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Flashcards in Neurology Deck (230):
1

alar plate is [ventral/dorsal]

dorsal (sensory)

2

what does the myelencephalon become

medulla

3

what does the metencephalon become

pons and cerebellum

4

what marker can confirm neural tube defect after you already detect a high AFP

acetylcholine esterase

5

what embryologically is the anterior 2/3 of the tongue derived from

1st and 2nd branchial (pharyngeal) arches

6

what embryologically is the posterior 1/3 of the tongue derived from

3rd and 4th branchial/pharyngeal arches

7

function hyoglossus

retracts and depresses tongue

8

function genioglossus

protrudes tongue

9

function styloglossus

draws sides of tongue upward

10

nerve and function of palatoglossus

X, elevates posterior tongue during swallowing

11

where can you find free nerve endings

all skin, epidermis, some viscera

12

what type of neurons have free nerve endings

A delta (myelinated) and C (unmyelinated) fibers

13

where can you find Meissner corpuscles

glabrous (hairless) skin

14

where can you find Pacinian corpuscles

deep skin layers, ligaments, joints

15

where can you find Merkel discs

finger tips, superficial skin

16

where can you find Ruffini corpuscles

finger tips, joints

17

free nerve endings sense

pain, temperature

18

Meissner corpuscles sense

dynamic, fine/light touch, position sense

19

Pacinian corpuscles sense

vibration, pressure

20

Merkel discs sense

pressure, deep static touch, position sense

21

Ruffini corpuscles sense

pressure, slippage of objects along surface of skin, joint angle change

22

where in CNS is acetylcholine made

basal cells of Meynert

23

where in CNS is dopamine made

ventral tegmentum, SN pars compacta

24

where in CNS is GABA made

nucleus accumbens

25

where in CNS is norepinephrine made

locus ceruleus

26

where in CNS is serotonin made

raphe nucleus

27

neurotransmitter changes in Parkinson

increased acetylcholine, decreased dopamine, decreased serotonin

28

neurotransmitter changes in Huntington disease

increased dopamine, decreased ACh, decreased GABA

29

neurotransmitter changes in Alzheimer

decreased ACh, increased glutamate

30

neurotransmitter changes in schizophrenia

increased dopamine

31

neurotransmitter changes in depression

decreased dopamine, decreased norepinephrine, decreased serotonin

32

neurotransmitter changes in anxiety

increased nore, decreased GABA, decreased serotonin

33

acetylcholine is increased in which disease(s)

Parkinson

34

ACh is decreased in which disease(s)

AD, huntington

35

dopamine is increased in which disease(s)

schizophrenia, huntington

36

dopamine is decreased in which disease(s)

depression, parkinson

37

GABA is decreased in which disease(s)

anxiety, huntington

38

norepinephrine is decreased in which disease(s)

depression

39

norepinephrine is increased in which disease(s)

anxiety

40

serotonin is decreased in which disease(s)

anxiety, dperession, parkinson

41

name 3 ares with fenestrated capillaries instead of BBB

area postrema (vomiting after chemo), OVLT (osmotic sensing), neurohypophysis

42

which hypothalamic nucleus makes ADH

supraoptic

43

which hypothalamic nucleus makes oxytocin

paraventricular

44

function of lateral area of hypothesis

hunger. "makes you grow laterally"

45

function of ventromedial area of hypothalamus

satiety. "makes your ventre shrink medially"

46

function anterior hypothalamus

parasympathetic, cooling

47

function posterior hypothalamus

sympathetic, heating

48

circadian rhythm is controlled by which hypothalamic nucleus

suprachiasmatic nucleus

49

EEG awake, eyes open

beta (highest frequency, lowest amplitude)

50

EEG awake, eyes closed

alpha

51

EEG N1 (light sleep)

theta

52

EEG N2 (deeper sleep)

sleep spindles and K complexes

53

EEG N3 (deepest non-REM)

delta waves (lowest frequency, high amplitude)

54

EEG REM sleep

beta waves (like when awake. highest frequency, lowest amplitude)

55

in which part of sleep is there loss of motor tone

REM

56

in which part of sleep is there sleep walking, night terrors and bedwetting

N3

57

in which part of sleep does bruxism occur

N2

58

in which part of sleep do dreaming, nightmares, and penile/clitoral tumescence occur

REM

59

where does LGN project to

calcarine sulcus

60

what are the inputs into MGN

superior olive and inferior colliculus

61

what are the inputs to the ventral lateral nucleus of thalamus

input from basal ganglia and cerebellum

62

where does the ventral lateral nucleus of the thalamus project to

motor cortex

63

decreased activity in which dopaminergic pathway leads to negative symptoms

mesocortical

64

increased activity in which dopaminergic pathway leads to positive symptoms

mesolimbic

65

which dopamine pathway inhibits prolactin release

tuberoinfundibular

66

which dopamine pathway is involved in movement in basal ganglia

nigrostriatal

67

name deep cerebellar nuclei from lateral to medial

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

68

which parts of brain compose striatum

caudate + putamen

69

which parts of brain compose lentiform

putamin + globus pallidus

70

what is blephorospasm

a type of dystonia, sustained eyelid twitching

71

treatment of essential tremor

nonselective beta blockers (e.g. propranolol), primidone, patients self-medicate with alcohol

72

characteristic lesion causing hemiballismus

contralateral STN lesion

73

Kluver-Bucy Syndrome

disinhibited behavior due to bilateral damage of amygdala. associated with HSV-1 encephalitis

74

in which direction do eyes look in a paramedian pontine reticular formation damage

away from lesion

75

in which direction do eyes look in frontal eye field damage

toward the lesion

76

AICA comes off which artery

basilar

77

PICA comes off which artery

vertebral

78

unique symptoms of lateral pontine syndrome

caused by AICA. hearing loss, paralysis of face, decreased lacrimation, decreased salivation, and decreased taste from anterior 2/3 of tongue

79

unique symptoms of lateral medullary syndrome

dysphagia, hoarseness, decreased gag reflex. caused by PICA

80

basilar artery infarct causes

locked in syndrome

81

AICA infarct causes

lateral pontine syndrome

82

PICA infarct causes

lateral medullary (Wallenberg) syndrome

83

anterior spinal artery infarct causes

medial medullary syndrome

84

what CCB can be used to prevent vasospasm following subarachnoid hemorrhage

nimodipine

85

first nerve synapse for DCML from upper body

nucleus cuneatus

86

first nerve synapse for DCML from legs

nucleus gracilis

87

genetic defect associated with some cases of ALS

superoxide dismutase 1

88

region UMN signs in brown sequard

below lesion ipsilaterally

89

region of LMN signs in brown sequard

at level of lesion ipsilaterally

90

dermatome that includes kneecaps

L4

91

dermatomes for penile and anal zones

S2, S3, S4

92

dermatomes that are like a high turtle neck

C3

93

dermatome for posterior half of skull cap

C2

94

dermatome for inguinal ligament

L1

95

dermatome for low collar shirt

C4

96

dermatome that includes thumbs

C6

97

dermatome at umbilicus

T10

98

dermatome at xiphoid

T7

99

dermatome at nipple

T4

100

cremaster reflex

L1, L2

101

triceps reflex

C7, C8

102

achilles reflex

S1, S2

103

patellar reflex

L3, L4

104

biceps reflex

C5, C6

105

anal wink reflex

S3, S4

106

what is the Galant reflex

lateral flexion of lower body toward stimulated side when in ventral suspension

107

what is the Monro reflex

abduct/extend arms, then draw them in

108

which cranial nerves have medial nuclei

III, IV, VI, XII

109

Parinaud syndrome

paralysis of conjugate vertical gaze due to lesion in superior colliculi

110

function and composition of solitarius nucleus

visceral sensory, including taste
VII, IX, X

111

function and composition of nucleus ambiguus

motor of pharynx, larynx, and upper esophagus
IX, X, XI (cranial portion)

112

Ramsay Hunt Syndrome

herpes zoster causing facial nerve palsy

113

which nerves go through/in wall of cavernous sinus

III, IV, V1, VI (all from superior orbital fissure. only VI goes through blood)

114

low frequency heard at (apex/base)

apex, wide and flexible

115

high frequency heard at (apex/base)

base, thin and rigid

116

what is Rinne test

air vs. bone conduction

117

what is Weber test

tuning fork on skull, see where it localizes

118

result of Rinne test in conductive hearing loss

abnormal result. in affected ear, bone > air

119

result of Rinne test in sensorineural hearing loss

normal result. in affected ear, air > bone

120

result of Weber test in conductive hearing loss

localizes to affected ear

121

result of Weber test in sensorineural hearing loss

localizes to normal ear

122

what is cholesteatoma

keratin debris in middle ear space

can erode ossicles and cause conductive hearing loss

123

retinitis pigmentos

inherited retinal degeneration. begins with night-blidness. has bone spicule-shaped deposits

124

which nuclei receive the light in the pupillary light reflex

pretectal nuclei

125

1st neuron in sympathetic path to eye from hypothalamus synapses on

ciliospinal center of Budge (c8-t2)

126

which neuron of the sympathetic path from hypothalamus to eye would be impinged by pancost tumor

2nd neuron

127

Marcus Gunn pupil

optic nerve damage causes abnormal swinging flashlight test. dilates when you come back to it

128

in which direction does head tilt when CN IV is damaged

toward side of lesion

129

finding in CN III palsy

down and out and/or blown pupil

130

finding in CN IV palsy

affected eye moves upward, especially when adducted

131

finding in CN VI palsy

eye is stuck medially because it cannot abduct

132

right INO refers to which eye

the eye that is paralyzed

133

which allele is associated with decreased risk of alzheimer

apo E2

134

which allele is associated with increased risk of alzheimer

apo e4

135

familial forms of alzheimer disease

presenilin 1, 2, APP

136

protein aggregates in frontotemporal dementia

hyperphos tau or ubiquinated TDP-43

137

Charcot triad of MS

scanning speech, intention tremor, nystagmus

138

defect in Krabbe disease

AR disorder in galactocerebrosidase

139

sx Krabbe disease

peripheral neuropathy, developmental delay, optic atrophy, globoid cells

140

defect metachromatic leukodystrophy

AR defect in arylsulfatase A

141

sx metachromatic leukodystrophy

CNS and PNS demyelination, ataxia, dementia

142

PML is at an increased risk with which therapies

natalizumab and rituximab

143

adrenoleukodystrophy defect

x-linked defect in very-long-chain fatty acid metabolism

144

frequency of absence seizures

3 Hz

145

acute treatment of cluster headache

100% O2, sumatriptan

146

cluster headache prophylaxis

verapamil

147

migraine acute treatment

NSAIDs, triptans, dihydroergotamine

148

migraine prophylaxis

lifestyle changes, beta blockers, CCBs, amitriptyline, topirimate, valproic acid

149

position testing in peripheral vertigo

delayed horizontal nystagmus

150

position testing in central vertigo

immediate nystagmus in any direction

151

defect in Surge-Weber (encephalotrigeminal angiomatosis)

activating GNAQ mutation affecting capillaries

152

cardiac associations with tuberous sclerosis

mitral regurgitation and cardiac rhabdomyoma

153

Lisch nodules

pigmented iris hamartomas. seen in NF1

154

characteristics of VHL

hemangioblastomas, angiomatosis, bilateral RCC, pheochromocytoma

155

which brain tumor causes parinaud syndrome

pinealoma. childhood tumor

156

which brain tumor causes perivascular pseudorosettes

ependymoma. childhood tumor

157

which brain tumor has pseudopalisading histology

glioblastoma. adult tumor

158

which brain tumor has psammoma bodies

meningioma. adult tumor

159

which brain tumor can cause EPO production

hemangioblastoma. adult tumor, MC in cerebellum

160

which brain tumor has chicken wire capillary pattern around the neoplastic cells

oligodendroglioma. adult tumor

161

which brain tumor has rosenthal fibers

pilocytic astrocytoma. childhood tumor

162

which brain tumor has primitive neuroectodermal histology

medulloblatoma. childhood tumor

163

which tumor has rod-shaped belpharoplasts (basal ciliary bodies) found near nucleus

ependymoma. childhood tumor

164

which brain tumor sends drop metastases to spinal cord

medulloblastoma. childhood tumor

165

which brain tumor has Homer-Wright rosettes

medulloblastoma. childhood tumor

166

which brain tumor has "motor oil-like" fluid in it

craniopharyngioma. childhood tumor

167

what is the best cholinomimetic to use in glaucoma emergencies

pilocarpine

168

class of drugs: dextromethorphan, diphenoxylate, pentazocine

opioids

169

which opioid receptor is for beta-endorphin

mu

170

which opioid receptor is for dynorphin

kappa

171

which opiod receptor is for encephalin

delta

172

which opioid is used in cough suppression

dextromethorphan, codeine

173

which opioid is used for diarrhea

loperamide, diphenoxylate

174

which opioid dilates the eye, unlike all the others

meperidine

175

which opioid is a kappa agonist, mu antagonist

pentazocine. used for moderate to severe pain

176

which opioid is a kappa agonist, mu partial agonist

butorphanol. used for severe pain

177

which drug is a weak opioid agonist that also inhibits 5HT

tramadol. used for chronic pain, but decreases seizure threshold

178

first line drug for partial seizures

carbamazepine

179

first line drug for tonic-clonic seizures

valproic acid or phenytoin

180

first line drug for absence seizures

ethosuximide. its the only seizure ethosuximide treats

181

first line drug for acute status epilepticus

benzodiazepines

182

first line drug for status epilepticus prophylaxis

phenytoin

183

seizure use ethosuximide

absence only

184

seizure use benzos

acute status epilepticus only

185

seizure use phenobarbital

general (partial + tonic-clonic)

186

seizure use phenytoin

general (1st line for tonic-clonic) + status epilepticus prophylaxis

187

seizure use carbamazepine

general (first line for partial)

188

seizure use valproic acid

broad spectrum (partial, tonic-clonic, absence). first line for tonic-clonic

189

seizure use vigabatrin

partial only

190

seizure use gabapentin

partial only

191

seizure use topiramate

general (partial + tonic-clonic)

192

seizure use lamotrigine

broad spectrum (partial, tonic-clonic, absence)

193

seizure use levetiracetam

general (partial + tonic-clonic)

194

seizure use tiagabine

partial only

195

which epliepsy drugs cause stevens johnsons?

ethosuximide, phenytoin, carbamazepine, lamotrigine

196

MOA ethosuximide

blocks thalamic T type calcium channels

197

MOA benzos

increase GABA-A action

198

MOA phenobarbital

increase GABA-A action

199

MOA phenytoin

blocks Na channels

200

MOA carbamazepine

blocks Na channels

201

MOA valproic acid

increases Na channel inactivation, increases GABA concentration

202

MOA vigabitran

increases GABA concentration

203

MOA gabapentin

inhibits high-voltage-activated Ca channels, GABA analog

204

MOA topiramate

blocks Na channels, increases GABA action

205

MOA lamotrigine

blocks voltage-gated Na channels

206

MOA levetiracetam

unknown

207

MOA tiagabine

inhibits GABA reuptake

208

which barbiturate is used for induction of amnesia

thiopental

209

short-acting benzos

alprazolam, triazolam, oxazepam, midazolam. ("ATOM", more addicting)

210

which inhaled anesthetic is hepatotoxic

halothane

211

which inhaled anesthetic is nephrotoxic

methoxyflurane

212

which inhaled anesthetic is proconvulsant

enflurane

213

MOA ketamine

blocks NMDA receptors

214

order of sensations lost with local anesthetic

pain, temperature, touch, then pressure

215

which local anesthetic can cause CV toxicity

bupivicaine

216

which local anesthetic can cause methemoglobin

benzocaine

217

class of drugs: tubucurarine, pancuronium, atracurium

nondepolarizing NMJ blockers

218

GABA-B activator in spinal cord used to relax smooth muscle

baclofen

219

centrally acting muscle relaxant

cyclobenzaprine

220

MOA amantadine for parkinson

increases dopamine release and decreases uptake

221

livedo reticularis is an AE from which parkinson drug

amantadine

222

carbidopa MOA

inhibits peripheral DOPA carboxylase to prevent L-DOPA --> dopamine

223

entacapone, tolcapone MOA peripherally

inhibits COMT to prevent peripheral conversion of L-DOPA to 3-OMD

224

selegiline, rasagiline MOA

inhibit MAO-B centrally to block conversion of dopamine to DOPAC

225

central MOA for tolcapone

inhibits COMT centrally to prevent conversion of dopamine to 3-MT

226

memantine MOA

NMDA receptor antagonist used in Alzheimer

227

AChE inhibitors used in Alzheimer

donepezil, galantamine, rivastigmine, tacrine

228

tetrabenazine and reserpine MOA

inhibit VMAT to decrease dopamine packaging, used in Huntington

229

MOA riluzole

decreases glutamate excitotoxicity to modestly improve ALS survival

230

MOA triptans

5HT-1B/1D agonists that inhibit trigeminal nerve activation, prevent vasoactive peptide release, and induce vasoconstriction