SF2 NBME / Misc Flashcards
(265 cards)
1
Q
Lentiform Nucleus (components)
A
Putamen + Globus Pallidus
2
Q
Nerves of Corneal Reflex
A
V1 -> VII
3
Q
Spina Bifida Occulta.
A
(Neural Tube Defect) Failure of caudal neuropore to close, but no herniation. Usually seen at lower vertebral levels. Dura intact.
Associated with tuft of hair or skin dimple at level of bony defect
4
Q
Structures passing through Jugular Foramen
A
CN IX, X, XI, and Jugular Vein
5
Q
Pathological Location of Serotonin Synthesis
A
Raphe Nucleus
6
Q
Developmental Origin of PNS Neurons and Schwann Cells
A
Neural Crest
7
Q
Athetosis
A
Slow, snake-like, writihing movements; especially seen in fingers
Characteristic of Basal Ganglia lesion + Huntington’s Disease
8
Q
First Order Neuron: Lateral Corticospinal Tract
A
UMN cell body in the Primary Motor Cortex. Descends ipsilaterally (through posterior limb of internal capsule). Most fibers decussate at Caudal Medulla. Descends CONTRALATERALLY
9
Q
Preoptic Nucleus
A
Regulate thermoregulation and sexual behavior. Releases GnRH.
10
Q
Senses and Location: Ruffini Corpuscles
A
Pressure, slippage of objects of skin, joint angle change
11
Q
Clinical sign: Anencephaly
A
Polyhydramnios (No swallowing center in brain). Fetus doesn’t swallow amniotic fluid
12
Q
Lesion of Subthalamic Nucleus
A
Contralateral Hemiballismus
13
Q
Cerebellar Tonsillar Herniation into Foramen Magnum
A
Coma and death result when these herniations compress the brainstem
14
Q
Astigmatism
A
Abnurmal curvature of cornea. Different refractive power at different axes.
Correct with cylindrical lenses
15
Q
Tonic-Clonic Seizure
A
Alternating stiffening and movement, postictal confusion, urinary incontinence, tongue biting
16
Q
Myoclonic Seizure
A
Quick, repetitive jerks
17
Q
Lissencephaly
A
Failure of neuronal migration resulting in a “smooth brain” that lacks sulci and gyri. May be associated with microcephaly and ventriculomegaly
18
Q
Passage Through Cranial Cavity: CN XII
A
Hypoglossal Canal
19
Q
Outer Ear
A
Visible portion of ear (pinna), includes auditory canadal and tympanic membrane.
20
Q
Resting Tremor
A
Uncontrolled movement of distal appendages; termor alleviated by intentional movement
Substantia Nigra issue (Parkinson’s esp)
21
Q
Myeleomeningocele
A
(Neural Tube Defect) Meninges AND neural tube (eg cauda equina) herniate through bony defect
Think about how Myelo- prefix sounds like myelin to remember this includes the neural tube herniating as opposed to Meningocele
22
Q
Normal Pressure Hydrocephalus
A
Affects the elderly; idiopathic; CSF pressure elevated only episodically; does not result in increased Subarachnoid space volume.
Triad: Urinary incontinence, gait apraxia, and congnitive dysfunction “wet, wobbly, and wacky”
23
Q
Lesion: Paramedian Pontine Reticular Formation
A
Ipsilateral gaze palsy (inability to look toward side of lesion)
24
Q
(Primitive Reflex) Plantar Reflex
A
Dorsiflexion of large toe and fanning of other toes with plantar stimulation. (Babinski sign if present in adults - UMN lesion)
25
Dorsal Motor Nucleus
Sens autonomic (parasympathetic) fibers to heart, lungs, upper GI
CN X
26
Function: Lateral Spinothalamic Tract
Pain and Temperature
27
Vitamin B12 Deficiency (Spinal Cord)
Subacute Combined Degeneration (SCD)
Demyelination of Spinocerebellar Tracts, Lateral Corticospinal Tracts, and Dorsal Columns. Ataxic gait, paresthesia, impaired position/vibration sense.
28
Endoneurium
Thin, supportive connective tissue that ensheaths and supports individual myelinated nerve fibers.
29
Developmental predecessor to Telencephalon and Diencephalon
Prosencephalon
30
Synapse: Spinothalamic Tract
Synapses at level of entry
31
UMN or LMN: Spastic Paresis
UMN
32
Pathological Location of GABA Synthesis
Nucleus Accumbens
33
Name of Sympathetic Ganglion going to head
Superior Cervical Ganglion
34
Cerebellum: Deep Nuclei (lateral to medial)
Dentate, Emboliform, Globose, Fastigial
"Don't Eat Greasy Food"
35
Input to Cerebellum
* Contralateral cortex via Middle Cerebellar Peduncle
| * Ipsilateral Proprioceptive information via Inferior Cerebellar Peduncle from Spinal Cord
36
Decreased Mesocortical Pathway Activity
Leads to "negative" symptoms (eg anergia, apathy, lack of spontaneity). Antipsychotic drugs have limited effect.
37
Result of CN IV damage
Patient cannot look down and out. Eye rotated laterally. Difficulty walking down stairs. Head tilted.
38
Symptom: Damage to Short Ciliary Nerves
Mydriasis
39
Papilledema
Optic disc swelling (usually bilateral) due to increased ICP. Enlarged blind spot and elevated optic disc wtih blurred margins.
40
Synapse: Lateral Corticospinal Tract
Cell body of anterior horn
41
Internal Carotid Plexus
Post-Ganglion Fibers from Superior Cervical Ganglion (Sympathetics); Wrap ICA
42
Striatum (components)
Caudate (Cognitive) + Putamen (Motor)
43
Function: Anterior Spinothalamic Tract
Crude touch and pressure
44
Herniation associated with Epidural Hematoma
Uncal (Transtentorial)
45
Structures passing through Foramen Magnum
Brainstem, Spinal root of CN XI, and Vertebral Arteries
46
Asterixis
Extension of wrists causes "flapping" motion
47
Developmental Origin of Microglia
Mesoderm
48
Postganglionic Neurotransmitter in Parasympathetic Nervous System
Acetylcholine
49
Supraoptic and Paraventricular Nuclei
Synthesis Vasopression (ADH) and Oxytocin
50
Reflex Spinal Root: Patellar Reflex
L3, L4
51
Lucid Interval (Epidural Hematoma)
Epidural hematomas might present with transient loss of consciousness, a recovery period, and then rapid deterioration due to hematoma expansion
52
Myoclonus
Sudden, brief, uncontrolled muscle contraction
53
Craniopharyngioma
Most common childhood supratentorial tumor. May be confused with Pituitary Adenoma because both cause Bitemporal Hemianopia
54
Neurotransmitter Changes: Parkinson's Disease
Increase: ACh
Decrease: DA, 5HT
55
Result of LMN Lesion of CN XII
1) Atrophy of Muscles
| 2) Protruded tongue deviates toward side of lesion
56
Medial Geniculate Nucleus
Input: Superior Olive and Inferior Colliculus of Tectum
Senses: Hearing
Destination: Auditory Cortex of Temporal Lobe
57
Neurotransmitter Changes: Depression
Decrease: DA, NE, 5HT
58
Inferior extent of Subarachnoid Space in Vertebrae
Lower border of S2
59
Huntington's Pathology
Atrophy of caudate and putamen with ex vacuo ventriculomegaly. Neuronal death via NMDA-R binding and glutamate excitotoxicity
Increase: Dopamine
Decrease: GABA, ACh
60
Sensory Neurons: Free Nerve Endings
A∂ - Fast, Myelinated
C - Slow, Unmyelinated
"A Delta plane is fast but a taxC is slow"
61
Marcus Gunn pupil
aka Relative Afferent Pupillary Defect (RAPD)
When the light shines into a normal eye, constriction of both eyes if observed. When the light is then swung to the affected eye, both pupils dilate instead of constrict due to impaired conduction of light signal along the injured optic nerve
62
Postganglionic Neurotransmitter in Sympathetic Nervous System
Norepinephrine (exception sweat glands / ACh)
63
Parkinson's Disease Pathology
Loss of dopaminergic neurons of substantia nigra pars compacta
64
Lateral Geniculate Nucleus
Input: CN II/chiasm/tract
Senses: Vision
Destination: Primary Visual Cortex
65
MRI Findings in Holoprosencephaly
Monoventricle and fusion of basal ganglia
66
Innervation: Outer Ear
* CN V3
* CN VII
* CN IX
* CN X
67
Cauda Equina Syndrome
Compression of spinal roots L2 and below, often due to intervertebral disc herniation or tumor.
Radicular pain, absent knee/ankle reflexes, loss of bladder/anal sphincter control, saddle anesthesia
68
Location of CSF flow in Meninges
Subarachnoid Space
69
Hormones controlled by Circadian Rhythm
1) ACTH
2) Prolactin
3) Melatonin
4) Norepinephrine
70
Tic Douloureux
Intense, stabbing pain. CN V or an be limited to single divisions of Trigeminal Nerve (Most Frequent: V2)
71
Catarct
Painless, often bilateral opacification of lens. Results in glare and decreased vision, especially at night.
Risk Factors:
* Age
* Smoking
* Excessive alcohol use
* Excessive sunlight
* Prolonged corticosteroid use
* Diabetes
* Trauma / Infection
72
Decreased Tuberoinfundibular Pathway Activity
Leads to increase in Prolactin secretion. Sexual dysfunction, galactorrhea, gynecomastia (in men), and decrease in libido
73
Kallmann Syndrome
Failure of GnRH-producing neurons (Preoptic Nucleus - Hypothalamus) to migrate from olfactory pit
74
Preganglionic Neurotransmitter in the Autonomic System (both Sympathetic and Parasympathetic)
Acetlycholine
75
Stroke causing Frontal Eye Field lesion
MCA Stroke
76
Epineurium
Dense connective tissue that surrounds entire nerve (fascicles and blood vessels)
77
Pinealoma
Tumor of Pineal Gland. Can cause Parinaud Syndrome (Compression of tectum -> Vertical gaze palsy); obstructive hydrocephalus (cerebral aquduct); Precocious puberty in males
78
Ependymal Cells
Ciliated simple columnar glial cells line the ventricles and central canal of spinal cord. Apical surfaces are covered in cilia (which circulate CSF) and microvilli (which help in CSF absorption). Specialized ependymal cells (choroid plexus) produce CSF
79
Innervation: Dilator Pupil
Sympathetics
80
Absence Seizure
3 Hz spike-and-wave discharges, no postictal confusion, blank stare
81
Notochord
Induces overlying ectoderm to differentiate into neuroectoderm and form neural plate
82
Retinal Vein Occlusion
Blockage of central or branch retinal vein due to compression from nearby arterial atherosclerosis. Retinal hemorrhage and venous engorgement. Edema in affected area
83
End level of Spinal Cord (Adault)
Lower border of L1-L2 vertebrae
84
Suprachiasmatic Nucleus
Regulate Circadian rhythm
85
Accomodation
Thickening of lens for near vision. Parasympathetics of CN III.
86
Output from Cerebellum
* Only output from Cerebellar cortex is Purkinje Cells (inhibitory)
* Deep Nuclei
87
Second Order Neuron: Dorsal Column Ascending Tracts
Decussates in Medulla. Ascends contralaterally as the Medial Lemniscus. Goes to VPL (Thalamus)
88
Cause: Leaking CSF through nasal cavity
Fracture of Cribriform Plate
89
Chromatolysis
Reaction of neuronal cell body to axonal injury. Changes reflect increased protein synthesis in effort to repair damaged axon.
1) Round Cellular swelling
2) Displacement of the nucleus to the periphery
3) Dispersion of Nissl substance throughout cytoplasm
90
Muscle(s) closing jaw
Masseter, teMporalis, Medial pterygoid
91
Pathological Location of Acetylcholine Synthesis
Basal Nucleus of Meynert
92
Central Poststroke Pain Syndrome
Neuropathic pain due to thalamic lesions. Initial paresthias followed in weeks/months by allodynia and dysesthesia on the contralateral side.
93
Chiari II Malformation
(Posterior Fossa Malformation) Herniation of Cerebellar Vermis and Tonsils through Foramen Magnum with Aqueductal Stenosis (Noncommunicating Hydrocephalus).
Usually associated with Lumbosacral Myelomeningocele (may present as paralysis/sensory loss at/below level).
94
Cell affected in Guillain-Barre Syndrome
Schwann Cell (demyelinating disease)
95
Anencephaly
(Neural Tube Defect) Failure of rostral neuropore to close. No forebrain, open calvarium.
96
Reflex Spinal Root: Cremasteric Reflex (Testicles move)
L1, L2
97
Brown-Sequard Syndrome (Name 5 Findings jackass)
Hemisection of Spinal Cord. Findings:
1) Ipsilateral loss of all sensation @ level
2) Ipsilateral LMN signs @ lesion
3) Ipsilateral UMN signs below lesion
4) Ipsilateral loss of proprioception, vibration, 2pt touch, and tactile sense below lesion
5) Contralateral loss of pain, temperature, and crude touch below level of lesion (spinothalamic)
If lesion above T1, may kill sympathetics
98
Dystonia
Sustained, involuntary muscle contractions..
Treated with BOTOX
99
Presbyopia
Aging-related impaired accommodation (focusing on near objects), primarily due to decreased lens elasticity, changes in lens curvature, and weak ciliary muscle. Patients need reading glasses often
100
Hemiballismus
Sudden, wild flailing of 1 arm and sometimes ipsilateral leg
101
CN V Motor Lesion
Jaw deviates TOWARD lesion due to unopposed pterygoid muscle
102
Lesion: Cerebellar Vermis
Truncal Ataxia, Nystagmus
103
Formed by Neural Plate
Neural Tube and Neural Crest Cells
104
Developmental origin of Anterior 2/3 of Tongue
1st and 2nd Pharyngeal arches
105
Pathological Location of Dopamine Synthesis
Ventral Tegmentum and/or SNc
106
Dopamine Receptor in Indirect Pathway
D2 Receptor
107
Decorticate Posturing
Flexion of upper extremities and extension of lower extremities.
Lesion above red nucleus
108
Wenicke-Korsakoff Syndrome
Confusion, Ataxia, Nystagmus, Ophthalmoplegia, memory loss (global), confabulation, personality changes
CAN O'beer
109
Passage Through Cranial Cavity: Opthalmic Artery
Optic Canal
110
Fracture which can cause Epidural Hematoma
Pterion (where the frontal, parietal, temporal, and sphenoid bones join together)
111
Tabes Dorsalis
Caused by Teritiary Syphilis. Results from degeneration/deyelination of Dorsal Columns and roots.
Progressive Sensory Ataxia (from proprioception).
Positive romberg sign and absent deep tendon reflexes. Associated with Charcot joints, shooting pain, Argyll Robertson pupils
112
Passage Through Cranial Cavity: Middle Meningeal Artery
Foramen Spinosum
113
Synapse: Dorsal Column Ascending Tracts
Nucleus Gracilis / Nucleus Cuneatus (ipsilateral medulla)
114
Lesion: Medial Longitudinal Fasciculus
* Impaired ADduction of ipsilateral eye
| * Nystagmus of contralateral eye with ABduction
115
Developmental Origin of Posterior 1/3 of Tongue
3rd and 4th Pharyngeal arches
116
Essential Tremor
High-frequency tremor with sustained posture, worsened with movement or when anxious
117
Basal Plate
Neural structure on ventral neural plate. MOTOR
118
Wallenburg's Syndrome
Lateral Medullary Syndrome. PICA.
Dysphagia, hoarseness, dec gag reflex, hiccups. Vomiting, vertigo, nystagmus, dec pain/temp sensation from contralateral body, ipsilateral face. ipsilateral Horner syndrome. Ipsilatareal ataxia, dysmeteria
119
Passage between 3rd and 4th ventricles
Cerebral Aqueduct of Sylvius
120
Cingulate (Subfalcine) Herniation under Falx Cerebri
Can compress ACA
121
Pathological Location of Norepinephrine Synthesis
Locus Ceruleus
122
Neurotransmitter Changes: Alzheimer's Disease
Decrease: ACh
123
UMN or LMN: Flaccid Paralysis
LMN
124
Neurotransmitter Changes: Huntington's Disease
Increase: DA
Decrease: ACh, GABA
125
Medial Medullary Syndrome
Infarct of ASA and/or Vertebral Arteries
```
Contralateral Payalysis (upper/lower limbs)
Deficit of Contralateral proproception
Ipsilateral hypoglossal dysfunction (deviates ipsilaterally)
```
126
Passage Through Cranial Cavity: CN II
Optic Canal
127
Pathologies which affect Oligodendrocytes
1) Multiple Sclerosis
2) Progressive Multifocal Leukoencephalopathy (PML)
3) Leukodystrophies
128
UMN or LMN: Weakness
Both
129
Nucleus Ambiguus
Motor innervation of pharynx, larynx, upper esophagus
CN IX, X, XI
130
Lewy Bodies
Composed of alpha-synuclein (intracellular eosinophilic inclusions in neuron body)
131
Decreased Nigrostriatal Pathway Activity
Leads to Extrapyramidal Symptoms (eg dystonia, akathisia, Parkinsonism, tardive dyskinesia)
132
Holoprosencephaly
Failure of the embyronic forebrain to separate into two cerebral hemispheres. Usually occurs during week 5-6. Maybe be related to mutations in Sonic Hedgehog Signaling pathway. Seen in Trisomy 13 (Patau) and Fetal Alcohol Syndrome
Moderate form: Cleft lip/palate
Severe: Cyclopia
133
Symptoms: Bell's Palsy
1. Facial Paralysis
2. Drooling (Buccinator)
3. Inability to Close Eye (Oribuclaris Oculi)
4. Loss of Taste to Anterior Tongue
5. Pain In/Behind Outer Ear
6. Hyperacousia (Stapedius)
134
Difference in Symptoms: Acoustic Neuroma vs Parotid Tumor / Peripheral Damage
Acoustic Neuroma has all CN VII/VIII Symptoms. On the other hand...
Parotid Tumor/Peripheral Damage:
Only Facial Paralysis. No loss of taste, hyperacousia, decrease in secretion from glands, etc
135
Ciliary Ganglion
Parasympathetics of CN III.
Innervate: Ciliary Muscles and Sphincter (Constrictor) Pupillae
136
Causes of Ptosis
Damage to Sympathetics (see Horner's Syndrome) or CN III (Levator Palpebrae Superioris)
137
Kluver-Bucy Syndrome
Disinhibited behavior (eg hyperphagia, hypersexuality, personality changes).
Bilateral lesion of Amygdala
138
Medulloblastoma
Most common malignant brain tumor in childhood. Commonly involves cerebellum.
Can compress 4th ventricle and cause Noncommunicating Hydrocephalus
139
Innervation and Function: Hyoglossus
Retracts and depresses tongue
CN XII
140
Neurotransmitter Changes: Schizophrenia
Increase: DA
141
Passage Through Cranial Cavity: CN VII
Internal Auditory Meatus
142
Huntington's Disease
Autosomal dominant trinucleotide (CAG) repeat expansion in the Huntingtin gene on Chromosome 4.
CAG Repeats. CAG. *C*audate loses *A*Ch and *G*aba
143
Posterior Nucleus (Hypothalamus)
Heating. Sympathetic
144
Complete Occlusion of Anterior Spinal Artery
Spares Dorsal Columns and Lissauer Tract
Mid-Thoracic ASA territory is watershed area, as artery of Adamkiewicz supplies ASA below T8. Aortic aneurysm repair can bring it on.
UMN deficit below the lesion (Corticospinal), LMN deicit at the level of lesion (anterior horn), and loss of pain/temp below the lesion (spinothalamic)
145
Passage Through Cranial Cavity: CN VIII
Internal Auditory Meatus
146
Jaw Jerk Reflex
Stretch reflex of Muscles that Close Mouth. Sensory/Motor V3
Masseter**
Temporalis
Medial Pterygoid
147
Anosmia
Loss of sense of smell
148
Ventral Posterolateral (VPL) Nucleus
Input: Spinothalamic and Dorsal Columns/Medial Lemniscus
Senses: Vibration, Pain, Pressure, Proprioception, Light Touch, Temperature
Destination: Primary Somatosensory Cortex
149
Major locations of CSF production
Lateral and Fourth Ventricles
150
Present with MS
* Acute Optic Neuritis (w/ Relative Afferent Pupillary Defect)
* Brainstem/Cerebellar syndromes
* Pyramidal tract demyelination
* Spinal Cord syndromes
151
Muscle(s) opening jaw
Lateral Pterygoid
152
Perfused by Lenticulostriate Branch of MCA
Basal Ganglia and Internal Capsule (Genu/Posterior Limb)
153
Sensory to Cornea
Long Ciliary Nerves (V1)
154
Open-Angle Glaucoma
Associated with age, Blacks, and family history. Painless, more common in U.S.
155
Senses and Location: Meissner Corpuscles
Dynamic, fine/light touch, position sense
Glabrous (hairless) skin
156
Glioblastoma Multiform
Highly malignant primary brain tumor found in the Cerebral Hemispheres.
Origin: Astrocytes
157
Intention Tremor
Slow, zigzag motion when pointing/extending toward a target.
Characteristic of cerebellar dysfunction
158
Ventral Lateral Nucleus (Thalamus)
Input: Cerebellum and Basal Ganglia
Senses: Motor
Destination: Motor Cortex
159
(Primitive Reflex) Sucking Reflex
Sucking response when roof of mouth is touched
160
Myeloschisis
(Neural Tube Defect) Also known as rachischisis. Exposed, unfused neural tissue without skin/meningeal covering
161
Chorea
Sudden, jerky, purposeless movements.
Seen in lesions of the basal ganglia. Huntington's Disease
162
Alar Plate
Neural structure on dorsal neural plate. SENSORY
163
Passage between 4th Ventricle to Subarachnoid Space
* 2x Formina of Luschka (Lateral)
| * Formina of Magendia (Medial)
164
Atonic Seizure
"Drop" seizures
165
Passage Through Cranial Cavity: CN V3
Foramen Ovale
166
Perineurium
Blood-nerve permeability barrier. Surrounds a fascicle of nerve fibers. Must be rejoined in microsurgery for limb reattachment.
167
Ossicles
Three bones in inner ear.
1) Malleus
2) Incus
3) Stapes
168
First Order Neuron: Dorsal Column Ascending Tracts
Enters Dorsal Root and Ascends Ipsilaterally (Fasciculus Gracilis/Cuneatus)
169
Second Order Neuron: Lateral Corticospinal Tract
Lower motor neuron leaves the spinal cord and onto the Neromuscular Junction
170
Anterior Nucleus (Hypothalamus)
Cooling. Parasympathetic.
171
(Primitive Reflex) Rooting reflex
Movement of head toward one side if cheek or mouth is stroked (nipple seeking)
172
Nucleus which CN VII, IX, and X relay taste sensation to
Solitary Nucleus (medulla)
173
Hypoxic Stroke
Due to hypoperfusion or hypoxemia. Common during cardiovascular surgeries, tends to affect watershed areas.
174
UMN or LMN: Fasciculations
LMN (spontaneous motor firing)
175
Communicating Hydrocephalus
Decreased CSF absorption by Arachnoid Granulations. Increased ICP, papilledema, and herniation
176
Friedreich's Ataxia
Autosomal recessive trinucleotide repeat disorder (GAA) on Chromosome 8 in gene that encodes Frataxin (iron-binding protein).
Degeneration of lateral corticospinal tract, spinocerebellar tract, dorsal columns, and dorsat root ganglia. Staggering gait, frequent falling, nystagmus, dysarthria, pes cavus, hammer toes, diabetes mellitus, hypertrophic cardiomyopathy.
177
Neurotransmitter Changes: Anxiety
Increase: NE
Decrease: GABA, 5HT
178
Akathisia
Restlessness and intense urge to move.
Can be seen as a side effect of Parkinson's treatment
179
Syringomyelia
Cystic cavity within central canal of spinal cord. Fibers crossin gin the Anterior White Commissure (SPINOTHALAMIC TRACT) are typically damaged first.
180
Occlusion in Locked-In Syndrome
Basilar Artery
181
(Primitive Reflex) Palmar Reflex
Curling of fingers if palm is stroked
182
Innervation and Function: Palatoglossus
Elevates posterior tongue during swallowing
CN X
183
CN XII Lesion
LMN. Tongue deviates toward side of lesion "lick your wounds"
184
Functions of Astrocytes
1) Physical support / repair
2) Extracellular K+ buffer
3) Removal of excess neurotransmitter
4) Component of blood-brain barrier
5) glycogen fuel reserve buffer
6) Reactive gliosis in response to neural injury
185
Function: Lateral Corticospinal Tract
Voluntary movement of contralateral limbs
186
Passage Through Cranial Cavity: CN I
Cribriform Plate
187
Epidural Space
Potential space between the dura mater and skull/vertebral column containing fat and blood vessels
188
Glaucoma
Optic disc atrophy with characteristic cupping, usually with elevated introcular pressure and progressive peripheral visual field loss if untreated.
189
Tonic Seizure
stiffening
190
Major Dopaminergic Pathways
1) Mesocortical
2) Mesolimbic
3) Nigrostriatal
4) Tuberoinfundibular
191
Developmental predecessor to Mesencephalon
Mesencephalon (HAH GOTCHA)
192
Reflex Spinal Root: Triceps Reflex
C6, C7
193
Lesion (Bilateral):Mammillary Body
Wernicke-Korsakoff Syndrome
194
Apex of basilar membrane
Low frequency (wide and flexible)
195
Parinaud's Syndrome
Vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus.
Lesion of Dorsal Midbrain.
196
Central Retinal Artery Occlusion
Acute, painless monocular vision loss. Retina cloudy with attenuated vessels and "cherry-red" spot at fovea. Evaluate for embolic source
197
Passage between Lateral Ventricles and 3rd Ventricle
Foramina of Monro
198
Test signs of Neural Tube defect
1) Elevated Alpha-Fetoprotein in Amniotic fluid and maternal serum (except spinal bifida occulta)
2) Elevated Acetylcholinesterase (AChE) in Amniotic fluid
199
Parkinson's Symptoms
TRAPS
```
Tremor (Resting)
Rigidity (Cogwheel)
Akinesia (or Bradykinesia)
Postural Instability
Shuffling Gait
```
200
Phagocytic scavenger cells of CNS (mesodermal, mononuclear origin). Activation in response to tissue damage -> release of inflammatory mediatory (eg, nitric oxide, glutamate).
Microglia
201
Meningocele
(Neural Tube Defect) Meninges (but no neural tissue) herniate through bony defect
202
Senses and Location: Free Nerve Endings
Pain, temperature.
All skin, epidermis, some viscera
203
First Order Neuron: Spinothalamic Tract
Sensory Nerve Endings (A∂ and C) enter spinal cord
204
Decerebrate Posturing
Extension of upper and lower extremities
Lesion at or below red nucleus
205
Hypothalamo-Spinal Tract
Descending control of Autonomic Function
206
Visual results of Pituitary Adenoma and Craniopharyngioma (another cancer of the Pituitary)
* Press on Optic Chiasm
| * Bitemporal Hemianopia
207
(Primitive Reflex) Galant Reflex
Stroking along one side of the spine while newborn is in ventral suspension (face down) causes lateral flexion of lower body toward stimulated side
208
Treatment for ALS / Lou Gehrig Disease
Riluzole "riLOUzole"
209
UMN or LMN: Atrophy
LMN
210
Dandy-Walker Malformation
(Posterior Fossa Malformation) Agenesis of Cerebellar Vermis leads to cystic enlargement of 4th Ventricle that fills the enlarged posterior fossa.
Associated with noncommunicating hydrocephalus and Spina Bifida
211
Second Order Neuron: Spinothalamic Tract
Decussates in spinal cord at the Anterior White Commissure. Ascends contralaterally to VPL (Thalamus)
212
Amyotrophic Lateral Sclerosis (Lou Gehrig Disease)
Combined UMN (Corticobulbar/Corticospinal) and LMN (medullary/spinal cord) degeneration. No sensory or bowel/bladder deficits.
LMN (Dysarthria, dysphagia, asymmetric limb weakness, fasciculations, atrophy); UMN, Pseudobulbar palsy (Dysarthria, dysphagia, emotional lability, spastic gait, clonus.
213
CN X Lesion
Uvula deviates AWAY from lesion.
214
Course of CN I into Nasal Cavity
Through Cribriform Plate of Ethmoid Bone
215
Risk Factors: Idiopathic Intracranial Hypertension
Female TOAD
Female, Tetracyclines (anti-biotics), Obesity, vitamin A, Danazol
216
Reflex Spinal Root: Anal Wink Reflex
S3, S4
217
Cape-like bilateral, symmetrical loss of pain and temperature sensation in upper extremities
Syringomyelia
218
(Primitive Reflex) Moro Reflex
"Hang on for life" reflex -- abduct/extend arms when startled, and then draw together
219
Limbic Structures
* Hippocampus
* Amygdala
* Mammillary Bodies
* Anterior Thalamic Nuclei
* Cingulate Gyrus
* Entorhinal Cortex
220
Wallerian Degeneration
Disintegration of the axon and myelin sheath on distal side of axonal injury with macrophages removing debris
221
Proximal side of a neuron during axonal injury
Axon retracts and the cell body sprouts new protrusions that grow toward other neurons for potential reinnervation. Serves as a preparation for axonal regeneration and functional recovery
222
Conjunctivitis
Inflammation of the conjunctiva, leads to red eye.
Allergic - itchy eyes and bilateral
Bacteria - pus present
Viral - Most common, often adenovirus. Sparse mucous discharge, swollen preauricular node; self-resolving
223
Lesion: Cerebellar Hemisphere
Intention tremor, limb ataxia, loss of balance.
Damage to Cerebellum = Ipsilateral deficits
224
UMN or LMN: Increased Tone
UMN
225
Dopamine Receptor in Direct Pathway
D1 Receptor
226
Pituitary Adenoma
May be nonfunctioning (silent) or hyperfunctioning (hormone-producing).
Non-functional tumors present with Bitemporal Hemianopia (pressure on optic chiasm).
227
Uncal Transtentorial Herniation
Uncus = Medial temporal lobe
Ipsilateral blown pupil, contralateral hemiparesis. Later: coma
228
Multiple Sclerosis
Autoimmune inflammation and demyelination of CNS with subsequent axonal damage.
229
Senses and Location: Merkel Discs
Pressure, deep static touch (eg shapes, edges), and position sense.
Finger tips, superficial skin
230
Lateral Nucleus (Lateral Hypothalamic Area)
Hunger center. Stimulated by ghrelin and inhibited by leptin
231
Exceptions to Cranial Nerve Innervation Being Bilateral
Contralateral:
* Lower Face (CN VII)
* Genioglossus (XII)
* Trapezius (XI)
Ipsilateral:
* Sternocleidomastoid (XI)
232
Lesion causing Hemiballismus
Contralateral subthalamic nucleus
233
Mnemonic: Cranial Nerves - Sensory, Motor, or Both
Some Say Marry Money But My Brother Says Big Brains Matter Most
234
Base of Basilar Membrane
High frequency
235
Developmental predecessor to Metencephalon and Myelencephalon
Rhombencephalon
236
Nucleus Tractus Solitarius
Visceral Sensory Information
CN VII, IX, X
237
Structures passing through Superior Orbital Fissure
CN III, IV, V1, VI
238
Ventromedial Nucleus (Hypothalamus)
Satiety. Stimulated by leptin.
239
Function: Dorsal Column Ascending Tracts
Pressure, Vibration, Fine Touch, Proprioception
240
Spinal Muscular Atrophy
Congenital degeneration of Anterior Horn. LMN lesion.
Autosomal recessive mutation is SMN1.
241
Result of CN III damage
1) Lateral Strabismus
2) Ptosis
3) Mydriasis (dilated pupil - paralyzed pupillary constrictor)
242
Innervation and Function: Styloglossus
Draw up sides of tongue to create a trough for swallowing
CN XII
243
Location of Lumbar Puncture (Adult)
L3-L5
244
Damage: Lateral Nucleus (Lateral Hypothalamic Area)
Anorexia and failure to thrive (infants)
245
Developmental origin of CNS neurons, ependymal cells, oligodendrocytes and astrocytes
Neuroepithelia in the Neural Tube
246
Passage Through Cranial Cavity: CN V2
Foramen Rotundum
247
Stage of sleep sleepwalking, night terrors, and bedwetting occur
Stage 3
248
Result of CN VI damage
Medial Strabismus (Paralysis of Lateral Rectus)
249
Senses and Location: Pacinian Corpuscles
Vibration and pressure
Deep skin layers, ligaments, joints
250
Increase Mesolimbic Pathway Activity
Leads to "positive" symptoms (eg delusions, hallucinations. Primary therapeutic target of Antipsychotic drugs
251
Ventral Posteromedial (VPM) Nucleus
Input: Trigeminal and Gustatory Pathway
Senses: Face sensation, taste
Destination: Primary Somatosensory Cortex
252
Huntington's Signs
* Chorea
* Athetosis
* Aggression
* Depression
* Dementia
253
Chairi I Malformation
(Posterior Fossa Malformation) Ectopia of cerebellar tonsils inferior to foramen magnum.
Congenital. Usually asymptomatic in childhood, manifests in adulthood with headaches and cerebellar symptoms. Associated with spinal cavitations (eg syringomyelia)
254
Reflex Spinal Root: Biceps/Brachioradialis Reflexes
C5, C6
255
CN XI Lesion
Weakness turning head to opposite side. Shoulder droop on side of lesion.
256
Notochord remnant in Adults
Nucleus Pulposus of Intervertebral Discs
257
Reflex Spinal Root: Achilles Reflex
S1, S2
258
Acute Closure (Glacuoma)
Ophthalmic emergency. Intraocular pressure pushes iris forward, angle closes abruptly.
Very painful, red eye, sudden vision loss, halos around lights, frontal headache, fixed and mid-dilated pupil, nausea, and vomiting. Mydriatic agents contraindicated.
259
Noncommunicating Hydrocephalus
Caused by structural blockage of CSF circulation within ventricular system
260
Embryological Germ Layers
Ectoderm, Mesoderm, Endoderm
261
Myopia
Nearsightedness. Eye too long for refractive power of cornea and lens. Light focused in front of retina.
Correct with concave lenses.
262
Production of Aqueous Humor
Produced by nonpigmented epithelium on ciliary body
263
Closed-Angle Glaucoma
Primary: Enlargement/anterior movement of lens against iris -> obstruction of normal aqueous flow through pupil -> fluid builds up behind iris, pushing peripheral iris against cornea and impeding flow through trabecular network
Secondary: Hypoxia from retinal disease induces vasoproliferation in iris that contracts angle
264
Innervation and Function: Genioglossus
Protrude tongue
CN XII
265
Hyperopia
Farsightedness. Eyes too short for refractive power of cornea and lens. Light focused behind retina.
Correct with convex lenses
