastatic disease, MS, 2 different diseases, malingering, hysteria

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20
Q

What is FOGS?

A

Family story of memory loss, orientation x3, general information, spelling

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21
Q

What is a positive Rhomberg test and what might that indicate?

A

pt sways when eyes are closed–> vestibular or proprioceptive defect

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22
Q

What is a positive drift test? What might it indicate?

A

hand will drop and rotate medially, indicates muscular weakness

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23
Q

If a patient sways when their eyes are open, what might that indicate?

A

cerebellar lesion

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24
Q

What is a positive babinski response and what might that indicate?

A

abnml dorsiflexion of the great toe and fanning of the other toes
–> UMN lesion

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25
Q

What is a positive Kernig sign and what might that indicate? What is another sign that can be done for a similar pathology?

A

Kernig: pain in low back on straightened lower extremity
–>meningeal irritation, meningitis
also, Brudzinski (flexion of the head results in marked neck pain and involuntary flexion of the hip)

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26
Q

What is the 3rd most common cause of death and the most common cause of neurologic disability?

A

stroke

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27
Q

Strokes involving anterior supply are generally bilateral/unilateral symptoms? Strokes involving posterior suppply?

A

anterior supply stroke: unilateral sxs

posterior: unilateral or bilateral and more likely to affect consciousness

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28
Q

What are sxs of stroke?

A

numbness, paralysis of contralateral limbs, aphasia, confusion, visual disturbances, dizziness, loss of balance/coordination, HA

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29
Q

What is the most common type of ischemic stroke?

A

thrombosis

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30
Q

TIAs are common in patients with:

A

internal carotid artery disease

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31
Q

What are Lacunar strokes and where are they more often seen?

A

destruction of small arteries that supply deep structures, seen more often in elderly patients with DM or poorly controlled HTN

32
Q

Which type of stroke has quicker onset and may have a preceding HA?

A

Embolic stroke

33
Q

Which type of strokes tend to occur at night?

A

Thrombotic strokes

34
Q

Which type of strokes tend to occur in the day?

A

Embolic strokes

35
Q

What are symptoms of a Lacunar stroke?

A

pure motor hemiparesis
pure sensory hemianesthesia
ataxic hemiparesis

36
Q

What tests are done to Dx a stroke?

A

Ct first, then MRI if inconclusive

Bedside glucose testing (to r/o hypoglycemia)

37
Q

What is the most common type of brain hemorrhage?

A

Subarachnoid Hemorrhage

38
Q

What are some causes of intracerebral hemorrhage?

A

AVMs, aneurysm, trauma, tumor, bleeding do

39
Q

What are some sxs of intracerebral hemorrhage?

A

HA, nausea, impairment of consciousness, N/V, Delirium, seizures, Hemiparesis, cerebellar dysfunction

40
Q

What is Broca’s area signifcant for and where is it?

A

motor for speech, Frontal lobe

41
Q

What are some sxs of subarachnoid hemmorrhage?

A

Sudden severe headache with LOC (HA is severe, peaking within seconds)
Severe neurological deficits
seizures possible
no neck stiffness initially but chemical meningismus may appear with vomiting

42
Q

What are the most common causes of cognitive impairment?

A

dementia

43
Q

Dementia affects mainly:

Delirium affects mainly:

A

Dementia affects mainly memory

Delirium affects mainly attention

44
Q

Delirium has ______ onset, whereas Dementia has a _____ onset/

A

Delirium has a more sudden onset, whereas dementia has a slower/gradual onset

45
Q

Delirium is typically caused by:

Dementia is typically caused by:

A

delirium: acute illness/ drug toxicity
Dementia: chronic brain do (alzheimers, eg, )

46
Q

What are signs/Sxs of Delirium?

A

Difficulty focusing, fluctuating consciousness, disoriented to time/place, may have hallucinations, delusions, paranoia, confusion, changes in personality or affect

47
Q

What is required for a diagnosis of delirium?

A

Acute change in condition that fluctuates during the day
Inattention
Plus one of the following: disturbances of consciousness, altered level of consciousness

48
Q

What are some of the most common etiologies for Dementia?

A

Alzheimers, Vascular Dementia, Lewy-body dementia and Parkinson Disease dementia, HIV-associated dementia, Frontotemporal dementia

49
Q

What are some disorders that might be classified as “reversible dementia”?

A

Normal pressure hydrocephalus, hypothyroidism, b12 deficiency, Lead toxicity

50
Q

What may be the first sign of dementia?

A

short-term memory

51
Q

What is the diagnostic criteria for dementia?

A 
Xognitive Sxs interfere with ability to do ADLs
Sxs represent a decline from previous functioning levels
Sxs are not explained by delirium or  a major psych do
2+ of following:
impaired ability to learn/remember new information
language dysfunction (aphasia)
visuospatial dysfunction
impaired executive functions (reasoning, complex tasks...)
changes in personality/behavior
52
Q

What labs/imaging might be run on a patient with dementia?

A

TSH, B12, CBC, LFTs, HIV/RPR is suspected

CT/MRI

53
Q

What is the most common cause of dementia?

A

Alzheimers

54
Q

What are some etiologies of Alzheimers?

A

genetic, mutations in amyloid precursor protein, mutations in apolipoprotein E alleles, low hormone levels, metal exposure

55
Q

What is the pathophysiology of Alzheimers?

A

neurodegeneration resulting from inappropriate deposition of the protein beta-amyloid in the brain.
beta-amyloid formed during the processing of amyloid precursor protein (APP)

56
Q

What persons are at risk of developing alzheimers by age 35?

A

People with trisomy 21

57
Q

Which condition is characterized by neurofibrillary tangles, hyperphophorylated tau proteins and loss of neurotransmitters (particularly Acetylcholine)?

A

Alzheimers disease associated dementia

58
Q

How is Alzheimers generally differentiated from other types of dementias?

A

Alzheimers generally doesn’t have motor deficits, whereas other causes of dementia do

59
Q

How is AD differentiated from Vascular dementia?

A

Modified Hachinski score

60
Q

What is the traditional diagnostic criteria for Alzheimers Dz?

A

clinical dementia documented by MSE
deficits in 2+ areas of cognition
gradual onset and progressive worsening of memory/cogn functions
no disturbance of consciousness
onset after 40, most often after 65
no systemic/neuro do that could account for Sxs

61
Q

What labs/imaging might help diagnose alzheimers?

A

B-amyloid or tau protein in CSF lumbar puncture
MRI/CT may show loss of volume
neuro exam, MSE exam

62
Q

What is the 2nd most common cause of dementia among the elderly?

A

Vascular dementia

63
Q

What are some symptoms of vascular dementia?

A

similar to other dementias with progressive focal neurological deficits (exaggerated DTRs, extensor plantar response, gait abnmlities, extremity weakness, hemiplegias, pseudobulbar palsy with pathologic laughing/crying, signs of extrapyramidal dysfxn)

64
Q

What is often found in Hx in a patient with vascular dementia?

A

hx of stroke

65
Q

How is vascular dementia differentiated from AD?

A

Hachinski Ischemic score

66
Q

What is Lewy-Body disease and how is it associated with Parkinsons disease?

A

Lewy-Body disease: cellular inclusions in the cytoplasm of cortical neurons.
Parkinsons disease is characterized as a movement do, but dementia seen in late Parkinsons is generally dt Lewy-Bodies in the substantia nigra

67
Q

What is the 3rd most common form of dementia?

A

Lewy-Body Dementia/Parkinson Disease Dementia

68
Q

How is Parkinsons Dz differentiated from Lewy-Body disease?

A

Lewy Body disease: cognitive dysfxn usu begin in 1 year, with tremors occuring later, symmetric deficits, fluctuating cognitive function, hallucinations, sleep do
Parkinsons: tremors first, with cognitive dysfxn in 10-15 years, psychiatric Sxs less frequent

69
Q

Definitive diagnosis of Parkinsons or Lewy-Body disease requires:

A

autopsy samples of brain tissue

70
Q

What kinds of cells are seen in Frontotemporal Dementia?

A

Pick cells (large ballooned neurons)

71
Q

What are 3 types of frontotemporal dementia?

A

frontal variant FTD, Primary Progressive Aphasia (PPA), Semantic dementia

72
Q

How does frontotemporal dementia differ from AD?

A

Frontotemporal dementia affects personality, behavior and lanugage function more, and affects memory less so than in AD

73
Q

What imaging might be done on a patient with frontotemporal dementia?

A

MRI may show severely thin atrophy in frontal and temporal lobes

74
Q

Normal Pressure hydrocephalus is thought to be caused by:

A

a defect in CSF resorption by arachnoid granulations

75
Q

Normal Pressure Hydrocephalus is characterized by:

A

gait disturbances, urinary incontinence, dementia, enlarged brain ventricles, nml/slightly elevated CSF pressure

76
Q

What type of gait is characteristic for Normal Pressure Hydrocephalus?

A

Magnetic gati

77
Q

What labs would one want to run on a patient with suspected normal pressure hydrocephalus?

A

MSE, Neuro PE, MRI/CT, CSF lumbar punction to evaluate CSF pressure

CPD3 (2 decks)

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