Flashcards in Neurology Exam 1 Deck (264):
Occipital Lobes functions q
The smallest of the four lobes.. mainly reposnible of visual sensory infomration.
straight leg raise test is sensitive to what
possible Lumbar herniated disk
Patella reflex checks
L2 L3 L4
CNS consists of what?
Brain and Spinal Cord
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.
MRI or CT- susspected stroke
what is the corpus callosum
a major highway of axons that connects one hemisphere to the other.. (i.e. left and right)
Brachioradialis checks which nerve roots
C5 / C6
Meninge that is delecate and stuck to the dura
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.
All four ventricles are connected and CSF eventually flows out and around the brain and spinal cord...
Lateral ventricles make a lot or little CSF
What is taken up by and reused by the neuron post acetylcholinesterase breaks . down ACH
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..
Thin meninge that is adheared to the brain and spinal cord
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
What is it when you draw a number on a palm and they tell you what you drew
In the brain the axons are considered to be ?
White matter and on the interior aspects of the brain
Orientation for exam includes
Person, Time, Place, Situation
what is the measurement of a normal EEG findings in an awake adult
8 hz or higher
where is grey matter / white matter in the spinal cord
Opposite the brain the gray is deep and white is more proximal.
Epileptiform patterns of discharges help neruologists to separate generalized from focal (partial( seizures using what test
Definite of interpretation abnormal CT scans
confirm right pt
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
Rule out swelling, mass effect and midline shift
what are neurons
Highly specialied cells capable of conducting action potentials for electrical and chemical communications.
achilles reflex checks
word for minimal difference in pupil size that is seen in 38% of healthy individuals
MRI diffusion- weighted images are really good at diagnosing even the most tiny what
where do craniopharyngioma's normally grow
Above the sella and can cause endocrine dysfunction and bitemporal field defects
identify objects with eyes closes what is the word
Which neoplasm is associated with an increased intracranial pressure d/t obstructive hydrocephalus
Ependyoma - because they arise from ependyma of a ventricle
What is in the ventricles of the brain
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
what are the two most commonly used imaging procedures in Neurologic medicine
CT and MRI
Most common brain mets
Carcinoma of the lung
renal cell carcinoma
Assess tone in uper extremities and lower extremities with wave like motion thgrough flexion and extension
CT Angiogram- benifits
Can be obtained faster and with less vascular invasion
what is the function of the posterior or dorsal horns
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.
The signals travel to the appropriate homunculus and then through the SMA and lastly through what structure for fine tuning
Which image is great for identifying acute ischemia on MRI
DWI- diffusion-weighted MR
what are astrocytomas
Malignacies derived from rogue astrocytes arising within the brain or spinal cord
what is a dermatome
A band of skin that is innervated by the sensory fibers of a single spinal nerve root
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
Type of glial cell that creates the myeli sheath and wraps the axons in the CNS
the central sulcus separats what two parts of the brain
Somatosensory and motor cortexes
position, vibration, fine touch travel through what tract
Ependymal cells that line the ventricles create the CSF, what is the structure they line
What is a Medulloblastoma
Non-invasive, repidly growing mass that usually originates in the posterior fossa, around the fourth ventricle
what are the parts fo f the bainstem
what are common sturctures in the brain to get calcified and look like a mass on CT imaging
inspectsize and contour of muscles bilaterally this can can suggest pathology via atrophy in what as documented
what can be used to assess stroke progression over time
Serial MR imaging and accompanying DWI / ADC images
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..
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
what is neurofibromatosis
Considered a neurocutaneous disease, Neurofibromatosis may occur either sporadically or on a familial basis with autosomal dominatn inheritance.
Complex lobe dealing with retention of information (memories), facial recognition, emotional association, language comprehension
cotton wisp for corneal reflex tests which reflex arch ?
CNV and CN VII
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
what is indicated if CSF is tinted yellow
Likely presence of Pus and raises immediate suspicion of bacterial meningitis
Anatomy and pathology are easier to understand on which MRI or CT
CT or MRI depends on situation
Signs and symptoms of parietal lobe lesions
Characteristically - contralateral disturbances of sensation and may cause sensory seizures
Astereognosis is common.
hemorrhagic storkes or other intracranial hemorrhages or often easily seen and ofen surrounded by what
edema and sulcal effacement
what can help you to identify fxs that might be really small
EMG is what
What is Acoustic neruoma
More appropriately Vestibular schwannoma. Benign neoplasms derived from the myelin of the CN VIII
if CT reveals no edema or very slight trace of edema and MRI will allow a more sensitive evaluation of teh area
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.
Flex hip and knee then straighten knee... pain and incresed resistance outside of tight hamstrings suggests meningeal inflammation
what disease is cogwheel rigidity commonly associated with
Parkinson's disease and other disorders of upper motor neuron
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.
What do Subdural Hematomas (SDH) look like
Crescent shaped and crooss suture lines or be along the tentorium or falx
what is the role of the hypothalamus
Maintain the physiologic homeostasis and the endocrine function and the pituitary
where do the lower muscle neurons synapse?
the spaces created between the meningeal cells... they include subdural subarachnoid, etc..
true of false they continue down the spinal cord as well..
Not as common but cancers can spread to teh meninges - this is a difficult situation to treat but what is it called
Internal capsule is white highway of what
Entering and exiting axons that run form the cortex to the midbrain
How does medulloblastoma spread
Frequently spreads by CSF. commonly spreads to other locations within the CNS
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.
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.
Supporting roles and cells of the brain that also transport the nutrients into the brain
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
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.
What do. we do with asymptomatic meningiomas that are found incidentally
Serial imaging... we will just watch growth and development. monitor for symptms etc.
primary motor cortex, ____ _____ ______ then
supplementary motor cortex (SMA) helps to facilitate the appropriate motor neuron excitation.
If upper motor neruon is lost what is expected
Spastic muscle weakness
too much tone
What is the most common type of primary CNS malignancy seen in children
MRI or CT- Choice for trauma
CT - quicker, and sees acute hemhorrage much faster
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.
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
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
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
when is surgery of intercranial masses often not an option
When tumor is in the basal ganglia, hypothalamus, thalamus, and brainstem,
What is the typical presentation of a cerebellar hemangioblastoma
Middle-aged pt with disequilibrium, ataxia, and sometimes hydrocephalus
The sinus associated with the tentorium cerebelli
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
what is. midline shift
When the midline structures are pushed to one side.
What makes a more poor prognosis for metastatic intracranial tumors
More locations of metastatic lesions typically equate to a poorer prognosis
what is the advantage of carotid US
being able to measure the thickness of intimal-medial arterial walls.
The lobes of the telencephalon
Type of glioma that arises from the ependyma of a ventricle, especially the fourth ventricle
Cells that line the ventricular system and helps to create CSF and BBB
ACH effects what gates
Acetylcholine-gated Sodium Channels - they open and depolarize the cells that will ultimately produce a muscle contraction
most commonly metatastic disease involes what parts of the brain
Cerebral hemispheres, cerebellar hemispheres, or brainstem.
what is the system called that voluntary movements communicate through
Corticospinal (Pyramidal) tract
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
low-grade tumors are derived of vascular wall tissue most commonly deep in the cerebellum
What is the tool used for assessing the patency or extent of carotid artery atheroslerotic disease
word for drooping eyelid
what cancer is most commonly occuring in immunocompromised hosts such as AIDS pts
Primary cerebral lymphoma
Create the myelin sheath in the peripheral nervous system
Problem with MRA
Takes so much longer to get the image and is much more expensive
A type of electordiagnostic study that is used in a combination of measurements is what
Nerve Conduction study
what is the tx and outcome of Acoustic Neruomas
Treatment is SX and outcome is. uually good, although hearing does not typically recover.
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.
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
what are we looking for in CSF
CSF: Serum Glucose ratio
what is the role of the brainstem
The connection of the higher brain centers and the rest of the body.
how to assess for attention span
deficits of leptomeningeal metastases
Wide range of multifocal deficits which can be associated with infiltration of the cranial and spinal nerve roots..
what are the different types of sequesnces that can be used when viewing an MRI
T1, T2, STIR, FLAIR, ADC, and DWI
Bellow the medulla the central nervous system extends as the
test visual fields with what
Wiggling fingers in all different areas of the visual field
CT delivers no radiation or radiation
MRI- no radiation but much more costly
What does gray matter consist of
aggregations of neuronal cell bodies.
What is included in the PNS
Spinal Nerve Roots and branches
Most common origination of Meningioma
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.
What is provided by neuropsychological tests
problem solving abilities, language comprehensionm, memory and attention abilites, processing speed, visual-spatial organization, planning, etc.
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
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.
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
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
What is the circle of willis
A system of anastomoses that will produce the main cerbral arteries
what is initiated if there is continual deterioration of a pt despite medical intervention.
make sure you can tell the difference between precious or old stroke versis a possible acute stroke
the gray verses dark charcoal
which main artery is most commonly involved with strokes
Middle cerebral arter (MCA)
dont forget the temporalis and masseter muscle palpation for which nerve
What infection has been associated with Primary Cerebral Lymphoma
EBV virus infections
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)
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
The cerebral hemispheres/ lobes of the brain
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
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
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
what are the clinical presentation of metatastic bain tumors
The same as the primary brain tumors and epends on the involved site...
what is shadowing artifact that occludes normal flow in carotid US
Evidence of arterial plaque
C6 / C7
why is white matter "white:
Axons in surrounded by the melyn sheeth
connector of lateral and third
what is arterial plaque in meaning to a provider
Increased risk of stroke
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
meninge stuck to the bone
Ankle Clonus positive is suggetive of what
UMN conditions or dieseses
more than 4 beats
The arteries of the brain create the "____ -__ - ____"
Circle of willis
Tx of meningioma
Surgical - can recur if the removal is incomplete
Masses are best evaluated by what
MRI, but CT can still be helpful
__________ 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
perfomed by a neruopsychologist
can help to guide an effective rehab and treatment methods
position sense travels via which tract
Management of spinal mass lesions
Decompression of the spinal cord and excision of the mass is acomplished whenever feasible
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
Typically if associated with other cancers what is Cerebellar hemangioblastomas; correlate with
Renal cell carcinoma or retinal lesions
Large ventricles that resemble giant horns and lie lateral...
the spinal cord ends in a structure known as the ...
supporting cells in ature that are surrounding the neurons
if you are less than what Hz on an EEG and awake is it considered abnormal
Less than 7 Hz
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
What is indicated if CSF is tented Red
What is the diagnostic test of choice for a soft tissue mass lesion
What is a myotome
The muscle groups innervated by motor fibers from a single spinal nerve root and follow a similar distribution as dermatomes.
where does the cord end and the the cauda equina begin
About L1 or L2
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.
what is an ADC an image of
MRI image of the negative of DWI
where are the ganglia located when referring to dorsal horns and sensory recognition
Posterior (dorsal) ganglion
we use what to estimate or guess where there is a stroke or which main artery
Angiogram can only take place with X ray?
False there is CT and MRI angiography as well
CTA and MRA
what is the essential component in an evaluation of a seizure disorder
Craniopharyngioma is what derived from what
Pituitary embryonic tissue-
remnants of the Rathke Pouch
what are the arteries that supply the brain
2 vertebral arteries
2 carotid arteries
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
Which eventually become the Internal Jugular veins
When is Urgent referral to a neruosurgery team necessary for intracrainial masses
Always.. it is always necessary
what color is Air eluding to sinus' in teh head
Black black black
Meningiomas are almost always benign or Malignant
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
what are some of the conditions associated with abnormal CSF fluid
Intracranial hemorrhage (SAH)
Inflammatory or autoimmune Primary or metastatic CNS canceres
what components make up the brain stem
Medulla Oblongata, Pons, Midbrain,
what represents a. rupture (aneurysm) from the circle of willis
Star pattern blood in the basal cisterns
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
The core of the brain including the thalamus and hypothalamus
Pain temperature and crude touch travels through what tract
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
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
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.
what is not an option for treatment of leptomeningeal metastases
common presentations of Astrocytomas
commonly nonspecific complaints of increased intracrainial pressure and eventually leads to some sort of focal neurologic deficit
Brainstem Gliomas are often Treatable or not?
Inoperable and treatment often involves shunting CSF and Radiation
Space between the arachnoid and pia
Subarachnoid space- contains the cerebrosipinal fulid
How do we observe body position and posture
During movement and at rest
Abnormal postion can alert you to different deficits
Damage to the cerebellum creates what
Ataxia - motror control loss.
where do most cranial nerves exit the brain
What is an EEG
Electroencephalography- records and depicts the electrical activity ofccuring along the surface of the brain
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)
which set of gray material is the motor function of the spinal cord
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
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.
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
What are tics, tremors, or fasiculations considered
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...
most common metastatic intracranial tumors are what
orriginating from somewhere else in the body
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.
what are the Cranial nerves and their function
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
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
larger than average head size
What are the most important arteries (main) of the brain
Anterior cerebral arteries
Middle cerebral arteries
Posterior cerebral arteries
diagnosis of neurofibromatosis
type 1 - largely a clinical diagnosis based on skin patches and lesions.
MRI of brain with and without contrast.
where are the vital respiratory and cardiac control centers of the body located
In the brainstem
Duct connecting 3rd and 4th ventricles
aqueduct of the midbrain
image for CT and or MRI is taken form what
Feet up... so our left is pt's right and etc..
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.
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
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
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
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
What is the corpus callosum important for
Necessary for the consciousness and awarness.
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
benifit of MRA
No radiation and great 3D reconstruction
Posterior Column decussates where
Lower portion of the medulla oblengata
What is useful in diagnosis of peripheral neruopathies, entrapment syndromes, and radiculopathies
Nerve conduction studies
two point descrimination should be done where and with what distance
5mm or less and on the finger pads.
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
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.
Primary Cerebral lymphoma is what
A lymphoma derived from WBCs in the brain
when do brainstem gliomas often show up
Typically present during childhood
where are lumbar punctures performed
L3-L4 or L4-L5
The brain / spinal cord float in what as a protectant
Meninges - surround
Float in cerebrospinal fluid
what helps CT to pick up tumors
Contrast studys - edema is also often surrounding tumors
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.
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.
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.. -
CT or MRI- determining fractures
CT- bone window
Nerve roots that Biceps checks
a motor end plate is what
The axon terminal plus the adjacent muscle fibers
What structures surrounds the CNS and protect it
Bones- Skull and vertebral column
The sinus associated with the falx cerebri
Superior sagittal sinus
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
What are the presentations of. brainstem gliomas
Cranial nerve palsies A long tract signs in the limbs
obstructive hydrocephalus can occur
what is mass effect
It is the shifting of the brain because of intracrainial pressure increasing from swelling mass or lesions.
What are the signs and symptmos of meningiomas
Completely dependent on the location of the mass
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
What are basal gangila
multiple structures that are involved with the management of motor function and other high level brain functions
Where is the most common structure of stroke... also one of the biggist reasons symptoms are visiable
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
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.
what is the treatment for Primary Cerebral Lymphoma
Surgical treatment is ineffective and corticosteroids, radiation, and chemotherapy are treatments of choice
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.
where do all of the fibers decussate to contralateral side
Lower portion of the medulla oblangata.
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
what percentage of primary intracranial neoplasms are gliomas (derived from glial cells)
There are two hemispheres of each lobe
Three systems of the nervous system
What does the thalamus do
Processes sensory information and relays that information to the appropriate cortex of the brain
Which test is used to evaluate a pt in a coma to determine the extent of neruologic viabiligy
how many cavities are in the ventricular system fo the brain
what is the wall that lies between the lateral bentricles
dominant side is typically Weaker or stronger
CT VS MRI better for acute hemorrhage