Primer 2 Flashcards Preview

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Flashcards in Primer 2 Deck (14):
1

In the brainstem, how are medial structures identified?
What are the four medial structures?

Start with M for "medial"
-Motor cranial nerve nuclei (3,4,6,12- all divide into 12)
-Motor pathway- aka corticospinal tract
-Medial Longitudinal Fasiculus (connects CN 6 & 3)
-Medial Lemniscus

2

In the brainstem, how are lateral structures identified?
What are the four lateral structures?

Start with S for "side"
-spinothalamic tract
-sensory CN nucleus (CN5 nucleus/ tract)
-sympathetic pathway
-spinocerebellar tract

3

What CN originate in the brainstem? In what specific regions?

1-2: above brainstem
3-4: in the mickey mouse midbrain
5,6,7,8: in the pons
9,10,12: in the medulla
11: below the brainstem (in spinal cord)

4

***Hallmark of a brainstem lesion?

crossed findings
means IPSI CN signs + facial sensation
and CONTRA extremity signs

5

***The following signs and symptoms are suggestive of what stroke syndrome? (See below) What area and artery are affected in this stroke syndrome?

-Horner's
-Hoarseness/Dysphagia
-Ipsilateral loss of pain and temp at face/ contra at body
-vertigo, nystagmus, ataxia, nausea

-Wallenberg Syndrome
-Lateral Medulla (side matches the side of CN5 symptoms)
-Usually PICA
-Also called lateral meduallary syndrome or PICA syndrome

*Common in young patients, may also be caused by vertebral artery dissection: remember Fergie's example of the woman sneezing/ causing this syndrome.

6

Differential diagnosis for Intranuclear Ophtalmoplegia?

-MS
-medial pontine/basilar artery stroke
(MLF/ CN6 are in medial pons)

7

Two possible causes of Locked In Syndrome:

1) bilateral basilar stroke effecting both sides of pons
2) rapid correction of hyponatremia (central pontine myelinolysis)

8

***The following signs and symptoms are suggestive of what stroke syndrome? (See below) What area and artery are affected in this stroke syndrome?

-contralateral paralysis
-dysphagia, dysphonia, dysarthria
-gaze that appears "down and out"

Weber's Syndrome
-medial midbrain
-PCA

*symptoms come from lesion in corticobulbar/corticospinal tracts and CN3.

9

The following signs and symptoms are suggestive of what stroke syndrome? (See below) What area and artery are affected in this stroke syndrome?

-ipsilateral horners
-ipsilateral ataxia
-ipsilateral facial nerve paralysis
-ipsi loss of pain/ temp at face, contra at body

Lateral Inferior Pontine Syndrome
AICA

10

The following signs and symptoms are suggestive of what stroke syndrome? (See below) What area and artery are affected in this stroke syndrome?

-Tongue deviation (ipsilateral)
-Contralateral paralysis + loss of fine touch

-medial medulla/ medial medullary syndrome
-anterior spinal artery (ASA)

11

The following signs and symptoms are suggestive of what stroke syndrome? (See below) What area and artery are affected in this stroke syndrome?

-contralateral paralysis/ loss of fine touch
-gaze away from lesion
-ipsi paralysis of lateral rectus
-intranucler ophtalmoplegia

medial pons / medial pontine syndrome
basilar artery

12

Name 7 drug classes that are teratogens:
(Hint- we HAVE learned about all of these things in class at one point or another already)

ACEi
seizure drugs (valproate, phenytoin)
lithium
vitamin A
warfarin
tetracycline

13

What are HOX genes?

Groups of genes responsible for skeletal dvlpmt

14

What is required for molecular entry into a nuclear pore?

nuclear localization signal
(Lys-Arg-Pro)