Neurology Flashcards
(183 cards)
1
Q
Obstruction is within the ventricular system
Ex: tumor in the region of the cerebral aqueduct
A
Non-communicating hydrocephalus
2
Q
Obstruction is within the subarachnoid space or arachnoid villi
A
Communicating hydrocephalus
3
Q
Enlargement of one or more ventricles (ventriculomegaly) caused by an obstruction of the bulk flow of CSF
A
Hydrocephalus
4
Q
Ventriculomegaly that results from a loss of brain tissue (brain atrophy)
A
Hydrocephalus ex vacuo
5
Q
Clinical symptoms of increased intracranial pressure
A
Headache, N/V, papilledema
6
Q
Mean arterial pressure minus the mean ICP
A
Cerebral perfusion pressure (CPP)
7
Q
Causes of increased ICP
A
Mass lesion, hydrocephalus, diffuse brain edema, obstruction, idiopathic intracranial hypertension
8
Q
Dilated ipsilateral pupil from compression of parasympathetic fibers in CN III is a clinical sign of what?
A
Uncal herniation
9
Q
Increase in brain volume due to an increase in fluid
A
Brain edema
Causes brain swelling that may produce a mass effect
10
Q
Type of brain edema that is extracellular edema due to BBB breakdown. Is this mainly found in the gray or white matter?
A
Vasogenic Brain Edema
Mainly in the white matter
11
Q
Type of brain edema that is intracellular edema due to an osmotic imbalance between the cell and the extracellular fluid. Is this mainly found in the gray or white matter?
A
Cytotoxic Brain Edema
Mainly in the gray matter
12
Q
Type of brain edema that is extracellular edema in periventricular white matter due to the transependymal flow of CSF in hydrocephalus.
A
Interstitial Brain Edema
13
Q
Condition where sutures of the skull fuse too early in development. These children will have developmental problems because the brain needs room to grow.
A
Syndesmosis
14
Q
Child presents with ataxia, gait disturbance, and unilateral or bilateral abducens nerve palsy
A
Pontine Glioma
15
Q
Is Parkinson’s a disease of the pyramidal or extrapyramidal motor system?
A
Extrapyramidal
16
Q
Is ALS a disease of the pyramidal or extrapyramidal motor system?
A
Pyramidal
17
Q
What is the main structure affected in chronic traumatic encephalopathy?
A
Septum pellucidum
18
Q
Comprehension preserved but language output is impaired and non-fluent
A
Broca’s aphasia
19
Q
Comprehension is severely impaired, while language is fluent.
A
Wernicke’s aphasia
20
Q
Expanded areas in the brain that hold CSF (not ventricles(
A
Cisterns
21
Q
Craniorachischisis totalis
A
Failure of closure of the entire neural tube
22
Q
Failure of neural tube closure is limited to region of the anterior neuropore
A
Anencephaly
23
Q
Failure of neural tube closure is limited to region of posterior neuropore
A
Myelomeningocele
24
Q
Large granules in the neuron body from the RER
A
Nissl substances
25
Cellular constituents of the neuron
Microtubules, neurofibrils, rough ER, and ribosomes
26
Nuclei are cell bodies located in the ______ while ganglia are cell bodies located in the ________.
CNS, PNS
27
Dendritic branches allow one neuron to receive messages from several presynaptic cells at the same time
Convergence
28
Axon branching allows several target cells to simultaneously receive a message from one neuron
Divergence
29
Most common structural type of neuron
Multipolar
30
Which structural type of neuron is specifically for special sensory?
Bipolar
31
Neuroglia (Glial cells) are ____ to _____ times more numerous than neurons
5, 10
32
Type of neuroglia that fills the spaces between neurons and surround the blood vessels in the CNS
Astrocytes
33
Type of neuroglia that deposit myelin within the CNS
Oligodendroglia
34
Type of neuroglia that remove debris in the CNS (known as the brain macrophages)
Microglia
35
Type of neuroglia that line the CSF-filled cavities of the CNS and create CSF
Ependymal cells
36
Glial cells that wrap around and cover axons in the PNS; form and maintain the myelin sheath
Schwann cells
37
Ability of the CNS to change
Plasticity
38
By age 3, ____% of synaptic connections have been made
80
39
During the first 10 years, a child's brain is _____ as active as the adult brain
Twice
40
After age _____, growth levels off and pruning begins
10
41
What is not used is pruned, and what is repeatedly used develops _______ ________
Stronger connections
42
60% of the nutrition taken in by a baby is used by the ______ during the first year
Brain
| Decreases to 30% by age 3
43
Period when a particular thing is learned better, stronger, faster. If this is missed, developing human may never be able to gain it back
Windows of Learning/Opportunity
44
Which windows of opportunity are crucial in a child up to 1 year old?
Trust, attachment, cause and effect thinking skills, early sounds
45
Which windows of opportunity are crucial in a child up to 2 years old?
Motor development, vision, language skills, and vocabulary
46
Can nerves in the CNS repair?
No
47
How do nerves in the PNS repair?
Wallerian Degeneration
| **only myelinated neurons
48
In Wallerian Degeneration, which cells are responsible for creating the tube to guide regeneration?
Schwann cells
49
Excitatory postsynaptic potentials send _________ signals, while inhibitory postsynaptic potentials send _________ signals
Depolarization
| Hyperpolarization
50
The two inhibitory neurotransmitters of the nervous system are:
GABA and Glycine
51
Always the first signaler on efferent pathways to the PNS
Acetylcholine
52
Catecholamines such as _________, _________, and _________ are made from the amino acid _________ and are destroyed by ____________
Dopamine, Epinephrine, Norepinephrine
Made from tyrosine
Destroyed by monoamine oxidase (MAO)
53
Serotonin is made from the amino acid _________, and is more of a modulator than a true transmitter. Almost always is released with another transmitter.
Tryptophan
54
Serotonin is ______ in muscle pathways, and ________ in sensory pathways
Excitatory, inhibitory
55
Always acts as the second neurotransmitter in the PNS
Acetylcholine
56
Second transmitter in the sympathetic SNS
NE or Epi
57
Neurotransmitter that always acts on skeletal muscles in the somatic NS
Acetylcholine
58
Region of the brain responsible for "consciousness, control, and motion"
Frontal Lobe
59
Region of the brain that controls memory for habits and motor activities
Frontal Lobe
60
Region of the brain that is the emotional control center
Frontal Lobe
61
Region of the brain responsible for "hearing, memory, association"
Temporal Lobe
62
Primary and associative olfactory regions are in what region of the brain?
Temporal Lobe
63
Region of the brain that contains the associative vision regions
Temporal Lobe
64
Region of the brain that links one's past and present sensory/emotional experiences into a continuous "self"
Temporal Lobe
65
Hippocampus is "tucked out of sight" on the medial side of the _______ lobe
Temporal
66
Which region of the brain is responsible for storing, processing and retrieving memories?
Hippocampus
67
In autism, patients have a heightened ability to store memories in the _____________
Hippocampus
68
Region of the brain responsible for "touch" and "sense integration"
Parietal Lobe
69
Region of the brain that contains the location for touch perception and visual attention
Parietal Lobe
70
Region of the brain that controls reading
Parietal Lobe
71
Region of the brain that is the center of visual perception
Occipital Lobe
72
Region of the brain where many cranial nerves enter and leave brain. Has centers for cough, gag, swallow, sneeze and vomit
Medulla Oblongata
73
Region of the brain with a cardiac and respiratory center
Medulla Oblongata
74
Region of the brain responsible for "sleep/wake" and "relaying information"
Pons
75
Region of the brain with control of respiratory patterns and conscious arousal
Pons
76
Region of the brain that relays sensory information between the cerebrum and cerebellum
Pons
77
Large mass of gray matter deeply situated in the forebrain. Relays information to the cerebral cortex that it receives from diverse brain regions --> last stop for associative information going to cortex
Thalamus
78
Axons from every sensory system (except olfaction) synapse here as the last relay site beofre the information reaches the cerebral cortex
Thalamus
79
Region of the brain responsible for many regulating functions including the autonomic nervous system, emotions and behavior, body temperature, hunger, thirst, and sleep-waking cycles
Hypothalamus
80
Region of the brain that plays a role in regulating complex moods, such as anger, placidity, and fatigue
Hypothalamus
81
What surgery may be performed in epileptic patients with global seizures?
Commissurotomy (removal of the corpus callosum)
82
Region of the brain known as the "emotional response area"
Amygdala
83
If pressure becomes elevated in the dural sinuses, blood can shift from the sinus out to the ________ space, decreasing intracranial sinus pressure
Subgaleal
84
What the the dural sinuses attached to?
Falx cerebri
85
Small veins that carry blood between the superior sagittal sinus and the subgaleal space
Emissary Veins
86
Flow in the emissary veins typically travel from ______ to _______
Scalp to sinus
87
Emissary veins can be torn in scalp trauma, leading to intracranial blood from the sinuses moving into the subgaleal space, causing a _______ _________
Subgaleal hematoma
88
Infection on the scalp can be carried into the SSS via the emissary veins, causing a _______
phlebitis
89
The outermost layer of dura mater forms the internal __________ of the skull
Periosteum
90
The inner layer of the dura mater, or the ________ layer, forms the double-thickness sheet of tissue
Meningeal
91
The choroid plexuses, structures that produce CSF, arise from the ______ ______
Pia mater
92
What kind of hemorrhages happen below the pia mater?
Subarachnoid
93
```
The subarachnoid space:
A: contains CSF
B: lies above the dura mater
C: lies below the pia mater
D: adheres to the brain and spinal cord
```
Contains CSF
94
Typically, ______ to _______ mL of CSF are present in the ventricles at any given time
125 to 150
95
Approximately _______ mL of CSF are produced every day
600
96
CSF travels through these to be reabsorbed into the SSS after traveling through the ventricles
Arachnoid Granulations
97
Glucose in CSF should be about _______ the level that plasma has
2/3
98
Protein and albumin levels in CSF should be ________ than in plasma
Lower
99
What should not be found in CSF normally?
WBCs
RBCs
Bacteria
100
What might cause elevated CSF protein?
1. Presence of cells that should be there: RBCs, WBCs, bacteria
2. Lots of diseases that include inflammation
101
What might cause decreased CSF glucose?
1. Critters in the CSF eating the glucose (bacteria)
| 2. Sometimes presence of cancer cells or lots of WBCs
102
What might cause decreased ICP?
1. Lower systemic pressure (dehydration, shock, etc).
| 2. A hole in the meninges where CSF is leaking out
103
What might cause increased ICP?
1. things that block CSF drainage (tumor, sinus thrombosis)
| 2. other liquids in CSF space (blood, etc.)
104
"Soft liquidy stuff in the middle of the intervertebral disk"
Nucleus pulposus --> absorbs shock
105
End of the spinal cord, located around L1/L2
Conus medullaris
106
Nerve bundle at the end of the spinal cord; extends to S5
Cauda equina
107
Upper Motor Neurons use ___________ as their neurotransmitter. Do not leave the CNS
Glutamate
108
Lower Motor Neurons use _______ as their neurotransmitter. Leave the CNS to go to target organ
Acetylcholine
109
The corticospinal tract is responsible for ________ _________
Voluntary motion
| Motor
110
The spinothalamic tract is responsible for __________
Sensory
| Proprioception, pain, temperature, light touch and pressure
111
The dorsal column tract is responsible for _________
Sensory
| Proprioception, deep touch, vibration
112
Brachial plexus = ?
C5, C6, C7, T1
113
Where do fibers decussate in the posterior column?
Lower Medulla
114
Where do fibers decussate in the spinothalamic tract?
At the level where they entered the dorsal horn
115
Where do fibers decussate in the corticospinal tract?
Medulla
| 10% remain ipsilateral
116
What is the most common cause of central cord syndrome?
Hyperextension of the spinal cord
117
Characterized by disproportionately greater motor impairment of the arms than the legs, with variable sensory loss below the level of injury
Central Cord Syndrome
118
Sacral sparing typically occurs in this
Central Cord Syndrome
| Will have better rectal tone than anterior leg function
119
Most common cause of anterior cord syndrome
Hyperflexion
120
Patients present with some degree of motor and sensory loss below the level of injury. However, deep touch, position sense, and vibration still in tact
Anterior Cord Syndrome
121
Most common cause of Brown-Sequard Syndrome
Penetrating injury
122
Characterized by motor loss and dorsal column sensory loss on the same side and spinothalamic sensory loss on the opposite side of the injury
Brown-Sequard Syndrome
123
Demyelination of the posterior columns and corticospinal tracts caused by B12 deficiency
Subacute Combined Degeneration
124
In subacute combined degeneration, demyelination of the ______ ________ and ________ _________ occurs
Posterior columns and corticospinal tracts
125
Symptoms of Subacute Combined Degeneration
Abnormal tinging and numbness, weakness of legs, arms or other areas
Symptoms are bilateral and progressive
126
Gradual loss of myelin with the posterior columns of the spinal cord
Tabes Dorsalis
127
Symptoms of tabes dorsalis
Decreased ability to sense proprioception, light touch, and vibration below the site of the lesion
128
10-15% of TIA patients have a stroke within ___ months
3
129
50% of strokes after TIAs occur within _____ hours
48
130
Ischemia due to occlusion of a blood vessel
Focal, territorial, local
131
Ischemia due to cardiac arrest, systemic hypotension, or increased intracranial pressure
Global, generalized
132
About _____ of subarachnoid hemorrhage patients experience rebleeding of aneurysm in first 4 weeks
40%
133
85% of berry aneurysms occur in _______ circulation, while 15% occur in ________ circulation
Anterior; posterior
134
Tangle of abnormal arteries and veins with no intervening capillary bed. Often wedge-shaped, involving brain and leptomeninges
Arteriovenous Malformation
135
Important signs of arteriovenous malformation
Seizures and bleeds
136
What is the tell tale sign of subarachnoid hemorrhage?
Acute hemorrhage seeping through sylvian fissure
137
In cerebral infarction, the _____ ______ is common obliterated
Sylvian fissure
138
Stain for myelin
Methyl blue
139
Oligodendrocytes show up as "fried egg" on this stain
Pink
140
Disease of myelin formation or maintenance by intrinsic cause
Leukodystrophy
141
Disease of normally formed myelin caused by extrinsic cause
Demyelinating disease
142
Immune mediated or inflammatory demyelinating diseases
MS, encephalomyelitis, leukoencephalitis
143
Viral demyelinating diseases
PML, AIDS
144
Toxic/Metabolic demyelinating diseases
Vapor abuse, soak glue/paint rags and inhaling
145
Characterized by loss of oligodendrocytes and fibrillary astrocytic gliosis
MS
146
Caused by papovavirus (JC strain) infection
Progressive Multifocal Leukoencephalopathy
147
Occurs as a complication for HIV patients with relatively short clinical course
Progressive Multifocal Leukoencephalopathy
148
"Rat bitten appearance to the white matter of the brain"
Progressive Multifocal Leukoencephalopathy
149
Caused by a rapid correction of serum electrolyte imbalance, resulting in rapid or excessive rise in serum sodium in hyponatremic patients
Central Pontine Myelinolysis
150
Perivascular presence of multinucleated giant cells, expressing HIV viral antigens
AIDS Leukoencephalopathy
151
Toxic cytokinds from activated macrophages/microglia may play an important role
AIDS Leukoencephalopathy
152
Inherited metabolic diseases primarily affecting white matter; caused by a mutation of the gene for the myelin protein or specific enzyme for myelin lipid metabolism
Leukodystrophy
153
Perturbation in the formation or maintenance of the myelin sheath
Leukodystrophy
| These are very sick children that are very compromised from cognitive standpoint
154
The autonomic nervous system is located in both the _____ and the _____. It coordinates and maintains a steady state.
CNS, PNS
155
Preganglionic neurons in the ANS are __________, while postganglionic neurons in the ANS are __________
Myelinated, unmyelinated
156
The sympathetic nervous system involves the _______________ (thoracolumbar/craniosacral), while the parasympathetic involves the _____________ (thoracolumbar/craniosacral)
Sympathetic - thoracolumbar
| Parasympathetic - craniosacral
157
The ___________ (sympathetic/parasympathetic) nervous system involves collateral ganglia, which are other ganglia that are not within the sympathetic trunk
Sympathetic
158
Unlike the SNS, the PNS doesn't have a trunk of ganglia. They all exist in the _________, close to the ________ they innervate.
Periphery
| Organs
159
Parasympathetics do NOT go to:
- Cardiac muscle cells (they do go to pacemaker cells)
- Uterus
- Sweat glands
- Goosebump muscles
- Skeletal muscles
- Adrenal gland
- Only select blood vessels
160
Sympathetic preganglionic fibers - Neurotransmitter:
Acetylcholine
161
Sympathetic preganglionic fibers - Receptor:
Cholinergic
162
Sympathetic postganglionic fibers - neurotransmitter
Norepinephrine
163
Sympathetic postganglionic fibers - receptor
Adrenergic
164
Parasympathetic pre and postganglinoic fibers - Neurotransmitter
Acetylcholine
165
Adrenal medulla: Preganglionic and Postganglionic neurotransmitters?
Pre - Ach
| Post - E, NE to bloodstream
166
A1- adrenergic receptors
Excitation
| Most common alpha receptors
167
A2- adrenergic receptors
Relaxation/Inhibition
168
B1- adrenergic receptors
Increases heart rate and contractility; causes release of renin
Think heart and kidney
169
B2-adrenergic receptors
Relaxes muscles in the bronchi, bladder
170
B3- adrenergic receptors
Mediates lipolysis and thermogenesis
| Think endocrine
171
All the ACh receptors on the postganglionic autonomic cells' dendriates are ________ (nicotinic/muscarinic)
Nicotinic
172
All muscle cell receptors at neuromuscular junctions are __________ (nicotinic/muscarinic)
Nicotinic
173
These ACh receptors are found in the CNS, exocrine glands, and the cardiac conducting system
Muscarinic
174
These ACh receptors are on GI and smooth muscle, and help these muscles contract
Muscarinic
175
Nicotinic Receptors are ___________ (gated ion channels/G protein coupled receptors) while Muscarinic receptors are ___________
Gated Ion Channels
| G protein coupled receptors
176
CNS neuron injury can lead to widespread release of ____________ neurotransmitters. This results in cell death and degradation of postsynaptic cells
Excitatory
177
Characterized by a complete loss of reflex function, flaccid paralysis, sensory deficit, and loss of bladder and rectal control in all segments below the level of the lesion
Spinal Shock
178
Transient drop in blood pressure and poor venous circulation are typical in this type of shock
Spinal Shock
179
Loss of thermal control is common in this type of shock, therefore warming is very important
Spinal Shock
180
Characterized by a cervical or upper thoracic cord injury, and is caused by absence of sympathetic activity from loss of supraspinal control and unopposed parasympathetic tone mediated by the intact vagus nerve
Neurogenic Shock
181
Syndrome of sudden massive reflex sympathetic discharge with little to no opposing parasympathetic discharge to bring it down
Autonomic Dysreflexia
182
This type of shock causes vasodilation, hypotension, bradycardia, and hypothermia
Neurogenic Shock
183
Symptoms of autonomic dysreflexia
```
Hypertension
Bradycardia
Pounding headache
Blurred vision
Sweating above lesion
Piloerection
```
