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First Aid
Neurology
| Question | Answer |
|---|---|
| Which neuro support cell is derived from mesoderm? the rest? | microglia, the rest are all from ectoderm |
| Which cell has a marker of GFAP | astrocyte |
| what do astrocytes do | physical support, repair, K+ metabolism, maintain BBB |
| what do microglia form after tissue damage | large ameboid phagocytic cells |
| HIV infections cause microglia to form | multinucleate giant cells |
| which myelin forming cell myelinates multiple nerves at once | oligodendroglia |
| which myelin forming cell myelinates only one nerve at a time | schwann cells |
| which neuro support cell looks like fried eggs on H/E Stain | oligodendroglia |
| which neuro support cell adds myelin to PNS? CNS? | PNS- schwann, CNS- Oligodenroglia |
| A bundle of nerves is called a? | fasicle |
| what surrounds a fasicle of nerve fibers | perineurium |
| What surrounds multiple nerve fasiclese | epineurium |
| What surrounds individual nerve fibers | endoneurium |
| which nerve layer(endo, peri, epi) needs to be rejoined during limb reattachment | peri |
| which nerve later (endo, peri, epi) acts like an extension of the blood brain barrier | peri |
| which NT is synthesized at the locus ceruleus | NE |
| which NT is sythesized at the Ventral Tegmentum | Dopamine |
| which NT is synthesized at the Substantia Nigra | Dopamine |
| Which NT is synthesized at the Raphe Nucleus | serotonin (5-HT) |
| Which NT is synthesized at the Basal nucleus of Meynert | Ach |
| What 3 things make up the Blood-Brain-Barrier | astocyte foot processes, tight junctions btw nonfenestrated capillary endothelial cells, and Basement membrane |
| what two molecules can cross Blood brain barrier via carries in barrier | glucose and amino acids |
| What is vasogenic edema | when destroyed BBB leading to ECF in brain, usually caused by infaract, infection, or neoplasm |
| where are examples of areas lacking BBB | area postrema (vomiting) and neurophypophysis (ADH release) |
| what is the supraoptic nucleus? Paraventricular nucleus? Where is it found? | controls thirst and water balance by making ADH (supra) and reproductive aspects via oxytocin (para), they are located in the hypothalamus |
| what is the adenohypophysis? what is found there? What controls it? | anterior lobe of the pituitary that stores hormonal signals and is controlled by release factors made in the hypothalamus. |
| What is the neurohypophysis | posterior pituitary that stores oxytocin and ADH made in the hypothalamus |
| Where is hunger controlled in the brain | hypothalamus |
| what part of the hypothalamus controls hunger and satiety | hunger-lateral area and satiety is ventromedial area |
| what happens if the lateral area of the hypothalamus is damaged | leads to anorexia and starvation, no hunger |
| what happens if the ventromedial area of the hypothalamus is damaged | leads to obesity and hyperphagia, no satiety |
| which part of the hypothalamus controls parasympathetics | anterior |
| which part of the hypothalamus controls sympathetics | posterior |
| what is the suprachiasmatic nucleus? where is it found? | part of the hypothalamus that controls circadian rhythms |
| which part of the hypothalamus causes cooling when hot | Anterior-Cooling (A/C) (sympathetics) |
| which part of the hypothalamus causes heat conservation when cold | posterior |
| which part of the brain controls temperature | hypothalamus |
| what is the septal nucleus? | controls sexual urges and emotions part of the limbic system |
| what is a poikilotherm | cold blooded animal |
| What is the Lateral Geniculate nucleus? where is it found | part of thalamus that is a relay for vision (optic nerve) |
| what is the Medial Geniculate Nucleus? Where is it found | part of the thalamus that is a relay for auditory information. |
| What does the VPL control? Where is it located | body sensation relay before entering cortex, found in thalamus |
| What does the VPM control? Where is it located | face sensation (CN V) relay before entering cortex, found in thalamus |
| What does the VA/VL control? Where is it located | motor relay from basal ganglia or cerebellum to process motor signals |
| if you damage the posterior thalamus which is more likely to be lost, motor or sensory function? | sensory (VPL/VPM) |
| if you damage the anterior thalamus which is more likely to be lost, motor or sensory function? | motor (VA/VL) |
| what is the circuit of the limbic system | hippocampus-> fornix-> mamillary bodies-> thalamus-> cingulate cortex-> back to hippocampus |
| what is the purpose of the limbic system | Feeding, Fleeing, Fighting, Feeling, Fucking |
| which type of neurons are used to send input to the cerebellum | climbing and mossy fibers |
| which type of neurons are used to send output from the cerebellum | perkinje fibers |
| What is the driect pathway in the basal ganglia, what is it's overall effect | cortex activates, as does Dopamine working at D1 receptors on the striatum(putamen/caudate) which inhibits Globus Pallidus Interna which inhibits thalamus(VA/VL) which activates the cortex. Overall we see the inhibition of GPi which normally inhibits move |
| How does the indirect pathway in the basal ganglia work? | cortex stimulates striatum but dopamine acts to inhibit the stiatum. The striatum normally inhibits Globus pallidus externa which inhibits subthalamic nucleus(STN). The STN normall activates GP interna which inhibits the thalamus. Overall we see that the |
| Which receptors does dopamine bind in the direct and indirect basal ganglia pathways | D1 in direct and D2 in indirect. |
| where in the cortex is the motor section | pre central gyrus |
| where in the cortex is the sensory section | post central gyrus |
| where in the cortex is wernicke's area | posterior aspect of the temporal lobe |
| where in the cortex is the primary auditor cortex | internal part of the temporal lobe (sylvian fissure) |
| where is Broca's area | inferior part of frontal lobe, next to temporal lobe |
| where are the frontal eye fields, what do they partcipate with | saccadic eyemovements, located on the superior aspect of the frontal lobe just infront of the motor cortex |
| what is heschl's gyrus | primary auditory cortex |
| which part of the motor cortex is involved with legs | internal aspect |
| where does the anterior cerebral A. provide blood to | central aspect of the cortex(includes sensory and motor for lower limbs) |
| where does the middle cerebral A. provide blood to | external aspect of the cortex (includes sensory and motor for upper body) |
| where does the posterior cerebral A. provide blood to | posterior cortex |
| Most common site of aneurysm in circle of Willis | anterior communicating A. |
| which cerebral artery supplies wernicke'e and broca's areas | Middle Cerebral A. |
| First branch of the basilar artery | AICA (anterior inferior cerebellar A.) |
| Last branch of the Vertebral A. | Posterior inferior cerebellar A. (PICA) |
| what branches initially come off the middle cerebral A | lateral striate |
| what are the lateral striate branches | branches of the MCA which supply internal capsule and basal ganglia structures. |
| What structure connects the lateral ventricles to the third ventricle | foramen of monroe |
| What connects the third ventricle with the fourth ventricle | cerebral aqueduct |
| What are the two exits for CSF in the fourth ventricle | Foramen of Luschka (Lateral) and Foramen of Magendie(Medial) |
| where does CSF go when it exits ventricles | cistern-> arachnoid granulations-> dural venous sinuses-> venous system |
| which vein connects anteriorly with the cavernous sinus | superior opthalmic v. |
| which veins/sinus make the confluence of sinuses | straight, occipital, superior saggital, transverse |
| what vessels drains CSF from sinuses to veinous system of body | internal juglar vein |
| how does the internal juglar vein exit the skull | jugular foramen |
| which sinus becomes the straight sinus | inferior sagittal sinus |
| what is a non-communicating hydrocephalus | one where there is a block within the ventricles |
| what is a communicating hydrocephalus | one where the block is in the subarachnoid space and the ventricles are free |
| how spinal nerves are there, what is their break down | 31 (8C, 12T, 5L, 5S, 1Cox) |
| How do the spinal never roots exit the vertebral coloumn (above or below corresponding vertebra) | C1->C7 exit above and C8 and down exit below vertebra with same name |
| where does vertebral disk herniation usually occur | between L5 and S1 |
| where does the spinal cord end in adults | L1/L2 |
| where does the subarachnoid space extend in adults | S2 |
| where is a Lumbar puncture performed in an adult | L3/L4 or L4/L5 |
| What is the order of structures pierced during a spinal tap | Skin-> superficial fascia-> Supraspinus Ligament-> Interspinous Lig.-> Ligamentum Flavum-> Eidural space-> Dura Mater-> Subdural space-> Arachnoid -> Subarachnoid space-> CSF |
| where is CSF located in the spinal column | subarachnoid space |
| what does the dorsal columns carry | pressure, vibration, touch, proprioception |
| what are the two subnuclei of the dorsal columns formed in the upper spinal column/brainstem? what do each carry? which is more medial? | Fasiciculus cuneatus(upper body/extremities) and Fasiciculus Gracilis(Lower body, and lower extremities), the FG is more medial |
| where is the spinothalamic tract located on a cross section of spinal cord | ventral laterally |
| what does the spinothalamic tract carry | pain and temperature |
| which spinal tract crosses the spinal cord as soon as it enters the dorsal horn | spinothalamic tract (pain and temp) |
| where is the lateral corticospinal tract located in the cross section of the spinal cord | laterally abover the STT |
| what does the lateral corticospinal tract carry | voluntary motor (downwards) |
| what is carried in the lateral horn | sympathetics (T1-L2) |
| what is the medial lemniscus | path that carries the dorsal columns information after the cuneate and gracilus cross over in medulla |
| where does the dorsal column pathway synapse | 1st at cuneate and gracilis nuclei, 2nd at at VPL then it goes to cortex |
| where does the spinothalamic tract synapse | 1st as soon as it enters spinal cord in dorsal horn grey matter, then it travels up spinal cord (contralaterally) 2nd at VPl then goes to cortex |
| where is the cell body of the primary sensory neurons in the spinothalamic tract | dorsal root ganglion |
| what type of neurons carry information in the spinothalamic tract,(what are the primary neuron fiber types) | A-delta and C fibers |
| where does the lateral corticospinal tract cross over | at the pyramids in medulla. |
| where does the lateral corticospinal tract synapse | 1st at anterior horn in spinal cord, 2nd at neuromuscular junction. |
| What is a pudendal nerve block used for | pregnancy |
| what landmark is used for pudendal nerve block | ischial spine |
| where is mcburney's point | 1/3 of way from superior iliac spine to umbilicus |
| what landmark is used for lumbar punctures | iliac crest |
| Name the dermatome, posterior aspect of skull "cap" | C2 |
| Name the dermatome, high turtle neck shirt area | C3 |
| Name the dermatome, low collar shirt area | C4 |
| Name the dermatome, nipple | T4 |
| Name the dermatome, xiphoid process | T7 |
| Name the dermatome, umbilicus | T10 |
| Name the dermatome, inguinal ligament | L1 |
| Name the dermatome, kneecaps | L4 |
| Name the dermatome, Penile zones | S2,3,4 |
| Name the dermatome, Anal Zones | S2,3,4 |
| Name the spinal root, Biceps | C5,C6 |
| Name the spinal root Triceps | C7,8 |
| Name the spinal root Knee | L3,4 |
| Name the spinal root Achilles | S1,2 |
| babinski sign is a sign that suggests | upper motor neuron lesion |
| what is the moro reflex | extension of the limbs when startled, seen in infants only |
| what is the rooting reflex | nipple seeking, seen in infants only (and horny males:-) ) |
| what is the palmar reflex | grasps objects in palm, seen only in infants |
| when do infant reflexs usually disappear | within 1 year |
| what does the muscle spindle sense | length of muscle fiber |
| what does the golgi tendon organ sense | tension in muscle fibers |
| what are the nerve fibers that come off of muscle spindles | 1A and 2 |
| what are the nerve fibers that come off of the golgi tendon | Ib |
| how does the deep tendon reflex work | intrafusal fibers in the muscle sense length of the muscle contract and signal via 1A fibers to the alpha motor neurons in the spinal cord to contract, this creates the reflex. |
| how do the golgi tendons work | sense tension in extrafusal muscle fibers and send signal to spinal cord that inhibits alpha motor neurons and relaxes muscle |
| what NT do Ia, Ib, and gamma neurons use | glutamate |
| what do the gamma neurons in the muscle spindle do | they will contract intrafusal fibers next to the muscle spindle when the muscle is relaxed so that the spindle always stays taut and the body knows the muscle length |
| which Cranial nerves come out of the brain stem medially | 3, 6 and 12 |
| what is the only cranial nerve to exit the brain stem dorsally | 4 |
| what is the superior colliculi | conjugate vertical gaze center |
| what is the inferior colliculi | connects to medial geniculate nucleus and is used in auditory processing |
| what is parinuad syndrome | lesion in superior colliculi leading to loss of conjugate vertical gaze |
| what is an example of a tumor that would affect the superior colliculi | pinealoma-> parinuad's syndrome |
| what does the pinal gland do | melatonin secretion, needed for circadian rythms |
| Name the 12 cranial nerves and whether they are motor, sensory or both | I-olfactory(S), II-optic(S), III-Oculomotor(M), IV-Trochlear(M), V-Trigeminal(B), VI-Abducens(M), VII-Facial(B), VIII-Auditory(vestibularcochlear)(S), IX- Glossopharyngeal(B), X-Vagus(B), XI-Spinal Accessory(M), XII-Hypoglossal(M) |
| Name the cranial nerve: Taste from posterior 1/3 of tongue | IX |
| Name the cranial nerve:parotid gland secretion | IX |
| Name the cranial nerve: lateral rectus | Abducens |
| Name the cranial nerve:constrict pupil | III |
| Name the cranial nerve: motor/sensory from GI tract | X |
| Name the cranial nerve:sensation from tonsils, pharynx, and middle ear | IX |
| Name the cranial nerve:sternocleidomastoid | XI |
| Name the cranial nerve:carotid sinus and body | IX |
| Name the cranial nerve:accommodation | III |
| Name the cranial nerve:sensation from face and teeth | V |
| Name the cranial nerve: sensation from eye | V |
| Name the cranial nerve:trapezius | XI |
| Name the cranial nerve:anterior 2/3 of taste | VII |
| Name the cranial nerve:sensation of anterior 2/3 of tongue | V |
| Name the cranial nerve: sensation of posterior 1/3 of tongue | IX |
| Name the cranial nerve: sensation from back of mouth | X |
| Name the cranial nerve: motor to tongue | XII |
| Name the cranial nerve:motor and sensory to pharynx, larynx, and bronchi | X |
| Name the cranial nerve:motor of facial expression muscles | VII |
| Name the cranial nerve:motor to stylopharyngeus muscle and upper pharynx | IX |
| Name the cranial nerve: motor to strap muscles | XI |
| Name the cranial nerve:motor to superior oblique | IV |
| Name the cranial nerve: secretion from lacrimal gland | VII |
| Name the cranial nerve:motor to muscles of mastication | V |
| what muscle is used to closed the eye | oblicuaris oculi |
| Name the cranial nerve: stapedius muscle in ear | VII |
| which cranial nerves emerge from medulla | 9, 10, 11, 12 |
| which cranial nerves emerge from pons | 5, 6, 7, 8 |
| which cranial nerves emerge from midbrain | 3, 4 |
| how does the corneal reflex work | feel touch with V and then close lid with VII |
| how does lacrimation nerve reflex work | feel touch with V and then secrete with VII (same as corneal) |
| how does jar jerk reflex work | feel it with V3 and then move it with V3 |
| how does the pupillary reflex work | see light with II and then constrict with III (parasympathetics) |
| which nerve does the gag reflex | IX |
| what arteries are referred to as the "arteries of cerebral hemorrhage" because they often clog or rupture in stroke | lenticulostriate (branch off MCA) |
| which cranial nerve arises btw the PCA and SCA | III |
| which cranial nerves are found in nucleus solitarius | VII, IX, X- visceral sensory information (taste, baroreceptors, gut distention) |
| which cranial nereves are found in the nucleus ambiguus | IX, X, XI - motor innervation of the pharynx, larynx, and upper esophagues(swallowing and speech) |
| What is found in the dorsal motor nucleus | parasympathetics to the heart, lungs, and upper GI |
| If someone loses the nucleus solitarius what would you expect | loss of taste |
| what would you expect if someone lost the nucleus ambiguus | trouble swallowing and non gag reflex |
| where does the olfactory nerve enter the skull | cribiform plate |
| where does the optic nerve enter the skull | optic canal |
| what leaves and enters the superior orbital fissure | CNIII, IV, V1, and VI |
| what leaves via the foramen rotundum | V2 |
| what leaves via the foramen ovale | V3 |
| what leaves via the foramen spinosum | Middle Meningeal A. |
| what leaves via the internal auditory meatus | VII and VIII |
| what leaves via the jugular foramen | IX, X, XI, and jugular vein |
| what leaves via the hypoglossal canal | XII |
| what leaves via the foramen magnum | XI and brain stem |
| where is the hypoglossal canal | next to the foramen magnum |
| where is the jugular foramen | next to the internal auditory meatus |
| where is the foramen rotundum | near the optic canal and super. orbital fissure |
| which is bigger, foramen ovale or spinosum | ovale |
| what vessels traverse the cavernous sinus | III, IV, V1, V2, VI and internal carotid A and pituitary. which Cranial nerve is found next to the carotid A in the cavernous sinus (by itself in the middle) |
| what is cavernous sinus syndrome | mass effect in sinus that leads to ophthalmopleagia, opthalmic and maxillary sensory loss (loss of II, IV, VI, and V1, V2) |
| what cranial nerve is injured if the pt can't say "Kuh-Kuh-Kuh", why? | X, palate elevation |
| what cranial nerve is injured if the pt can't say "La-la-la", why? | XII, tests tongue |
| what cranial nerve is injured if the pt can't say "Mi-Mi-Mi", why? | VII, tests lips |
| what are the muscles of mastication | masseter, temporalis, medial and lateral pterygoid |
| which muscles of mastication close the jaw | 3 M's Masseter, TeMporalis and Medial pterygoid |
| which muscles of mastication open the jaw | lateral pterygoid |
| what is the only nerve that ends in "glossus" that isn't innervated by the hypoglossal? | palatoglossus, CN X |
| all the muscles with "palat" in name except one? is innervated by? | all innervated by CN X, except tensor veli palatini which is CN V |
| what do C and alpha delta fibers do? | pain and temperature (free nerve endings) |
| what do meissner's corpuscles do | fine touch- finger tip receptors |
| where are meissner's corpuscles found | hairless skin(glabrous) |
| what are pacinian corpuscles | vibration sensors |
| where are pacinian corpuscles found | deep skin layers, ligaments and joints |
| what are merkel's disks, where are they found | fine touch (pressure) andnear hair follicles in skin |
| what is conductive hearing loss | when the mechanics of the ear cannot transmit sound wave (normal 8th nerve) |
| what is sensorineural hearing loss | when the 8th nerve can't relay info to cortex (normal inner ear) |
| which type of hearing loss results in a negative rinne test | conductive |
| what is the rinne test | when you test whether air or bone conduction is better using the mastoid process |
| what is the weber test | when you test to see if sound localizes to one ear or another |
| what type of hearing loss has sound localized to the normal ear during weber test? localized to bad ear? | normal-sensorineural, bad- conductive |
| which frequency are lost first (high or low) in elderly hearing loss first | high then low |
| what is the primary component of perilymph | Na+ |
| what is the primary component of endolymph | K+ |
| where is endolymph made | stria vascularis |
| what do the saccule and utricle detect | linear acceeleration |
| what do the semi circular canals detect | angular acceleration |
| what type of fluid is found within the structures of the inner ear | endolymph |
| what type of fluid surrounds the outside of the structures in the inner ear | perilymph |
| what are the otolithic organs | utricle and saccule (measure linear acceleration) |
| how do the semicircular canals work | endolymph inside moves and pushes the hair cells(kinocilium and sterocilia) which are part of the ampulla. |
| how does the utricle or saccule work | endolymph moves and presses kinocilium/sterocilia located in the macula. |
| what is the cochlea | part of inner ear where sound gets processed |
| how does the cochlea work | sound waves enter the cochlea via the inner ear bones, this deflects hair cells on the organ of corti which transmit message to 8th nerve |
| the hair cells in the ear that are short and stiff produce which type of frequencies | high |
| the hair cells in the ear that are long and flexible produce which type of frequencies | low |
| what is connected to the lens to make it move | ciliary process |
| what are the layers of the back of the eye | sclera->choroid-> retina-> vitreous humor |
| where is aqueous humor drained | in the anterior chamber by the canal of schlemm |
| what vessel is located directly above the optic nerve | opthalmic A. |
| what happens to the eye with 3rd nerve damage | eye is down and out |
| what happens to the eye with 4th nerve damage | eye is downward and diplopia |
| what happens to the eye with 6th nerve damage | eye is deviated medially |
| which muscle is innervated by the 6th nerve | lateral rectus |
| which muscle is innervated by the 4th nerve | superior oblique |
| how does the pupillary light reflex work | light enters eye-> Optic nerve goes to pretectum (near aquiduct)-> goes to Edinger-Westphal nucleus on both the left and right-> activates the third nerve-> that sends parasympathetics to the ciliary ganglia-> activates pupillary constrictor muscle. |
| Shine light in patients left eye, and you see no constriction in either eye, what is wrong | optic nerve on left is damaged (could be neurosphyillus) |
| Shine light in patients left eye, only see constriction in right pupil, what is wrong | 3rd nerve on left is damaged |
| shine light in patient's left eye, only see constriction in left pupil, what is wrong | 3rd nerve damage on the right |
| what is Marcus Gunn phenomenon | afferent pupillary defect (optic nerve damage) |
| knock out the optic nerve on the right before the chiasm, what does the patient lose | vision on the right (right anopia) |
| what causes right anopia | damage to the right optic nerve before the chiasm |
| damage at the optic chiasm causes what type of vision problem | bitemporal hemianopsia, loss of peripheral visual fields in both eyes |
| damage to the optic nerve on the right after the chiasm results in what type of visual loss | left homonymous hemianopia loss of vision on left side of each eye |
| patient loses vision on the left side of each eye, where is the damage | optic nerve just after the chiasm |
| what are the two branches made after the optic nerve synapses at the LGN, which lobe of the brain do each travel through | meyer's loop(temporal lobe) and dorsal optic radiation(parietal lobe) |
| the optic tract is severed at the right parietal lobe, what is the resulting vision loss | left lower quadrant anopia (both eyes) |
| patient loses vision in the left lower quandrant of each eye, where is the damage | parietal lobe of right brain |
| the optic tract is severed at the right temporal lobe, what is the resulting vision loss | left upper quadrant anopsia(both eyes) (pie in the sky) |
| pt loses vision in the upper left quadrant of each eye, where is the damage | right temporal lobe |
| patient loses vision in the center of their eyes, what causes this, what is this called | central scotoma caused by macular degeration |
| patient loses vision on the left side of each eye with central sparing, where is the damage | occipital lobe of right side. |
| does a blind person have pupillary light reaction | yes |
| does a blind person have neaer synkinesis | no |
| how does the lens round up | ciliary muscle constricts which relaxes the ciliary process and allows the lens to take natural relaxed shape |
| what is MLF syndrome | when you look one direction and the opposite eye doesn't follow and you get nystagmus in moving eye. This is caused by damage to the Medial Longitudinal Fasciculus (ex. looking right activates the VI nerve to constrict the lacteral rectus on the right, VI |
| patient is asked to look to their right, upon doing so they have nystagmus in their right eye and no movement of their left eye. What is this syndrome called? What is damaged? and what is a common cause? | called MLF syndrome, damage to the Medial longitudinal fasciculus on the left, commonly due to multiple sclerosis |
| What chemical is elevated suggesting a Neural tube defect | alpha-fetoprotein |
| Alpha feto-protein is elevated in a fetus, what does this suggest | Neural tube defect |
| what is spinal bifida occulta | failure of lamina to close but no herniation |
| what is a meningocele | when meninges herniate through the spinal canal defect |
| what is a meningomyelocele | when spinal cord and meninges herniate through spinal canal defect. |
| which type of neural tube defect is a/w a tuft of hair | spina bifida occulta |
| what is the least severe type of NTD | spina bifida occulta |
| what is the most severe type of NTD | meningomyelocele |
| what is arnold-chiari malformation | when cerebullum and caudal brain stem herniate through foramen magnum causing hydrocephalus. |
| what is holoprosencephaly | failure of the proencephalon(forebrain) to separate into two halves which often causes cyclopia(one eye). It is a/w patau's and Fetal ETOH syndome |
| baby has elevated AFP and polyhdramnios what is a likely diagnosis | anencephaly or NTD |
| what are the parts of the developing brain | telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon |
| what makes up the proencephalon | telencephalona dn diencephalon |
| what makes up the rhombencephalon(hindbrain) | met and myel encephalons |
| what part of the developing brain makes the cerebal hemispheres | telencephalon |
| what part of the developing brain makes the thalamus | diencephalon |
| what part of the developing brain makes the midbrain | mesencephalon |
| what part of the developing brain makes the pons | metencephalon |
| what part of the developing brain makes the cerebellum | metencephalon |
| what part of the developing brain makes the medulla | myelencephalon |
| what part of the developing brain makes the lateral ventricles | telencephalon |
| what part of the developing brain makes the 3rd ventricle | diencephalon |
| what part of the developing brain makes the aqueduct | mesencephalon |
| what part of the developing brain makes the 4th ventricle | metencephalon |
| is it a sign of Upper or lower motor neuron damage, atrophy | lower |
| is it a sign of Upper or lower motor neuron damage, fasciculation | lower |
| is it a sign of Upper or lower motor neuron damage, increased reflexes | upper |
| is it a sign of Upper or lower motor neuron damage, increased muscle tone | upper |
| is it a sign of Upper or lower motor neuron damage, decreased muscle tone | lower |
| is it a sign of Upper or lower motor neuron damage, babinski sign | upper |
| is it a sign of Upper or lower motor neuron damage, spastic paralysis | upper |
| what type spinal cord damage is seen in arnold-chiari malformation | syringomyelia |
| this dz presents with both upper and lower motor neuron deficits | ALS |
| this dz presents with only lower motor neuron deficits from destruction of the anterior horns | poliomyelitis (or Werdnig-Hoffman dz) |
| where does polio affect the spinal cord | anterior horns-> lower motor neuron deficit |
| what is werdnig-hoffman dz | damage of anterior horns of spinal cord causing lower motor neuron damage (tongue fasiculations, hyptotonia of muscles, flaccid paralysis) babies sit in frog leg position |
| what part of the spinal cord does MS affect | mostly white matter but it is asymmetrical and random demyelination |
| patient presents with loss of pain, temperature, and motor of both sides of their body but still have fine touch, vibration and pressure, what caused this | occulsion of the anterior spinal artery destroying everything except the dorsal columns |
| patient has loss of fine touch, vibrations, and pressure bilaterally. They have normal pain/temp, and motor, what caused this | loss of dorsal columns,occlusion of posterior spinal artery |
| degeneration of the dorsal columns and dorsal roots | tabes dorsalis (teriary syphilis) |
| patient complains of feeling no pain or temperature bilaterally, usually in upper extremities | syringomyelia from cyst in the central canal destroying the spinothalamic tract as it crosses spinal cord |
| loss of proprioception and ataxic gait, hyperreflexia | demyelination of dorsal columns, lateral corticospinal tract and spinocerebellar tract due to either B12 neuropathy or Friedreich ataxia |
| what does B12 neuropathy cause | demyelination of dorsal columns, lateral corticospinal tract and spinocerebellar tract (impaired vibration, propioception, and ataxia) |
| what is the brown-sequard lesion | hemisection of the spinal cord, you would see loss of pain and temperature contralaterally, loss of motor and pripioception ipsilaterally |
| patient presents with loss of pain and temperature contralaterally, loss of motor and pripioception ipsilaterally, what is wrong | hemisection of spinal cord(brown-sequard lesion) |
| Signs of horner syndrome | ptosis, miosis, and anhydrosis |
| what is a common cause of horner's | pancoast tumor, brown sequard above T1 |
| Name the brain lesion area, motor aphasia with comprehension | broca's (no talking) |
| Name the brain lesion area, sensory aphasia with poor comprehension | wernicke's (talk but make no sense) |
| Name the brain lesion area,conduction aphasia | arcuate fasiculus (area connecting wernicke's and broca's) |
| what is conduction aphasia | inability to repeat or name objects but have fluent speech and intact comprehension (damage to arcuate fasiculus-area connecting wernicke's and broca's) |
| Name the brain lesion area,kluver-Bucy syndrome | amygdala |
| what is kluver-bucy syndrome | hyperorality, hypersexuality, disinhibited behavior, inability to recognize faces and images (damage to limbic system) |
| Name the brain lesion area, personality changes | frontal lobe |
| Name the brain lesion area, reemergence of primitive reflexes | frontal lobe |
| Name the brain lesion area,spatial neglect syndrome | right parietal lobe |
| what is spatial neglect syndrome | (agnosia of the contralateral side of the world) |
| Name the brain lesion area, reduced levels of arousal and wakefulness (coma) | reticular activating system |
| Name the brain lesion area,wernicke-korsakoff | mammillary bodies |
| Name the brain lesion area, tremor at rest, chorea, athetosis | basal ganglia |
| Name the brain lesion area, intention tremor, limb ataxia | cerebellum hemisphere |
| T or F, damage of the left cerebellum produces deficits on the right side of the body | F, it is ipsilateral |
| Name the brain lesion area,truncal ataxia and dysarthria | cerebellar vermis |
| Name the brain lesion area,contralateral hemiballismus | subthalamic nucleus |
| Name the brain lesion area,anterograde amnesia | hippocampus |
| which direction would the eyes move if there is a lesion at the Frontal eye fields | toward the lesion |
| which direction would the eyes move if there is a lesion at the Paramedian pontine reticular formation | away from the lesion |
| where is the vermis of the cerebellum located relatively | centrally |
| what is athetosis | slow, writhing movements, especially of fingers. |
| what is hemiballismus | sudden failing of 1 arm. |
| what is a neurofibrillary plaque | phosphorylated tau protein |
| which type of amyloid plaque builds with alzheimer's | alpha/Beta amyloid |
| which patient population is at high risk of developing alzheimer's at a very early age | Down Syndrome |
| which genes are a/w alzheimer's | APOE E4 (late onset/familial) and presilin-1 and 2(early onset/familial) |
| what is the 1st and 2nd most common cause of dementia in the elderly | 1-alzheimers 2-multi-infarct dementia |
| what is seen on CT/MRI to diagnose alzheimer's | widening of sulci and ventricles with atrophy gyri(cortex) |
| what is Pick's dz | frontotemporal lobe atrophy from pick's bodies leading to parkinsonian aspects, aphasia and dementia |
| pt presents with aphasia, dementia and parkinsonian movements | Pick's Dz |
| what is a pick's body | intracellular aggregated tau proteins |
| what is lewy body dementia | parkinsonism with dementia and hallucinations. Caused by alpha-synuclein defect |
| pt presents with parkinson like movements, dementia and hallucinations, what is wrong | Lewy-body dementia, alpha-synuclein defect |
| pt presents with rapidly progressive dementia (weeks to months) and myoclonus | Creutzfelt-Jakob dz |
| Associated with lewy bodies, and depigmentation of substantia nigra pars compact | Parkinson's |
| caused by a defect in superoxide dismutase 1 | ALS |
| floppy baby presents with tongue fasiculations, what does it have and what is the problem | werdnig-Hoffman, degeneration of anterior horn |
| Pt presents with sore throat, fever, nausea followed by a period of muscle weakness, atrophy and hyporeflexia, what would their CSF fluid look like (glucose, protein, WBCs) | glucose normal, protein slightly high, and increased WBCs. This is due to poliovirus |
| Who has a higher risk of developing MS, a woman born in Connecticut or the same woman born in Texas? | Connecticut (higher prevalance, the further from the equator) |
| Pt presents with scanning speech, intention tremor, incontinence, internuclear ophthalmoplegia, and nystagmus, what's wrong | Multiple Sclerosis |
| Pt presents with slow movement of one eye while the other experiences nystagmus whent old to look to the right, he also has short clipped speech and tremor of the muscles that worsen upon movement, diagnosis | multiple scelerosis |
| autoimmune ddz a/w increased IgG in the CSF | multiple sclerosis |
| this demyelinating dz is a/w the JC virus and AIDS pts | progressive multifocal leukoencephalopathy (PML) |
| what is progressive multifocal leukoencephalopathy | demyelinating dz often seen in AIDS pts due to the JC virus |
| which lysosomal storage dz is a/w demyelination | metachromatic leukodystrophy |
| metachromatic leukodystrophy is what? | lysosomal storage dz, with a def. of arylsulfatase A leading to demyelination |
| what is guillain-Barre syndrome? what causes it? | a demyelinating dz of the peripheral nerves and motor fibers ventral roots usually due to molecular mimicry from infection, stress or inoculations where autoantibodies attack periperhal myelin |
| Common outcome of guillain-Barre? Treatment? | given respiratory support and plasmapheresis/IV Ig until pt recovers, most recover competely |
| this neurological dz presents with an elevated CSF protein but normal cell count(albuminocytologic dissociation) | guillain-Barre |
| what are the two types of seizures? what's the difference? | partial(involves 1 part of the brain) and generalized(diffuse involvement of the brain) |
| what are the two types of partial seizures? what's the difference? | simple (consciousness intact)and complex (impaired consciousness) |
| most common form of adult seizure | complex partial |
| T or F, partial seizures can never become generalized | F, they can |
| A kid comes in and is just staring off into space, what type of seizure should be suspected | absence (petit mal) |
| pt comes in with seizures, first the patient falls to the floor with clenched fists and jaw, loses his bladder control and then has a series of jerky movements afterward, what type of seizure is this | grand mal (tonic-clonic) |
| what is meant by myoclonic seizure | quick repetitive jerks |
| what is meant by tonic seizure | stiffening |
| what is meant by atonic seizure | falls to the floor, commonly mistaken for fainting |
| what is epilepsy | diorder characterized by multiple(recurrent) seizures |
| what is the number one causes of a epidural hematoma | rupture of the middle meningeal artery, often due to fracture of the temporal bone |
| patient comes in with head trauma, CT shows a "biconvex disk" near fracture, what is wrong | epidural hematoma |
| what is a subdural hematoma | venous bleeding with a delayed onset of symptoms |
| which type of hematoma in the head has a CT showing hemorrhage that crosses suture lines | subdural hematoma |
| what is a subarachnoid hemorrhage | rupture of an aneurysm, usually berry |
| patient presents with "the worst headache of the their life" and a yellow or bloody spinal tap | aubarachnoid hemorrhage |
| which type of hemorrhage in the skull appears crescent shaped | subdural |
| what is a parenchymal hematoma | one caused by HTN or DM, or tumor |
| where is the most common location of a berry aneurysm | bifurcation of the anterior communicating A. |
| what are charcot-Bouchard microaneurysms | aneurysms a/w HTN that affect small vessels |
| what is stuge weber syndrome | congenital disorder with port-wine stain and ipsilateral leptomeningeal angioma. |
| what is tuberous sclerosis | hamartomas in the CNS, skin, and other organs |
| what is von-Hippel Lindau dz | covernous hemangiomas in the skin, mucosea, and other organs, a/w renal cell carcinoma, hemangioblastomas in retina, brain stem and cerebellum |
| T or F, most of adult primary brain tumors are infratentorial | F, supratentorial |
| T or F, most of the children primary brain tumors are infratentorial | T |
| Most common primary tumor of adult brain | glioblastoma multiforme (grade IV astrocytoma) |
| what is the prognosis of a glioblastoma multiforme | poor (< 1 year) |
| patient has brain mass that shows "pseudopalisading" pleomorphic tumor cells which border central areas of necrosis and hemorrhage | glioblastoma multiforme |
| what is the second most common primary brain tumor in adults | meningioma |
| what do meningioma's develop from | arachnoid cells |
| brain tumor in adult with spindle cells aranged in a whorl pattern and psammoma bodies | meningioma |
| 3rd most common adult brain tumor | schwannoma |
| this brain tumor is often localized to the frontal lobes | oligodendroglioma |
| this brain tumor presents with chicken wire capillary patterns and a fried egg cell apparence | oligodendroglioma |
| this tumor is derived from rathke's pouch | craniopharyngioma |
| what is the most common childhood supratentorial tumor of the brain | craniopharyngioma |
| well circumscribed, brain tumor in a child that has eosinophilic corkscrew shaped fibers | pilocytic astrocytoma (low-grade) |
| highly malignant child brain tumor foudn in the cerebellum | medulloblastoma |
| this tumor is found in the 4th ventricle frequently | ependymoma |
| brain tumor a/w von-Hippel-Lindau | hemangioblastoma (found in cerebellum) |
| which brain tumor can lead to secondary polycythemia | hemangioblastoma (produces EPO) |
| this brain tumor is a/w foamy cells and high vascularity | hemangioblastomas |
| this brain tumor commonly has perivascular pseudorosettes and rod shaped basal ciliary bodies (blepharoplasts) | ependymoma |
| this brain tumor is highly radiosensitive in children | medulloblastoma |
| what is chiari I | low lying cerebellum obstructs CSF flow and compresses medulla, tonsils descend through foramen magnum |
| what is chiari II | cerebellar vermis and medulla desecnd through foramen magnum |
| what is chiari II | cerebellar vermis and medulla desecnd through foramen magnum, this is fatal |
| what is Dandy Walker syndrome | malformation of the posterior fossa that results in a large fossa, absent cerebellum and a cyst in its place |
| which way does the tongue deviate in a XII nerve lesion | toward side of lesion |
| which way does the jaw deviate in a CN V lesion | toward the lesion |
| which way does the patient fall with a unilateral lesion of the cerebellum | toward the side of lesion |
| which way does the uvula deviate with a CN X lesion | away from the lesion |
| which way is there weakness turning the head with a XI lesion | while turning away from lesion |
| which shoulder droops in a CN XI lesion | on side of lesion |
| patient presents with paraylsis of the lower face only | upper motor nerve lesion of the VIIth nerve |
| patient presents with ipsilateral paralysis of the whole face where is the lesion | lower motor neuron lesion of CN VII (Bell's Palsy) |
| what dz are a/w bell's palsy | lyme, AIDS, Sarcoidosis, Tumors, Diabetes |
| what is the falx cerebi | dividing tissue down the middle of the brain |
| patient presents with dilated pupil and ptosis on one side, homonymous hemianopia on the opposite eye and paraylsis on side of dilated pupil and duret hemorrhages | uncal herniation (destroys lateral corticospinal tract and third nerve and compresses PCA) |
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honered1
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