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Flashcards in Neurology Deck (88):
1

supraoptic nucleus of hypothalamus

ADH production

2

paraventricular nucleus of hypothalamus

oxytocin

3

lateral area of hypothalamus

hunger, destruction-->anorexia, failure to thrive (infants). Inhibited by leptin.

4

ventromedial area of hypothalamus

Satiety, destruction (eg craniopharnygioma)-->hyperphagia. Stimuated by leptin.

5

anterior hypothalamus

cooling, parasympathetic

6

posterior hypothalamus

heating, sympathetic

7

suprachiasmatic nucleus

circadium rhythms

8

Sleep cycle regulation

at night, nocturnal release of ACTH/prolactin/melatonin/NE: SCN-->NE release-->pineal gland-->melatonin

9

extraocular movement during REM are due to..

activity of PPRF (conjugate gaze center)

10

VPL of thalamus

input from spinothalamic and dorsal columns/medial lemniscus; pain/temp, pressure/touch, vibration/proprioception; transmits signals to primary somatosensory cortex

11

VPM of thalamus

input from trigeminal and gustatory pathway; face sensation and taste; primary somatosensory cortex

12

LGN of thalamus

input from CNII; vision; signals to calcarine sulcus

13

MGN of thalamus

input from superior olive and inferior colliculus of tectum; hearing; signs to auditory cortex of temporal lobe

14

VL of thalamus

input from basal ganglia, cerebellum; motor; signals to motor cortex

15

Lateral lesions of cerebellum

control voluntary movement; tendency to fall toward ipsilateral side

16

medial lesions of cerebellum

truncal ataxia, nystagmus, head tilting; wide based cerebellar gait; deficits in truncal coordination; bilateral motor deficits

17

lateral to medial deep nuclei of cerebellum

dentate, emboliform, globose, fastigial (don't eat greasy foods)

18

MCP of cerebellum

receives input via contralateral cortex

19

ICP of cerebellem

receives ipsilateral proprioceptive information (spinal cord) via climbing and mossy fibers

20

SCP of cerebellum

output tract, purkinje cells-->deep nuclei-->contralateral cortex via SCP

21

Direct pathway of basal ganglia

D1 receptor; facilitates movement; cortex-->putamen-->GPi-->thalamus-->cortex

22

Indirect pathway of basal ganglia

D2 receptor; inhibits movement; cortex-->putamen-->GPe-->STN-->GPI-->thalamus-->motor cortex

23

excitation of GPe:

increase in movement via inhibition of STN and resultant decrease in inhibitory signals from GPi to thalamus

24

excitation of GPi:

decrease in movement via inhibition of thalamus and a resultant decrease in stimulatory signals to cortex

25

sudden, wild flailing of 1 arm +/- ipsilateral leg

hemiballismus; contralateral subthalamic nucleus (lacunar stroke)

26

sudden, jerky, purposeless movements

chorea; basal ganglia--huntingtons

27

slow, writhing movements; esp in fingers

athetosis; basal ganglia--huntingtons

28

sudden, brief, uncontrolled muscle contraction

myoclonus; jerks/hiccups common in metabolic abnormalities like renal/liver failure

29

sustained, involuntary muscle contractions

dystonia

30

action tremor, exacerbated by holding posture/limb position

essential tremor (postural tremor); genetic predisposition, patients often self medicate with EtOH; tx with B blockers and primidone

31

uncontrolled movement of distal appendages; tremor alleviated by intentional movement

resting tremor; parkinson disease (pill rolling) tremor

32

slow zigzag motion when point/extending toward target

intention tremor; cerebellar dysfunction

33

hyperorality, hypersexuality, disinhibited behavior

Kluver Bucy syndrome, bilateral amygdala lesion; associated with HSV-1

34

disinhibition and deficits in concentration, orietation, judgment, emergence of primitive reflexes

frontal lobe lesion

35

spatial neglect syndrome (agnosia of contralateral side of the world)

right parietal-temporal cortex

36

agraphia, acalculia, finger agnosia, left/right disorientation

left parietal temporal cortex; gerstmann syndrome

37

reduced levels of arousal and wakefulness (coma)

reticular activating system in midbrain

38

confusion, ataxia, nstagmus, memory loss (anterograde and retrograde amnesia), confabulation, personality changes

Wernicke Korsakoff, bilateray mammillary bodies

39

contralateral hemiballismus

subthalamic nucleus

40

anterograde amnesia

hippocampus, bilateral

41

eyes looking away from side of lesion

PPRF

42

eyes look toward lesion

frontal eye fields

43

nonfluent aphasia with intact comprehension

broca aphasia (brocas area--inferior frontal gyrus of frontal lobe)

44

fluent aphasia with impaired comprehension and repetition

Wernicke aphasia--superior temporal gyrus of temporal lobe

45

non fluent aphasia with impaired comprehension

global aphasia; both broca and wernicke lesioned

46

poor reptition but fluent speech, intact comprehension

conduction aphasia; caused by damage to left superior temporal lobe and or left supramarginal gyrus

47

nonfluent aphasia with good comprehension and repetition

transcortical motor

48

poor comprehension with fluent speech and repetition

transcortical sensory

49

nonfluent speech, poor comprehension, good repetition

mixed transcortical

50

MCA stroke

motor cortex--upper limb/face; sensory cortex--upper limb and face; temporal lobe (Wernicke area); frontal lobe (Broca area)

51

ACA stroke

motor cortex--lower limb; sensory cortex--lower limb

52

lenticulostriate artery stroke

striatum, internal capsule; lacunar infarcts

53

ASA stroke

lateral corticospinal tract; medial lemniscus; caudal medulla--hypoglossal nerve

54

PICA stroke

lateral medulla--vestibular nuclei; lateral spinothalamic tract; spinal trigeminal nucleus; nucleus ambiguus, sympathetic fibers, inferior cerebellar peduncle

55

AICA stroke

lateral pons--cranial nerve nuclei; vestibular nuclei; facial nucleus; spinal trigeminal nucleus, cochlear nuclei, sympathetic fibers; middle and inferior cerebellar peduncles

56

PCA stroke

occipital cortex, visual cortex

57

basilary artery stroke

pons, medulla, lower midbrain, corticospinal and corticobulbar tracts, ocular cranial nerve nuclei, PPRF

58

ACOM stroke

can impinge CNII, ocular defects

59

PCOM stroke

CN III palsy (eye is down and out) with ptosis and mydriasis

60

contralateral paralysis--upper limb and face, contralateral loss of sensation--upper limbs and face; aphasia if in dominant hemisphere; hemineglect if in nondominal hemisphere

MCA stroke

61

contralateral paralysis--lower limb, contralateral loss of sensation--lower limb

ACA stroke

62

contralateral hemiparesis/hemiplegia

lenticulostriate artery strok; lacunar infarcts 2ndary to unmanaged HTN

63

contralateral hemiparesis--upper and lower limbs; decreased contralateral proprioception; ipsilateral hypoglossal dysfunction (tongue deviates towards lesion)

ASA stroke, medial medullary syndrome (infarct of paramedian branches of ASA and vertebral arteries)

64

vomiting, vertigo, nystagmus; decreased pain and temp sensation from ipsilateral face and contralateral body; dysphagia/hoarsness; decreased gag reflex; ipsilateral horner syndrome; ataxia/dysmetria

PICA stroke; lateral medullary syndrome (Wallenberg); nucleus ambiguus effects are specific to PICA lesions (dysphagia, hoarseness)

65

vomiting, vertigo, nystagmus, paralysis of face, decreased lacrimation, salivation, decreased taste from anterior 2/3 tongue, decreased corneal reflex; ipsilateral loss of hearing/Horner syndrome

AICA stroke; facial nucleus effects specific to AICA lesions

66

contralateral hemianopia with macular sparing

PCA

67

Poliomyelitis and spinal muscular atrophy (werdnig hoffman disease)

LMN lesions only due to destruction of anterior horns; flaccid paralysis

68

Multiple sclerosis

demyelination; affects posterior columns/ random white matter; scanning speech/intention tremor/nystagmus

69

amyotrophic lateral sclerosis

combined UMN/LMN deficits with no sensory, cognitive or oculomotor deficits

70

enzyme deficiency that can cause ALS?

superoxide dismutase I

71

tx for ALS?

riluzole; decreases presynaptic glutamate release

72

absence of DTRs and + romberg

tabes dorsalis--teritary syphilis affecting posterior columns

73

bilateral loss of pain/temp sensation usually C8-T1

syringomyelia; syrinx expands and damages anterior white commissure of spinothalamic tract (2nd order neurons)

74

ataxic gait, paresthesia, impaired position sense, vibration sense

subacute combined degeneration--demyelination of dorsal columns and lateral corticospinal tracts; VitB12 or E deficiency

75

Friedrich ataxia

AR; GAA repeat on chromosome 9 in gene that codes frataxin--mitochondrial functioning impairment; staggering gait, frequent falling, nystagmus, dysarthria, pes cavus, hammer toes, hypertrophic CM (cause of death); childhood kyphoscoliosis

76

Parinaud syndrome

paralysis of conjugate vertical gaze due to lesion in superior colliculi

77

Cribiform plate

CNI

78

middle cranial fossa--through sphenoid bone

CN 2-6

79

optic canal

CN2, opthalmic artery, central retinal vein

80

superior orbital fissue

CN 3, 4, V1, 6, opthalmic vein, sympathetic fibers

81

foramen rotundum

CN V2

82

foramen ovale

CN V3

83

foramen spinosum

middle meningeal artery

84

Posterior cranial fossa through temporal or occipital bone

CN 7-12

85

internal auditory meatus

CN 7, 8

86

jugular foramen

CN 9, 10, 11, jugular vein

87

hypoglossal canal

CN12

88

foramen magnum

spinal roots of CN9, brain stem, vertebral arteries