vascular, CN / ophtho and ICU buzz phrases

Question 1

vasogenic edema

Answer 1

extracellular edema. Blood brain barrier damage (brain tumor)

Question 2

cytotoxic edema

Answer 2

intracellular edema. associated with cellular membrane damage (ischemia)

Question 3

plateau waves or lundberg A waves

Answer 3

increased intracranial pressure

Question 4

crescentic hematoma

Answer 4

subdural hematoma. rupture of bridging veins

Question 5

biconvex hematoma

Answer 5

epidural hematoma. rupture of the middle meningeal artery

Question 6

angular acceleration and shear injury

Answer 6

diffuse axonal injury

Question 7

CSF with xanthochromia

Answer 7

SAH

Question 8

neurologic worsening in SAH with unsecured aneurysm

Answer 8

suspect rebleeding

Question 9

neurologic worsening with secured aneurysm, and between 3 and 15 days

Answer 9

suspect vasospasm

Question 10

hydrocephalus and intraventricular hemorrhage

Answer 10

consider external ventricular drain if ICP needs to be monitored or treated

Question 11

pinpoint pupils, apneustic breathing pattern

Answer 11

pontine lesion

Question 12

ataxic breathing pattern

Answer 12

medullary lesion

Question 13

decorticate posture

Answer 13

lesion above the red nucleus

Question 14

decerebrate posture

Answer 14

lesion between the red nucleus and the vestibular nucleus

Question 15

petechial hemorrhages in the brain after trauma with bone fractures

Answer 15

consider fat embolism

Question 16

brain injury and anisocoria

Answer 16

consider uncal herniation

Question 17

state of pathologically reduced consciousness from which the patient can be aroused to purposeful response only with external stimulation

Answer 17

stupor

Question 18

deep sleep cannot be aroused, may grimace or have stereotyped movements but does not localize to the stimulus

Answer 18

coma

Question 19

awake and conscious, but quadriplegic, paralysis of lower cranial nerves and horizontal gaze. preserved vertical gaze and blinking

Answer 19

locked in state

Question 20

previously comatose, but with return of the sleep wake cycles. lack cognitive function

Answer 20

unresponsive wakefulness

Question 21

alteration of consciousness with poor attention and fluctuation

Answer 21

delirium

Question 22

ipsilateral third nerve palsy and contralateral hemiplegia

Answer 22

weber’s syndrome (midbrain lesion)

Question 23

ipsilateral third nerve palsy and contralateral involuntary movements

Answer 23

benedikt’s syndrome (lesion in the ventral portion of the mesencephalic tegmentum)

Question 24

ipsilateral seventh nerve palsy with contralateral ataxia and tremor

Answer 24

claude’s syndrome (lesion in the dorsal portion of the mesencephalic tegmentum)

Question 25

ipsilateral seventh nerve palsy with contralateral hemiplegia

Answer 25

millard gubler syndrome (lesion in the pons)

Question 26

limited upward gaze, convergence retraction nystagmus light-near dissociation, lid retraction, and skew deviation of the eyes

Answer 26

parinaud's syndrome (lesion affecting the quadrigeminal plate)

Question 27

quadriplegia, inability to speak, limited horizontal gaze, with preserved consciuosness, vertical gaze, and blinking

Answer 27

locked in sydrome

Question 28

vertigo, nystagmus, nausea, hiccups, hoarseness, dysphagia, ipsilateral paralysis of the palate and vocal cord, decreased gag reflex, impaired sensation on the ipsilateral hemiface, loss of sensation to pain and temperature in the contralateral hemibody, ipsilateral ataxia and lateropulsion, and ipsilateral horner's syndrome

Answer 28

wallenberg's syndrome caused by a lateral medullary infarction associated with posterior inferior cerebellar artery or vertebral artery occlusion

Question 29

ipsilateral hearing loss, vertigo, ipsilateral ataxia, ipsilateral horner's syndrome, sensory deficit in the ipsilateral hemiface and contralateral hemibody

Answer 29

anterior inferior cerebellar artery infarct

Question 30

contralateral hemibody sensory loss with subsequent development of pain, allodynia, and paresthesias. Results from a thalamic lesion

Answer 30

dejerine-roussy syndrome

Question 31

finger agnosia, right-left disorientation, agraphia, and aculculia

Answer 31

gerstman's syndrome

Question 32

normal variant with vascular supply to both medial thalami

Answer 32

artery of percheron

Question 33

deep branch from ACA that supplies anterior limb of the internal capsule, inferior part of head of caudate nucleus, and anterior part of globus pallidus

Answer 33

recurrent artery of Huebner

Question 34

infarct in the posterior circulation from thrombus lodging in the distal basilar. Symptoms: behavioral abnormalities, altered level of consciousness, and abnormalities of ocular motion

Answer 34

top of the basilar syndrome

Question 35

thalamus, contralateral hemisensory loss

Answer 35

pure sensory lacunar s/o

Question 36

posterior limb of internal capsule, contralateral motor deficits. also described with ventral pons lacunes.

Answer 36

pure motor lacunar syndrome

Question 37

paramedian pons, "clumsy hand" and dysarthria

Answer 37

clumsy hand dysarthria lacunar syndrome

Question 38

dilated thin walled vessels with no smooth muscle or elastic fibers, and no intervening brain parenchyma.

Answer 38

cavernous malformation

Question 39

thin walled venous structure with normal intervening brain tissue

Answer 39

venous angioma

Question 40

abnormally dilated capillaries, normal intervening brain tissue

Answer 40

capillary telangiectasia

Question 41

nidus, with arteries and veins communicating without an intervening normal capillary bed in between

Answer 41

AVM

Question 42

hemorrhage in the putamed, caudate, thalamus, pons, cerebellum, and deep white matter. Associated iwth lipohyalinosis and charcot-bouchard microaneurysms

Answer 42

hypertensive ICH

Question 43

lobar hemorrhages on MRI gradient echo. congo red positive amyloid material, seen as apple green birefringence with polarized light

Answer 43

cerebral amyloid angiopathy

Question 44

central nystagmus

Answer 44

nonfatiguing, absent latency, not suppressed by visual fixation, duration of nystagmus greater than 1 minute, any direction, but purely torsional or vertical direction is classically central. (pure torsional BPPV can mimic)

Question 45

central vertigo

Answer 45

subjectively less severe vertigo than peripheral, more prominent gait impairment, other neurologic signs coexist, absent hearing changes and tinnitus

Question 46

peripheral nystagmus

Answer 46

fatiguable, latency present, suppresion by visual fixation duration of nystagmus is less than 1 minute, direction is unidirectional and usually horizontal with a torsional component.

Question 47

peripheral vertigo

Answer 47

subjectively more severe, walking typically preserved, hearing changes and tinnitus common

Question 48

taste anterior two thirds of tongue

Answer 48

facial nerve

Question 49

tactile sensation anterior two thirds of tongue

Answer 49

trigeminal nerve

Question 50

taste posterior one third of tongue

Answer 50

glossopharyngeal nerve

Question 51

parasympathetic source to head and neck

Answer 51

superior salivatory nucleus

Question 52

motor nuclei to pharanyngeal and laryngeal muscles

Answer 52

nucleus ambiguus

Question 53

provides innervation to the parotid gland by glossopharyngeal nerve

Answer 53

inferior salivatory nucleus

Question 54

nuclei for taste sensation

Answer 54

rostral nucleus solitarius

Question 55

nuclei for baroreceptor reflex

Answer 55

caudal nucleus solitarius

Question 56

nuclei for parasympathetic output to chest, thorax, and GI tract

Answer 56

dorsal motor nucleus of vagus

Question 57

corneal reflex

Answer 57

afferent: trigeminal nerve, efferent: facial nerve

Question 58

gag reflex

Answer 58

afferent: glossopharyngeal nerve, efferent: vagus nerve

Question 59

pupil sparing third nerve palsy

Answer 59

diabetic pupil/diabetic cranial nerve palsy

Question 60

ptosis, miosis, anhidrosis - (location along carotid)

Answer 60

Horner's syndrome - proximal to carotid bifurcation

Question 61

fourth nerve palsy (compensatory action)

Answer 61

contralateral head tilt

Question 62

argyll robertson pupil

Answer 62

neurosyphillis, accomodation reflex present, pupillary reflex absent

Question 63

marcus gunn pupil

Answer 63

afferent pupillary defect, no response to firect light, but response to consensual light in contralateral eye present

Question 64

down and out pupil

Answer 64

third nerve palsy

Question 65

hydroxyamphetamine 1% eye drops - response: Horner's pupil dilates

Answer 65

horner's pupil dilates | first or second order neuron lesion

Question 66

hydroxyamphetamine 1% eye drops - response: horner's pupil does not dilate

Answer 66

third order neuron Horner's pupil