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Flashcards in Neurology Exam 1 Deck (264):
1

Occipital Lobes functions q

The smallest of the four lobes.. mainly reposnible of visual sensory infomration.

2

straight leg raise test is sensitive to what

possible Lumbar herniated disk

3

Patella reflex checks

L2 L3 L4

4

CNS consists of what?

Brain and Spinal Cord

5

Carotid US is as acurate as angiography

False. not as acurate but it is a reliable test that has no radiation and is tolerated by pts well.

6

MRI or CT- susspected stroke

CT first

7

what is the corpus callosum

a major highway of axons that connects one hemisphere to the other.. (i.e. left and right)

8

Brachioradialis checks which nerve roots

C5 / C6

9

Meninge that is delecate and stuck to the dura

Arachnoid matter

10

what sometimes happens with the pupils when there is intracranial mass lesions

You sometime see a Ipsilateral Pupillary dilation.

this if happens is because the 3rd cranial nerve inferior to the frontal lobe is compressed.

11

All four ventricles are connected and CSF eventually flows out and around the brain and spinal cord...

TRUE

12

Lateral ventricles make a lot or little CSF

A lot

13

What is taken up by and reused by the neuron post acetylcholinesterase breaks . down ACH

Choline

14

what mimics fxs and need to be identified as normal

Sutures of the skull, they are well corticated- they have an appropriate white clear line on both sides and in the middle... different from fxs that will not have white outline on the middle fpart of othe fx just the outside of the normal bone..

15

Thin meninge that is adheared to the brain and spinal cord

Pia matter

16

s/s of type 2 neurofibroamatosis

much less common... characterized by the development of benign vestibular schwannomas bilaterally

gradual hearing loss
ringing in teh ears
poor balance
HA's

17

What is it when you draw a number on a palm and they tell you what you drew

Graphesthesia

18

In the brain the axons are considered to be ?

White matter and on the interior aspects of the brain

19

Orientation for exam includes

Person, Time, Place, Situation

20

what is the measurement of a normal EEG findings in an awake adult

8 hz or higher

21

where is grey matter / white matter in the spinal cord

Opposite the brain the gray is deep and white is more proximal.

22

Epileptiform patterns of discharges help neruologists to separate generalized from focal (partial( seizures using what test

EEG

23

Definite of interpretation abnormal CT scans

confirm right pt
any artifacts?
evaluate overall brain volume
look at bone windows for fxs
look for evidence of stroke or ischemia
rule out epidural, subdrual, or subarachnoid hemorrhage
rule out hemorrhagic stroke or intracranial hemorrhage
any masses?
Rule out swelling, mass effect and midline shift

24

what are neurons

Highly specialied cells capable of conducting action potentials for electrical and chemical communications.

25

achilles reflex checks

S1

26

word for minimal difference in pupil size that is seen in 38% of healthy individuals

Anisocoria

27

MRI diffusion- weighted images are really good at diagnosing even the most tiny what

strokes

28

where do craniopharyngioma's normally grow

Above the sella and can cause endocrine dysfunction and bitemporal field defects

29

identify objects with eyes closes what is the word

Stereognosis

30

Which neoplasm is associated with an increased intracranial pressure d/t obstructive hydrocephalus

Ependyoma - because they arise from ependyma of a ventricle

31

What is in the ventricles of the brain

CSF

32

Oligodendroglioma

obviously derived form CNS myelin cells
These usually arise in the cerebral hemispheres of adults and are very slow growing malignancies usually over several years

33

what are the two most commonly used imaging procedures in Neurologic medicine

CT and MRI

34

Most common brain mets

Carcinoma of the lung
breast cancer
renal cell carcinoma
Melanoma
Colorectal

35

Assess tone in uper extremities and lower extremities with wave like motion thgrough flexion and extension

lol ok

36

CT Angiogram- benifits

Can be obtained faster and with less vascular invasion

37

what is the function of the posterior or dorsal horns

Sensory neurons

38

Occipital love intracranial mass lesions

Tumors often can lead to any number of disturbances with vision including: Blindness, visual field defects, sudden inability to see color, visual hallucinations, ETC.

39

The signals travel to the appropriate homunculus and then through the SMA and lastly through what structure for fine tuning

Cerebellum

40

Which image is great for identifying acute ischemia on MRI

DWI- diffusion-weighted MR

41

what are astrocytomas

Malignacies derived from rogue astrocytes arising within the brain or spinal cord

42

what is a dermatome

A band of skin that is innervated by the sensory fibers of a single spinal nerve root

43

Homunculus are larger for what parts fo teh body

The parts that need more fine motor function and those areas that have finer motor control. I.E. hands and face

44

Type of glial cell that creates the myeli sheath and wraps the axons in the CNS

Oligodendrocytes

45

the central sulcus separats what two parts of the brain

Somatosensory and motor cortexes

46

position, vibration, fine touch travel through what tract

Posterior Column

47

Ependymal cells that line the ventricles create the CSF, what is the structure they line

Chorioid plexus

48

What is a Medulloblastoma

Non-invasive, repidly growing mass that usually originates in the posterior fossa, around the fourth ventricle

49

what are the parts fo f the bainstem

The midbrain
Pons
Medulla oblongota

50

what are common sturctures in the brain to get calcified and look like a mass on CT imaging

Pineal gland

Choroid plexus

51

inspectsize and contour of muscles bilaterally this can can suggest pathology via atrophy in what as documented

Muscle Bulk

52

what can be used to assess stroke progression over time

Serial MR imaging and accompanying DWI / ADC images

53

What needs to be obtained prior to a lumbar tap

Head CT obtained...
Which can rule out contraindications for the lumbar puncture

** big one... Rule out abcess in the brain.. you want to make sure that the pressure releif from the needle doause not cause a herniation of the brainstem. This would cause the foramen magnum to crush the brain stem..

54

What is Brudizinskis sign

As you flex the neck.. watch the hips and kness. if they can not remain relaxed then there may be meningeal inflammation

55

what is neurofibromatosis

Considered a neurocutaneous disease, Neurofibromatosis may occur either sporadically or on a familial basis with autosomal dominatn inheritance.

56

Temporal lobes

Complex lobe dealing with retention of information (memories), facial recognition, emotional association, language comprehension

57

cotton wisp for corneal reflex tests which reflex arch ?

CNV and CN VII

58

In addition to sx or in absence of sx what is often used as part of the treatment plan for intercranial masses

Chemotherapy and Radiation

59

what is indicated if CSF is tinted yellow

Likely presence of Pus and raises immediate suspicion of bacterial meningitis

60

Anatomy and pathology are easier to understand on which MRI or CT

CT or MRI depends on situation

61

Signs and symptoms of parietal lobe lesions

Characteristically - contralateral disturbances of sensation and may cause sensory seizures

Astereognosis is common.

62

hemorrhagic storkes or other intracranial hemorrhages or often easily seen and ofen surrounded by what

edema and sulcal effacement

63

what can help you to identify fxs that might be really small

acute hemorrhage

64

EMG is what

Electromyography

65

What is Acoustic neruoma

More appropriately Vestibular schwannoma. Benign neoplasms derived from the myelin of the CN VIII

66

if CT reveals no edema or very slight trace of edema and MRI will allow a more sensitive evaluation of teh area

OK

67

what do you want to make sure you catch and is an immediate sx with repair and evacuation.

complex skul fracture with suppression or movment of the bones with exradural hematoma there are fractures and possible bone structures that will be rubbing on and destroying brain tissue, you can see seizures and other symptoms of this... however it has had asymtomatic patients as well such as the litlle 3 or 4 yo girl that tyler talked about in class where she fell off the back of the slide.

68

Kernigs sign

Flex hip and knee then straighten knee... pain and incresed resistance outside of tight hamstrings suggests meningeal inflammation

69

what disease is cogwheel rigidity commonly associated with

Parkinson's disease and other disorders of upper motor neuron

70

what is involved with a cerebral angiogram

Accessing the arterial system with a catherter and injecting radioapaque dye while fluoroscopy of the skull takes place.

71

What do Subdural Hematomas (SDH) look like

Crescent shaped and crooss suture lines or be along the tentorium or falx

72

what is the role of the hypothalamus

Maintain the physiologic homeostasis and the endocrine function and the pituitary

73

where do the lower muscle neurons synapse?

Neuromuscular junction

74

the spaces created between the meningeal cells... they include subdural subarachnoid, etc..

true of false they continue down the spinal cord as well..

True

75

Not as common but cancers can spread to teh meninges - this is a difficult situation to treat but what is it called

Leptomeningeal metastases

76

Internal capsule is white highway of what

Entering and exiting axons that run form the cortex to the midbrain

77

How does medulloblastoma spread

Frequently spreads by CSF. commonly spreads to other locations within the CNS

78

Glioblastoma Multiforme (GBM) has what kind of prognosis

Course is rapidly progressive and has very poor prognosis

total surgical removal is usually not possible, although surgery is common to decompress the brain or stop bleeding.

Radiation and chemotherapy may or may not prolong survival.

5- year survival rate is less than 10 percent.

79

What does the cord do

a series of segmental relays with the periphery, serving as a conduit for information, communication between the brain and tissues.

80

Supporting roles and cells of the brain that also transport the nutrients into the brain

Astrocytes.

81

DTR in UE's and LE's what is the numbers associated

4+- very brisk and hyperactice with clonus
3+ more brisk than the average but no disease noted
2+ average or normal
1+ somewhat diminsihsed , low normal no notable disesase at this time
0 - no response

82

very early after stroke a CT can remain normal. so what is an initial CT really trying to figure out

Hemorrhagic or other type of stroke. this will dictate our approach for treatment.

83

What do. we do with asymptomatic meningiomas that are found incidentally

Serial imaging... we will just watch growth and development. monitor for symptms etc.

84

primary motor cortex, ____ _____ ______ then

supplementary motor cortex (SMA) helps to facilitate the appropriate motor neuron excitation.

85

If upper motor neruon is lost what is expected

Spastic muscle weakness
too much tone

86

What is the most common type of primary CNS malignancy seen in children

Medulloblastoma

87

MRI or CT- Choice for trauma

CT - quicker, and sees acute hemhorrage much faster

88

what is the pathophysiology of neurofibromatosis

the mainfestation of. NF1 results from mutation or deletion of the NF1 gene, which normal serves as a suppressor gene.
-chromasome 17

NF2- merlin- gene similaralteration of chromosome 22

There are two genes known to cause schwannomatosis- generally these are benign tumors. but malignat degeneration can rarely occur and leads to peripheral sarcomas

89

Segmental lower motor neuron deficit is common at what level

lower motor neruon deficit is coommon at the level of the lesion.

With Upper motor neuron deficitis it is found below the lesion

90

what are the spaces that are created to create more surface area at synapse

Subnerual clefts that are on teh muscle fiber side of the synaptic trough

91

when is surgery of intercranial masses often not an option

When tumor is in the basal ganglia, hypothalamus, thalamus, and brainstem,

92

What is the typical presentation of a cerebellar hemangioblastoma

Middle-aged pt with disequilibrium, ataxia, and sometimes hydrocephalus

93

The sinus associated with the tentorium cerebelli

Transverse sinuses

94

what is a good test that allows us the ability to visualize the vasculature of the brain, this is helpful in diagnosing stenosis, full blockage, and aneurysms, etc

Angiography

95

what is. midline shift

When the midline structures are pushed to one side.

96

What makes a more poor prognosis for metastatic intracranial tumors

More locations of metastatic lesions typically equate to a poorer prognosis

97

what is the advantage of carotid US

being able to measure the thickness of intimal-medial arterial walls.

98

The lobes of the telencephalon

Frontal lobes
Parietal lobes
Temporal lobes
Occiital lobes

99

Type of glioma that arises from the ependyma of a ventricle, especially the fourth ventricle

Ependymoma

100

Cells that line the ventricular system and helps to create CSF and BBB

Ependymal cells

101

ACH effects what gates

Acetylcholine-gated Sodium Channels - they open and depolarize the cells that will ultimately produce a muscle contraction

102

most commonly metatastic disease involes what parts of the brain

Cerebral hemispheres, cerebellar hemispheres, or brainstem.

103

what is the system called that voluntary movements communicate through

Corticospinal (Pyramidal) tract

104

With CT Bone window does what to the brain tissue

Completely grays it out... you can not distinguish brain anatomy.. this is good when you think you have a mass.. you can see if it is truly a mass or an underlying bone ossifications

105

Cerebellar Hemangioblastoma

low-grade tumors are derived of vascular wall tissue most commonly deep in the cerebellum

106

What is the tool used for assessing the patency or extent of carotid artery atheroslerotic disease

Carotid US

107

word for drooping eyelid

Ptosis

108

what cancer is most commonly occuring in immunocompromised hosts such as AIDS pts

Primary cerebral lymphoma

109

Create the myelin sheath in the peripheral nervous system

Schwann Cells

110

Problem with MRA

Takes so much longer to get the image and is much more expensive

111

A type of electordiagnostic study that is used in a combination of measurements is what

Nerve Conduction study

112

what is the tx and outcome of Acoustic Neruomas

Treatment is SX and outcome is. uually good, although hearing does not typically recover.

113

management of Intracranial mass lesions

treatment depends on the type of tumor, its sixe the site of the tumor, and the overal condition of the pt.

114

what is important to make sure your pt has prior to contrast administration for angiograms

Proper good kidney function.

also if the pt is elderly, diabetic, or have other significant comorbid conditions make sure the dye is appropriate. Some contrast can cause acute kidney injury

115

what are we looking for in CSF

Gross appearance
Protein level
Glucose level
CSF: Serum Glucose ratio
Gram Stain
WBC Count

116

what is the role of the brainstem

The connection of the higher brain centers and the rest of the body.

117

how to assess for attention span

Serial 7's
world backwards

118

deficits of leptomeningeal metastases

Wide range of multifocal deficits which can be associated with infiltration of the cranial and spinal nerve roots..

119

what are the different types of sequesnces that can be used when viewing an MRI

T1, T2, STIR, FLAIR, ADC, and DWI

120

Bellow the medulla the central nervous system extends as the

Spinal cord

121

test visual fields with what

Wiggling fingers in all different areas of the visual field

122

CT delivers no radiation or radiation

Radiation
MRI- no radiation but much more costly

123

What does gray matter consist of

aggregations of neuronal cell bodies.

124

What is included in the PNS

Cranial nerves
Spinal Nerve Roots and branches
Neuromuscular Junction

125

Most common origination of Meningioma

Dura mater

126

what is the diagnostic approach for Spinal Mass lesions

MRI of the spine with and without contrast is the. diagnostic imaging modality of choice to ID and localize the lesion

CT myelogram is another option that can highlight mass lesions in the spine.

127

What is provided by neuropsychological tests

problem solving abilities, language comprehensionm, memory and attention abilites, processing speed, visual-spatial organization, planning, etc.

128

what are the symptoms of frontal lobe intracranial mass lesions

Often leads to progressive intellectual decline, slowing of mental activity, & personality changes.

Expressive aphasia, anosmia, focal motor seizures or contralateral pyramidal deficits

129

what is the name of the system of system that causes muscle contraction when there is sudden and rapid stretch of the muscles

Reflex arch.. these are the deep tendon reflexes and the golgi tendon aparatus system and things that prevent injury.

130

What helps to reduce Cerebral edema so is used in the management of intracranial masses.

Corticosteroids such as decadron

IV or PO can be administered

131

what are the most common sources of spinal mass lesions that were not primary to the spine

Prostate, Breast, Lung, Kidney, are all common primary sources for spinal metastases

132

What is the circle of willis

A system of anastomoses that will produce the main cerbral arteries

133

what is initiated if there is continual deterioration of a pt despite medical intervention.

Palliative care

134

make sure you can tell the difference between precious or old stroke versis a possible acute stroke

the gray verses dark charcoal

135

which main artery is most commonly involved with strokes

Middle cerebral arter (MCA)

136

dont forget the temporalis and masseter muscle palpation for which nerve

Trigeminal

137

What infection has been associated with Primary Cerebral Lymphoma

EBV virus infections

138

What are the signs and symptoms of intracranial mass lesions

Lesions manifested often by seizures with , olfactory, gutatory, and or auditory hallucinations.

Left- sided lesions may lead to receptive aphasia (wernicke's area)

139

the dura layers create a space two spaces in the brain that seporate the lobes these are known as the ???

Falk Cerebri and Tetorium cerebelli

140

Telencephalon

The cerebral hemispheres/ lobes of the brain

141

What are the sign and symptmos of intracranial mass lesions

The clinical presentation completely depends on the location of the mass lesion.

a focal neruologic deficit will likely occur that correspons with the function of the adjacent brain anatomy.

May lead to S/S of increased intracrainial pressure, such as an intellectual decline, emotional liability, seizures, HA's nausea, vomiting, and malaise

142

prognosis of astrocytomas

variable and by the time of diagnosis, total excision is i usually impossible

Chemotherapy and radiation may be helpful, but not always

143

Evoked potential testing also known as EP's do what

Measure the electrophysiologic response of the nervous system using (EEG) to a certain type of environmental stimulus

144

what are the clinical presentation of metatastic bain tumors

The same as the primary brain tumors and epends on the involved site...

145

what is shadowing artifact that occludes normal flow in carotid US

Evidence of arterial plaque

146

Triceps checks

C6 / C7

147

why is white matter "white:

Axons in surrounded by the melyn sheeth

148

connector of lateral and third

Interventricular faramen

149

what is arterial plaque in meaning to a provider

Increased risk of stroke

150

how to test for cerebellar disease or dysfunction

Point- to - point movement... finger to nose to finger to nose..
You can also check with rapid alternating movements. or a tandem walk heel to toe

151

meninge stuck to the bone

Dura matter

152

Ankle Clonus positive is suggetive of what

UMN conditions or dieseses

more than 4 beats

153

The arteries of the brain create the "____ -__ - ____"

Circle of willis

154

Tx of meningioma

Surgical - can recur if the removal is incomplete

155

Masses are best evaluated by what

MRI, but CT can still be helpful

156

__________ testing is known when a large amount of data about a subjects cognitive, motor, behavioral, linguistic, and executive functioning is found using techniques that are provided by a licensed specialist

Neuropsychological testing.

perfomed by a neruopsychologist

can help to guide an effective rehab and treatment methods

157

position sense travels via which tract

Dorsal column.

158

Management of spinal mass lesions

Decompression of the spinal cord and excision of the mass is acomplished whenever feasible

159

Traumatic subarachnoid hemorrhage can occur anywhere..... most often the SAH blood will be over one of the convexities and in one or more of what structure

Sulci in the subarachnoid space

160

Typically if associated with other cancers what is Cerebellar hemangioblastomas; correlate with

Renal cell carcinoma or retinal lesions

161

Large ventricles that resemble giant horns and lie lateral...

Lateral Ventricles

162

the spinal cord ends in a structure known as the ...

Conus medullaris

163

supporting cells in ature that are surrounding the neurons

Glial cells

164

if you are less than what Hz on an EEG and awake is it considered abnormal

Less than 7 Hz

165

EDH - Epidural hematoma can happen with or without skull fracture. What does this look like?

Lens shapped generally within a single suture line. they do not typically cross. they look contained

166

What is indicated if CSF is tented Red

SAH

167

What is the diagnostic test of choice for a soft tissue mass lesion

MRI

168

What is a myotome

The muscle groups innervated by motor fibers from a single spinal nerve root and follow a similar distribution as dermatomes.

169

where does the cord end and the the cauda equina begin

About L1 or L2

170

where is the initiation of voluntary movement

Premotor cortex. on the contralateral side of the brain of teh muscles that you are wanting to fire.

171

what is an ADC an image of

MRI image of the negative of DWI

172

where are the ganglia located when referring to dorsal horns and sensory recognition

Posterior (dorsal) ganglion

173

we use what to estimate or guess where there is a stroke or which main artery

Humunculus

174

Angiogram can only take place with X ray?

False there is CT and MRI angiography as well
CTA and MRA

175

what is the essential component in an evaluation of a seizure disorder

EEG

176

Craniopharyngioma is what derived from what

Pituitary embryonic tissue-

remnants of the Rathke Pouch

177

what are the arteries that supply the brain

2 vertebral arteries
2 carotid arteries

178

What is the venous return of blood from the cephalic region

Superior sagital sinus that drains the blood along with CSF, these sinuses eventually drain to the

Transveres sinuses,
Then
Sigmoid sinuses

Which eventually become the Internal Jugular veins

179

When is Urgent referral to a neruosurgery team necessary for intracrainial masses

Always.. it is always necessary

180

what color is Air eluding to sinus' in teh head

Black black black

181

Meningiomas are almost always benign or Malignant

Benign

182

symptoms of spinal mass lesions typically develop slowly and pain is common with extradural masses. they might have spinal tenderness

THis is just a fact

183

what are some of the conditions associated with abnormal CSF fluid

Infectious disease
Intracranial hemorrhage (SAH)
Inflammatory or autoimmune Primary or metastatic CNS canceres

184

what components make up the brain stem

Medulla Oblongata, Pons, Midbrain,

185

what represents a. rupture (aneurysm) from the circle of willis

Star pattern blood in the basal cisterns

186

What is typically needed for good visualization of leptomeningeal metastases

MRI with Contrast... involved with meninges and CSF analysis can revel presence of cancer cells

187

The core of the brain including the thalamus and hypothalamus

Diencephalon

188

Pain temperature and crude touch travels through what tract

Spinothalamic tract

189

what percentage of leptomeningeal metastases will survive and what timeframe

10 percent survive for one year after diagnosis so palliative care is imporant for all patients

190

what are the three types of stimulus used for specific conditions and measuring the tests for evoded potential testing.

Visual Evoked potentials
Short-latency Somatosensory EPs
Short-latency Brainstem Auditory EPs

191

what is the function of the cerebellum

heavy with motor control... it is used in the coordination of movement. adjusting motor impulse to facilitate accurate precesion and timing.

192

what is not an option for treatment of leptomeningeal metastases

Surgical excision

193

common presentations of Astrocytomas

commonly nonspecific complaints of increased intracrainial pressure and eventually leads to some sort of focal neurologic deficit

194

Brainstem Gliomas are often Treatable or not?

Inoperable and treatment often involves shunting CSF and Radiation

195

Space between the arachnoid and pia

Subarachnoid space- contains the cerebrosipinal fulid

196

How do we observe body position and posture

During movement and at rest
Abnormal postion can alert you to different deficits

197

Damage to the cerebellum creates what

Ataxia - motror control loss.

198

where do most cranial nerves exit the brain

brainstem

199

What is an EEG

Electroencephalography- records and depicts the electrical activity ofccuring along the surface of the brain

200

what are the signs and symptoms of spinal mass lesions

Spinal cord dysfunction by direct compression, by ischemia secondary to arterial or venous obstruction or by invasive infiltration (as with intramedullary astrocytomas)

201

which set of gray material is the motor function of the spinal cord

Anterior horns.

202

Intercranial Mass Lesions in the brainstem and cerebellar lesions cause what

Tumors in. te brainstem or cerebellum can lead to cranial nerve palsies, ataxia, incoordination, nystagmus, and pyramidal/sensory deficits in the extremities

fourth ventricle oclussion can cause- obstructive hydrocephalus

203

What are the two speech and language areas of the brain and which does what

Broca's - dominant in frontal - in charge of language production (damage creates expressive aphasia)

Wernicke's - dominant in temporal lobe- language comprehension (damage to this area causes receptive aphasia)

These are located in the dominant hemisphere.. so left side of brain for right handed individuals... for left handed individuals it could be either left or right area of the brain.

204

what are the different distinct forms fo Neurofibromatosis

Three distinct forms

There is Neruofibromatosis Type-1 (the most common)

Neruofibromatosis Type 2 (characterized by the formation of vestibualr schwannomas)

Schwannomatosis - characterized by formation of painful schwannomas on the spinal and peripheral nerves

205

What are tics, tremors, or fasiculations considered

Involuntary movements

206

What are the functions of the Frontal lobe

Dopamine-sensitive cells, Reward center, the planning, attention, motivation, inhibition, etc. also the home of the motor cortex...

207

most common metastatic intracranial tumors are what

orriginating from somewhere else in the body

208

who do we refer to Neuropsychological testing

TBI pts, pts who fail to achieve developmental milestones, learning or attention deficits, neruo degenerative disorders, seizure disorders, parkinsons disease pts, stroke pts, dementia etc.

209

what are the Cranial nerves and their function

Olfactory- smell
Optic - vision sensory
Oculomotor- pupillary constriction, eylid elevation, and most of the extraocular movements.
Trochlear- downward and internal rotation of the eye through the superior oblique muscle
Trigeminal- motor of mastication \; sensory of facial sensation in three divisions (V1, V2, V3)
Abducens - Lateral deviation of the eyeball via the lateral rectus muscle
Facial- Motor fucntion-muscles of face closing eye is included Sensory- taste of anterior 2/3 of tongue
Vestibulocochlear- hearing and balance
Glossopharyngeal- Muscles of pharynx involved with swallowing Sensory- eardrum and taste of 1/3 posterior tongue
Vagus- motor- palate, pharynx, and larynx, sensory of the pharynx and larynx
Accessory - motor innervation of the sternocleidomastoid and trapezius
Hypoglossal nerve - motor function of the tongue

210

s/s of neurofibromatosis type 1

type 1 - usually appears in childhood often by 10

flat, light brown spots on the skin (cafe au lait spots)
frecling in the armpits or groin
tiny bumps on iris
soft bumps under the skin
learning disabilties
larger than average head size
short stature

211

What are the most important arteries (main) of the brain

Anterior cerebral arteries
Middle cerebral arteries
Posterior cerebral arteries

212

diagnosis of neurofibromatosis

type 1 - largely a clinical diagnosis based on skin patches and lesions.

MRI of brain with and without contrast.

213

where are the vital respiratory and cardiac control centers of the body located

In the brainstem

214

Duct connecting 3rd and 4th ventricles

aqueduct of the midbrain

215

image for CT and or MRI is taken form what

Feet up... so our left is pt's right and etc..

216

what is it called when the brain damage is evident on CT

Low density.. infarcted brain will look darkened and will be dark fray. eventually it will be filled with CSF and the dead necrotic tissue will wash away.

217

what is. the most common initial symptom and what are other presentations of acoustic neuromas

Most common initial- ipsilateral hearing loss

Common- Tinnitus, HA, numbness, facial weakness, vertigo, and long tract signs

218

What is the positive for Babinski / what does it mean

Flanking out of toes instead of curlin gin ... - it is suggestie of an uper motor neuron disease process such as spinal cord or cortical injury

219

Which is study of choice fo the cranial imaging MRI or CT

Neither... or either... lol it is really both. both are heavily used for studying the brain and spinal cord. Each has reasons to be the imaging or first choice for different scenarios

220

management of neurofibromatosis

cannot be cured.
signs and symptmos can be treated
including the removal of tumors surgically if compression and or pain occur.
generally the outcome is better if tx can begin earlier in life
vestibular schwannomas can lead to significant morbidity and mortality
all pts should be referred to a neruologist if the diagnosis is suspected

221

What is the corpus callosum important for

Necessary for the consciousness and awarness.

222

what does the first / second numbers in visual accuity mean

what your pt sees at 20 ft normal vision people can see at X ft ... Thus 20/200 is at 20 ft your pt sees what someone with normal vision sees at 200 ft

223

benifit of MRA

No radiation and great 3D reconstruction

224

Posterior Column decussates where

Lower portion of the medulla oblengata

225

What is useful in diagnosis of peripheral neruopathies, entrapment syndromes, and radiculopathies

Nerve conduction studies

226

two point descrimination should be done where and with what distance

5mm or less and on the finger pads.

227

which tract decussates immediately at the spinal cord and travels straight to the thalamus passing by the part of the medulla that normally causes decussation?

Spinothalamic Tract - pain temp and crude touch

228

What does Electomyography use to measure the response of muscles to lower motor neuron innervation and stimulation

Small needles that are inserted into the muscle that act as the recording electorrde as peripheral neres are stimulated.

229

Primary Cerebral lymphoma is what

A lymphoma derived from WBCs in the brain

230

when do brainstem gliomas often show up

Typically present during childhood

231

where are lumbar punctures performed

L3-L4 or L4-L5

232

The brain / spinal cord float in what as a protectant

Meninges - surround
Float in cerebrospinal fluid

233

what helps CT to pick up tumors

Contrast studys - edema is also often surrounding tumors

234

what is the collection process of CSF

4 tubes.. in the proper order... make sure that you dont fill them all the way you are taking less than that.

235

What are the functions of the Parietal loes

Integrates a large amount of senosry information. including spatial sense, navigation, and the sensation of touch in the somatosensory cortex.

236

what breaks down ACH in the cleft to help stop the muslce contractions and resotre the needed parts to create more ACH in teh appropriate areas.. -

Acetylcholinesterase

237

CT or MRI- determining fractures

CT- bone window

238

Nerve roots that Biceps checks

C5 /C6

239

a motor end plate is what

The axon terminal plus the adjacent muscle fibers

240

What structures surrounds the CNS and protect it

Meninges
Bones- Skull and vertebral column

241

The sinus associated with the falx cerebri

Superior sagittal sinus

242

s/s of schwannomatosis

This is rare.. usually affects the people after the age of 20

this condition is characterized by. teh extensive formation of several schwannomas thourghout the body which are painful and can result in paralysis and paresthesias

243

What are the presentations of. brainstem gliomas

Cranial nerve palsies A long tract signs in the limbs

obstructive hydrocephalus can occur

244

what is mass effect

It is the shifting of the brain because of intracrainial pressure increasing from swelling mass or lesions.

245

What are the signs and symptmos of meningiomas

Completely dependent on the location of the mass

246

What does LP stand for... what is it and where do we fgo

Lumbar puncture (spinal tap) we do this in the L3-4 or L4-5 and we do it to obtain a sample of the cerebrospinal fluid

247

What are basal gangila

multiple structures that are involved with the management of motor function and other high level brain functions

248

Where is the most common structure of stroke... also one of the biggist reasons symptoms are visiable

Internal Capsule.

249

What is the diagnositc approach of Intracranial Mass lesions

CTof the head. - often the inital imaging performed, depending on the intial clinical presentation

MRI with and without contrast is the diagnostic test of choice
Full excision is generally perferred if possible but sterotactic needle biopsy is often performed when the diagnosis is unclear or excisional surgery is not feasible

250

What are the indications for a Spinal Tap

Suspicion of meningitis
Suspicion of Subaracnoid Hemorrhage
Suspici0on of neurologic disease like Guillain-Barre syndrome and MS
Therapeutic relief of idiopathic intracranial hypertension.

251

what is the treatment for Primary Cerebral Lymphoma

Surgical treatment is ineffective and corticosteroids, radiation, and chemotherapy are treatments of choice

252

Pronator drift checks for

Uper motor neuron weakness or stability... this is a proprioception test as is rhomberg.. that is more parietal loes not really the cerebellar function.

253

where do all of the fibers decussate to contralateral side

Lower portion of the medulla oblangata.

254

what are the most common tumors found in the spine

Metatastic mass lesions...

only about 10 percent are intramedullary, with the most common form of intramedullary tumor being ependymoma

255

what percentage of primary intracranial neoplasms are gliomas (derived from glial cells)

50%

256

There are two hemispheres of each lobe

True

257

Three systems of the nervous system

CNS
PNS
ANS

258

What does the thalamus do

Processes sensory information and relays that information to the appropriate cortex of the brain

259

Which test is used to evaluate a pt in a coma to determine the extent of neruologic viabiligy

EEG

260

how many cavities are in the ventricular system fo the brain

4

261

what is the wall that lies between the lateral bentricles

Septum peducidum

262

dominant side is typically Weaker or stronger

Stronger

263

CT VS MRI better for acute hemorrhage

CT

264

If lower motor neruon is lost what is expected

Flaccid muscle weaness (lack of tone)