Neurology p. 470-474

Question 1

What 2 Spinal tracts are ascending and sense pressure?

Answer 1

Dorsal column

Spinothalamic tract

Question 2

which track has a 2nd synapse on NMJ?

Answer 2

Lateral corticospinal tract

Question 3

Which 2 tracts decussate at the 2ND-ORDER NEURON?

Answer 3

Dorsal column
Spinothalamic tract (Anterolater)

Question 4

Which 2 tracts decussate in medulla?

Answer 4

Dorsal column

Lateral corticospinal tract (pyramidal decussation)

Question 5

Which 2 tracts sense pressure?

Answer 5

Spinothalamic tract

Dorsal column

Question 6

Which 2 tracts cell body in dorsal root ganglion?

Answer 6

Spinothalamic tract

Dorsal column

Question 7

Which tract decussates at anterior white commissure?

Answer 7

Spinothalamic tract

Question 8

Where is the cell body of Lateral corticospinal tract?

Answer 8

cell body in 1° motor cortex

Question 9

Which 2 tracts have a 3RD-ORDER NEURON end in Sensory cortex?

Answer 9

Spinothalamic tract

Dorsal column

Question 10

Which tract sends vibration, fine touch, and proprioception to the cortex?

Answer 10

Dorsal column

Question 11

Atrophy UMN or LMN?

Answer 11

LMN

Question 12

Where does the Lateral corticospinal tract become LMN?

Answer 12

at spinal cord as 2ND-ORDER NEURON

Question 13

Which tract sends
Lateral: pain, temperature
Anterior: crude touch,

Answer 13

Spinothalamic tract

Question 14

Spastic paralysis UMN or LMN?

Answer 14

UMN

Question 15

Which motor neuron sign is seen in both UMN and LMN?

Answer 15

Weakness

Question 16

UMN or LMN in Werdnig-Hoffmann disease? Where is the distruction? And mode of inheritance?

Answer 16

LMN lesions only
destruction of anterior horns; flaccid paralysis.
Autosomal recessive

Question 17

Fasciculations UMN or LMN?

Answer 17

LMN

Question 18

A pt with weakness and fasciculations and spastic paralysis but has no sensory or oculomotor deficits suffers from what spinal coed dz?

Answer 18

ALS

Question 19

Scanning speech, intention tremor, nystagmus are sx of what spinal cord dz?

Answer 19

MS

Question 20

Clasp knife spasticity UMN or LMN?

Answer 20

UMN

Question 21

Reflexes and Tone incr with UMN or LMN?

Answer 21

UMN

Question 22

pt has impaired sensation and proprioception,
progressive sensory ataxia (inability to sense or feel
the legs Žcausing poor coordination). What is the path?

Answer 22

Tabes dorsalis

Question 23

Amyotrophic lateral sclerosis involves UMN or LMN? Name the cause?

Answer 23

both

defect in superoxide dismutase 1.

Question 24

Lesion to what spinal artery destroys all but spares dorsal columns and Lissauer tract? and why is that part spared?

Answer 24

Complete occlusion of anterior spinal artery

because gracilis and cuneatus are supplied by Posterior spinal arteries.

Question 25

⊕ Romberg sign is seen in which 2 spinal cord lesions?

Answer 25

``` Tabes dorsalis ALS Vit B12 def. Friedreich's ataxia Ménière's disease ```

Question 26

Which artery supplies ASA below ∼ T8?

Answer 26

Adamkiewicz

Question 27

MOA of Riluzole and what is treats?

Answer 27

incr modestly  survival of ALS |  decr presynaptic glutamate release

Question 28

demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts i seen in which path?

Answer 28

Vit B12 def

Question 29

Name 3 demyelination paths of the spinal cord?

Answer 29

MS Tabes dorsalis vit B12 def

Question 30

Sx of Syringomyelia? Where is it seen? defect in what path?

Answer 30

- Bilateral loss of pain and temperature sensation (usually C8–T1) - See in Chiari I malformation - white commissure of spinothalamic tract (2nd-order neurons)

Question 31

What is frataxin and what path is it seen?

Answer 31

iron binding protein,

Question 32

What test can help dx Polio?

Answer 32

stool sample - Virus recovered from stool or throat.

Question 33

In Brown-Séquard syndrome which finding in is the only Contralateral finding?

Answer 33

pain and temperature loss below level of lesion (due to spinothalamic tract damage)

Question 34

7 year old child presents with kyphoscoliosis, frequent falling and diabetes has a defect on chromosome 9. What is the pathphys and what will be the cause of death?

Answer 34

Friedreich ataxia - defected frataxin causes impairment in mitochondrial functioning. (oxidative stress) MCC of death: hypertrophic cardiomyopathy around 7years trinucleotide repeat disorder (GAA)

Question 35

In which 6 paths do we find Horner syndrome?

Answer 35

Any lesion above T1 - Brown-Séquard syndrome - PICA - Cavernous sinus syndrome - Bronchogenic apical lung tumor - Pancoast tumor - Clustera headaches

Question 36

In Brown-Séquard syndrome at which levels are UMN sings and at which are there LMN signs?

Answer 36

UMN signs below the lesion | LMN signs at the lesion

Question 37

"--- at the belly butten".

Answer 37

T10

Question 38

"--- at the teat pore."

Answer 38

T4

Question 39

" --- is IL (Inguinal Ligament)."

Answer 39

L1

Question 40

"Down on ALL 4’s "

Answer 40

L4- knees

Question 41

“ --- keep the penis off the floor.”

Answer 41

S2, 3, 4

Question 42

Diaphragm and gallbladder pain referred to the | right shoulder via --- nerve

Answer 42

phrenic

Question 43

``` Testing for reflexes: Biceps = Triceps = Patella = Achilles = ```

Answer 43

``` Biceps = C5 nerve root. Triceps = C7 nerve root. Patella = L4 nerve root. Achilles = S1 nerve root ```

Question 44

Level of cremaster reflex?

Answer 44

L1, L2

Question 45

Level of anal wink reflex?

Answer 45

S3, S4

Question 46

Describe Galant reflex?

Answer 46

Stroking along one side of the spine while newborn is in ventral suspension (face down) causes lateral flexion of lower body toward stimulated side

Question 47

Describe Rooting reflex?

Answer 47

Movement of head toward one side if cheek or mouth is stroked (nipple seeking)

Question 48

Describe Plantar reflex?

Answer 48

Dorsiflexion of large toe and fanning of other toes with plantar stimulation Babinski sign—presence of this reflex in an adult, which may signify a UMN lesion

Question 49

Describe Moro reflex?

Answer 49

“Hang on for life” reflex—abduct/extend arms when startled, and then draw together

Question 50

Gland for melatonin secretion, circadian | rhythms?

Answer 50

Pineal gland (neroectoderm)

Question 51

CN nuclei that lie medially at brain stem:

Answer 51

III, IV, VI, XII. “Factors of 12, except 1 and 2.”

Question 52

Area for conjugate vertical gaze center?

Answer 52

Superior colliculi

Question 53

Area of midbrain for auditory?

Answer 53

Inferior colliculi

Question 54

Midbrain contains which nuclei?

Answer 54

CN III, IV

Question 55

Paralysis of conjugate vertical gaze due to lesion in superior colliculi Describes? What paths can cause that?

Answer 55

``` Parinaud syndrome ("suncken eye syndrome") stroke, hydrocephalus, pinealoma ```

Question 56

Pons contains nuclei of which CN? ƒƒ ƒƒ

Answer 56

CN V, VI, VII, VIII

Question 57

Medulla contains nuclei of which CN?

Answer 57

CN IX, X, XII

Question 58

Spinal cord contains nucleus of which CN?

Answer 58

CN XI

Question 59

CN nuclei position: Lateral nuclei = Medial nuclei =

Answer 59

Lateral nuclei = sensory (aLar plate). —Sulcus limitans— Medial nuclei = Motor (basal plate).