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BB2 Cards from FA
Brain and Behavior 2 Flashcards from First Aid
| Question | Answer |
|---|---|
| What are risk factors for suicide? | White, male, alone, prior attempts, presence and lethality of plan, medical illness, alcohol or drug use, on 3 or more prescription meds. |
| What is a memory key for suicide risk factors? | SAD PERSONS |
| What does SAD PERSONS represent? | Sex (male), Age, Depression, Previous attempt, Ethanol, Rational thought, Sickness, Organized plan, No spouse, Social support lacking |
| What are the 7 effects of long-term deprivation of affection? | 1. Weak2. Wordless3. Wanting (socially)4. Wary (lack trust)5. Weight loss6. anaclitic depression7. physical illness [Hint: 5 W's and 2 more] |
| What is the result of severe long-term deprivation of affection? | death |
| Irreversible changes of long term deprivation of affection occurs after how long? | 6 months |
| What is anaclitic depression? | depression in an infant owing to continued separation from caregiver--can result in failure to thrive. Infant becomes withdrawn and unresponsive |
| What can cause regression to younger behavior in children? | Stress:- physical illness- punishment- birth of new sibling- tiredness |
| What are evidence of physical abuse in children? | - healed fractures on x-ray- cigarette burns- subdural hematomas- multiple bruises- retinal hemorrhage or detachment |
| Who is usually the abuser in physical abuse in children? | female primary caregiver |
| Physical abuse in children leads to how many deaths in the U.S.? | ~3000 deaths/yr. |
| At what ages does sexual abuse in children peak? | 9 to 12 years of age |
| What are evidence of sexual abuse in children? | genital/anal trauma, STDs, UTIs |
| Who is usually the abuser in sexual abuse in children? | known to victim, usually male |
| What are the developmental milestones at about 3 months old in an infant? | - holds head up- social smile- Moro reflex disappears |
| What are the developmental milestones at about 4-5 months old in an infant? | - rolls on back- sits when propped |
| What are the developmental milestones at about 7-9 months old in infancy? | - stranger anxiety- sits alone- orients to voice |
| What are the developmental milestones at about 12-14 months old in infancy? | - upgoing Babinski disappears |
| What are the developmental milestones at about 15 months old in infancy? | - walking- few words- separation anxiety |
| When does a child achieve object permanence? | Toddler, 12-24 months old |
| When does a child achieve rapprochement? | Toddler, 18-24 months old |
| When can a child parallel play? | Toddler, 24-48 months old |
| When does a child achieve core gender identity? | Toddler, 24-36 months old |
| When does a child become toilet trained? | Preschool, 30-36 months old |
| What are the development milestones at about 3 years old in preschool? | - group play- rides tricycle- copies line or circle drawing |
| What are the development milestones at about 4 years old in preschool? | - cooperative play- simple drawings (stick figure)- hops on 1 foot |
| What are the developmental milestones during the schoolage years (6-11y/o)? | - development of conscience (superego)- same-sex friends- identification with same-sex parent |
| What are the developmental milestones during adolescence? | - abstract reasoning (formal operations)- formation of personality |
| When is adolescence for boys and for girls? | Boys: 13 years oldGirls: 11 years old |
| What are the 5 changes in the elderly? | 1. sexual changes: sexual interest does NOT decrease (men: slower erection/ejaculation, longer refractory period; women: vaginal shortening, thinning, dryness)2. sleep patterns: decreased REM, decreased slow-wave sleep, increased sleep latency, increase |
| What are the Kubler-Ross dying stages? | Denial-Anger-Barganing-Grieving-Acceptancedon't occur necessarily in this order[Hint: Death Arrives Brining Grave Adjustments] |
| What is grief? | normal bereavement characterized by shock, denial, guilt, and somatic symptomsTypically lasts 6mo. to 1yr. |
| What is pathologic grief? | includes excessively intense or prolonged grief or grief that's delayed, inhibited, or denied |
| Name 2 neurotransmitter changes associated with depression. | Decreased NE and serotonin (5-HT) |
| Name 1 neurotransmitter change associated with Alzheimer's disease. | Decreased Ach |
| Name 2 neurotransmitter changes associated with Huntington's disease. | Decreased GABA and Ach |
| Name 1 neurotransmitter change associated with Schizophrenia | Increased Dopamine |
| Name 1 neurotransmitter change associated with Parkinson's disease. | Decreased Dopamine |
| Name 7 functions of the frontal lobe. | Concentration, Orientation, Language, Abstraction, Judgment, Motor regulation, Mood |
| What is the most notable change in function in a frontal lobe lesion? | Lack of social judgment |
| What percentage of time is spent in stage 1 sleep? | 0.05 |
| What percentage of time is spent in stage 2 sleep? | 0.45 |
| What percentage of time is spent in stage 3-4 sleep? | 0.25 |
| What percentage of time is spent in REM sleep? | 0.25 |
| Name 5 possible waveform patterns seen in the various sleep/wake stages. | Alpha, Beta (highest frequency, lowest amplitude), Theta, Delta (lowest frequency, highest amplitude), Sleep spindles with K-complexes |
| What waveform pattern is seen in a young adult who is awake (eyes open), alert, and has active mental concentration? | Beta waves |
| What waveform pattern is seen in a young adult who is awake but has his/her eyes closed? | Alpha waves |
| What waveform pattern is seen in a young adult who is in light (stage 1) sleep? | Theta waves |
| What waveform pattern is seen in a young adult who is in deeper (stage 2) sleep? | Sleep spindles and K-complexes |
| What waveform pattern is seen in a young adult who is in the deepest, Non-REM (stage 3-4) sleep? | Delta waves |
| What waveform pattern is seen in a young adult who is in REM sleep? | Beta waves |
| What is a helpful mnemonic for the order of the corresponding waveform patterns in each stage of sleep? | At night, BATS Drink Blood. |
| Name 3 possible findings in non-REM sleep. | Sleepwalking, night terrors, and bedwetting |
| Name 5 possible findings in REM sleep. | Dreaming, loss of motor tone, possible memory processing function, erection, and increased brain 02 use |
| What is considered the key to initiating sleep? | Serotonergic predominance of the raphe nucleus |
| What neurotransmitter can reduce REM sleep? | NE |
| Extraocular movements during REM sleep are due to what portion of the brain? | Parapontine Reticular Formation/Conjugate Gaze Center |
| What phenomenon caused REM sleep to be known as 'paradoxical' or 'desynchronized' sleep? | The EEG pattern during REM sleep is the same as the EEG of a person that is awake and alert. |
| What medication shortens stage 4 sleep and is useful in the treatment of night terrors and sleepwalking? | Benzodiazepines |
| What medication shortens stage 4 sleep and can be used to treat enuresis? | Imipramine |
| Name 4 physiological actions found in REM sleep. | Increased/variable pulse, rapid eye movements, increased/variable blood pressure, and penile/clitoral tumescence |
| How often does REM sleep occur? | Every 90 minutes (duration may increase during the night) |
| Does REM sleep increase or decrease with age? | Decreases |
| What is the principal neurotransmitter involved in REM sleep? | Ach |
| Distinguish between central and obstructive sleep apnea. | In central sleep apnea, there is no respiratory effort. In Obstructive sleep apnea, there is respiratory effort against airway obstruction. |
| Define sleep apnea. | Person stops breathing for at least 10 seconds during sleep. |
| Name five findings associated with sleep apnea. | Obesity, loud snoring, systemic/pulmonary HTN, arrhythmias, and possibly sudden death. |
| Name a possible chronic outcome of sleep apnea. | Chronic fatigue |
| What is narcolepsy? | Person falls asleep suddenly |
| Are hallucinations common in narcolepsy patients? | Yes. Both hypnagogic (just before sleep) and hypnopompic (with awakening) are both common. |
| Define cataplexy. | Sudden collapse (falls asleep) while awake. |
| Does narcolepsy have a genetic component? | Yes. Studies have shown a strong genetic component of narcolepsy. |
| What is a common treatment for narcolepsy? | Stimulants (e.g. amphetamines) |
| Name 3 changes in sleep stages often found in people with depression. | 1. Reduced slow-wave sleep 2. Decreased REM latency 3. Early morning awakening (important screening question) |
| Name 2 effects of stress on the body. | 1. Induces production of FFA, 17-OH corticosteroids, lipids, cholesterol, and catecholamines 2. Affects water reabsorption, muscular tonicity, gastrocolic reflex, and mucosal circulation. |
| What 3 things does the differential diagnosis for sexual dysfunction include? | 1. Drugs (e.g. antiHTN, neuroleptics, SSRIs, and ethanol) 2. Diseases (e.g. depression and diabetes) 3. Psychological (e.g. performance anxiety) |
| What is the order of loss or orientation? | Time, place, and Person |
| What questions do you have to answer when assessing an patient's orientation? | Is the patient aware of him/herself as a person? Does the patient know his/her name? |
| Define Anosognosia. | being unaware that one is ill |
| Define Autotopagnosia. | Being unable to locate one's own body parts |
| Define depersonalization. | body seems unreal or dissociated |
| A person who is unable to remember things that occurred after a CNS insult has…? | Anterograde Amnesia |
| Anterograde amnesia caused by thiamine deficiency? | Korsakoff's amnesia |
| What is destroyed in Korsakoff's Amnesia? | Mamillary bodies(bilaterally) |
| What patient population will you see Korsakoff's? | Alcoholics |
| What else is classically associated with Korsakoff's? | Confabulations, ie. Making it up as you go along |
| What is the inability to remember things that happened before CNS insult? | Retrograde Amnesia |
| What is retrograde amnesia a complication of? | ECT-electroconvulsive therapy(shock) |
| What are the maladaptive signs of substance use? | Tolerance, Withdrawl, Substance taken in larger amounts than intended, Persistent desire or attempst to cut down, lots of energy spent trying to obtain substance, withdrawl from responsibility, used continued in spite of knowing the problems that it cause |
| How is maladaptive pattern of substance abuse defined? | 3 or more of the above signs in 1 year |
| What is the definition of substance abuse? | maladaptive pattern of use leading to clinically significant impairment or distress, symptoms have not met criteria for dependence |
| What is the criterion for dx of substance abuse? | One or more of the following in 1 year: Recurrent use resulting in failure to complete responsiblities, recurrent use in physically hazardous situations, recurrent legal problems, continued use in spite of persistent problems of use |
| What are the signs of alcohol use? | Disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts |
| What are the signs of alcohole withdrawl? | Tremor, Tachycardia, HTN, malaise, nausea, seizures, delirium tremens, tremulousness, agitation, hallucinations |
| What are the signs of opioid intoxication? | CNS depression, nausea and vomiting, constipation, pupillary constriction, seizures |
| What are the signs of opioid withdrawl? | Anxiety, insomnia, anorexia, sweating/piloerection(cold turkey), fever, rhinorrhea, nausea, stomach cramps, diarrhea, flu-like symptoms, yawning |
| What are the signs of Amphetamine intoxication? | Psychomotor agitation, impaired judgement, pupillary dilation, HTN, tachycardia, euphoria, prolonged wakefulness and attention, cardiac arrhythmias, delusions, hallucinations, fever |
| What are the signs of Amphetamine withdrawl? | Post-use crash, including anxiety, lethargy, headache, stomach cramps, hunger, severe depression, dysphoric mood, fatigue, insomnia/hypersomnia |
| What are the signs of cocaine intoxication? | Euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, HTN, hallucinations(including tactile:bugs on skin), paranoid ideations, angina, and sudden cardiac death |
| What are the signs of cocaine withdrawl? | Hypersomnolence, fatigue, depression, malaise, severe craving, suicidality |
| Whare are the signs of PCP intoxication? | Belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis and delirium |
| What are the signs of PCP withdrawl? | Recurrence of intoxication symptoms due to reabsorption in GI tract, sudden onset of severe, random, homicidal violence |
| What are the signs of LSD intoxication? | Marked anxiety and depression, delusions, visual hallucinations and flashbacks |
| Whare are the signs of Marijuana intox? | Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired jugdment, social withdrawl, increased appetite, dry mouth and hallucinations |
| What are the signs of Barbiutate intox? | respiratory depression |
| Whar are the signs of barbituate withdrawl? | Anxiety, seizures, delirium, life-threatening CV collapse |
| Whare are the signs of Benzodiazepine intox? | Amnesia, ataxia, somnolence, minor resp depression |
| What are the signs of benzo withdrawl? | Rebound anxiety, seizures, tremor, insomnia |
| Whare are the signs of caffeine intox? | restlessness, insomina, increased diuresis, muscle twitching, cardiac arrhythmias |
| What are the signs of caffeine withdrawl? | Headache, lethargy, depression, weight gain |
| Who do you need to see to witness caffeine withdrawl approx every six weeks? | Blake Williams |
| What are the symptoms of nicotine intoxication? | Restlessness, insomnia, anxiety, arrhythmias |
| Whar are the signs of nicotine withdrawl? | Irritablility, headache, anxiety, weight gain, craving, tachycardia |
| What is the trigger for DT's? | alcohols withdrawl |
| When do DT's peak? | 2-5 days after last drink |
| Are DT's life threatening? | Yes |
| What are the symptoms of DT's(in order of appearance)? | ANS Hyperactivity(tachycardia, tremors, and anxiety), Psychotic symptoms(hallucinations, delusions), confusion |
| How many heroin addicts are there in the US? | ~500,000 |
| Is Heroin prescribable? | NO, it is schedule I (ie. not prescribable) |
| What are the signs of narcotic abstinence syndrome? | dilated pupils, lacrimation, rhinorrhea, sweating, yawning, irritability, and muscle aches |
| What is a hallmark sign of heroin addiction? | track marks |
| What are some related diagnoses of Heroin addicts? | Hepatitis, abscesses, OD, hemorrhoids(reason enough to shy away), AIDS, and right-sided endocarditis |
| What are 2 opioid comptetitive inhibitors? | Naloxane and Naltrexone |
| What drug is used for long term maintenance of heroin detox? | Methadone |
| What are the characteristics of Delirium? | Decreased attention span and level of arousal, disorganized thinking, hallucinations, illusions, misperceptions, disturbance of sleep-wake cycle, cognitive dysfxn |
| What is the most common psych illness on medical and surgical floors? | Delirium, often reversible |
| What is the key to delirium diagnosis? | Waxing and waning level of conciousness that develops rapidly |
| What are some common causes of delirium? | substance use/abuse or medical illness |
| Whare are the characteristics of Dementia? | development of mulitple cognitive deficits: memory, apahasia, apraxia, agnosia, loss of abstract thought, behavioral/personality changes, impaired judgement |
| What is the key to dementia diagnosis? | rule out delirium-patient is alert, no change in level of conciousness. More often gradual onset. |
| What can be confused with dementia in elderly? | depression |
| What is dementia characterized by? | commonly irreversible memory loss |
| How is a major depressive episode characterized? | 5 of the following for 2 weeks, including (1) depressed mood or (2) anhedoniSleep disturbances, Loss of Interest, Guilt, Loss of Energy, Loss of Concentration, Change in Appetite, Psychomotor retardation, Suicidal ideation, Depressed mood |
| How is a major depressive disorder characterized? | Recurrent-requires 2 or more depressive episodes with a symptom free interval of 2 months |
| What is the lifetime prevalence for Major Depressive Disorder in Males and Females: | 13% for males, and 21% for females |
| What is Dysthymia? | milder form of depression lasting at least 2 years |
| Define a Manic episode. | Distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week |
| To be a manic episode what characteristic behaviors must be present? | 3 or more of the following: Distractibility, Insomnia, Grandiosity, Flight of Ideas, Inc in Activity/pyschomotor agitation, Pressured Speech, Thoughtlessness |
| What is a Hypomanic Episode? | it is like a manic episode except mood disturbance is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization; no psychotic features |
| How many criteria sets exist for bipolar disorder? | 6 separate criteria exist for bipolar disorders with combinations of manic, hypomanic, and depressed episodes |
| Bipolar I describes? | manic |
| Bipolar II describes? | hypomanic |
| What is drug of choice for bipolar? | Lithium |
| What is Cyclothymic disorder? | milder form of bipolar lasting at least 2 years |
| If a patient consciously fakes or claims to have a disorder in order to attain a specific gain, how is this behavior described? | Malingering |
| In what kind of disorder does a person consciously create symptoms in order to assume a sick role and get medical attention? | Factitious Disorder |
| What syndrome is manifested by a chronic history of multiple hospital admissions and willingness to receive invasive procedures? | Munchausen's |
| What is it called when a parent causes their child to become ill in order to receive attention? | Munchausen's by proxy |
| Is the motivation concious in Munchausen's by proxy? | NO |
| What are the 6 somatoform disorders? | conversion, somatoform pain disorder, hypochondriasis, somatization disorder, body dysmorphic disorder, pseudocyesis |
| Are the illness production and motivation in somatoform disorders consicous drives? | No |
| Define Conversion disorder. | symptoms suggest motor or sensory neurologic or physical disorder, but tests and PE are negative |
| What is a pain somatoform disorder? | pain that is not explained completely by illness |
| What is Hypochondriasis? | misinterpretation of normal physical findins, leading to preoccupation with and fear of having a serious medical illness in spite of medical reassurance |
| What is a somatization disorder? Varitey of complaints in multiple organ systems | |
| Whate is body dysmorpic disorder? | patient is convinced that part of one's own anatomy is malformed |
| Whate is pseudocyesis? | false belief of being pregnant associated with objective signs of pregnancy |
| What is primary gain? | what the symptom does for the patient's internal psychic economy |
| What is secondary gain? | What the symptoms gets the patient(sympathy or attention) |
| What is tertiary gain? | what the caretaker gets |
| Define a panic disorder. | Discrete period of intense fear and discomfort peaking in 10 minutes with 4/5 characteristics |
| What are the 5 characteristics of panic? | Palipitations, Abdominal distress, Nausea, Increased perspiration, Chest pains, chills and choking |
| When must a painc disorder be dx? | in the context of the occurrence |
| What is a phobia? | fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or entity |
| What does exposure to object of phobia evoke? | an anxiety response |
| Does the person who has the phobia recognize their fear as excessive? | yes, they are exhibiting insight |
| What are treatment options of phobias? | systematic desensitization |
| Does the phobic fear interfere with normal routine? | yes |
| what is the fear of marriage? | gamophobia |
| what is the fear of pain? | algophobia |
| what is the fear of heights? | acrophobia |
| what is the fear of open places? | agoraphobia |
| What is post-traumatic stress disorder? | when a person experienced or witnessed an event that involoved actual or threatened death or serious injury. The traumatic event is reexperienced; person persistently avoids stimuli associated with the trauma and experiences persistent symptoms of increas |
| What is the response to the traumatic event? | intense fear, helplessness or horror |
| How long does the disturbance due to PSSD last? | > 1 month and causes distress or social/occupational impairment |
| Define Personality trait. | an enduring pattern of perceiving, relating to, and thinking about the environment and oneself that is exhibited in a wide range of important social and personal contexts |
| Define Personality disorder | when patterns become inflexible and maladaptive, causing impairment in social or occupational functioning or subjective distress |
| How are Cluster A personalities described? | as odd or ecentric; cannot develop meaningful social relationships; Weird |
| What are the types of Cluster A personalities? | Paranoid, Schizoid, Schizotypal |
| Describe a Paranoid Personality | distrustful and suspicious; projection is main defense mech |
| Describe a Schizoid Personality. | voluntary social withdrawl; no psychosis; limited emotional expression |
| Describe a Schizotypal Personality. | interpersonal awkwardness, odd thought patterns and appearance |
| How are Cluster B personalities described? | Dramatic, emotional, or erratic; Wild |
| Name the types of Cluster B personalities. | Antisocial, Borederline, Histrionic, Narcissistic |
| How would you describe an Antisocial? | as having a disregard for and violation of rights of others, criminality |
| Who are more likely to be antisocial, male or female? | male |
| How would you describe a Borderline personality? | unstable mood and behavior; impulsive, sense of emptiness |
| Who are more likely to be borderline, male or female? | female |
| How would you describe a histrionic personality? | excessive emotionally, somatization, attention seeking, sexually provocative |
| How would you desribe a Narcissistic personality? | grandiosity; sense of entitlement, many demand 'top' physician/best health care |
| How are Cluster C personalities described? | Anxious and fearful, 'Worried' |
| What are the types of Cluster C personalities? | Avoidant, Obsessive-Compulsive, Dependent |
| How would you describe an avoidant personality? | sensitive to rejection, socially inhibited, timid, feelings of inadequacy |
| How would you decribe an obsessive-compulsive? | preoccupation with order, perfectionism and control |
| How would you decribe a dependent personality? | submissive and clinging, excessive need to be taken care of, low self-confidence |
| Hallucinations are…. | perceptions in the absence of external stimuli |
| Illusions are…. | misinterpretation of actual external stimuli, ex. Mistaking coat rack for man |
| Delusions are…. | false beliefs not shared by other memebers of culture/subculture that are firmly maintained in spite of obvious proof to the contrary |
| What is the difference between delusions and loos associations? | delusion is a disorder in the content of thought(the actual idea) where a loose association is a disorder in the form of thought(the way the idea is tied together) |
| How many hallucination types are there? Name them. | 7; Visual, Auditory, Olfactory, Gustatory, Tactile, Hypnagogic, Hypnopompic |
| When are the halluinations common? | Visual(acute organic brain syndrom), Auditory(Schizophrenia), Olfactory(aura of psychomotor epilepsy), Gustatory(rare), Tactile(DT's and Cocaine abusers), Hypnagogic(while going to sleep), Hypnopmpic(while waking from sleep) |
| How is Schizophrenia described? | periods of psychosis and disturbed behavior lasting >6months, |
| What are the Positive symptoms of Schizophrenia? | Hallucinations, delusions, strange behavior and loose associations |
| What are the negative symptoms of schizophrenia? | flat affect, social withdrawl, thought blocking, lack of emotion |
| Whare are the 4 A's of schizophrenia? | Ambivalence(uncertainty), Autism(self-preoccupation and lack of communication), Affect(blunted), Associations(loose) |
| Name the 5 subtypes of schizophrenia. | Disorganized, Catatonic, paranoid, Undifferentiated, Residual |
| What is the Fifth A? | Auditory hallucinations |
| What are the etiologic factors for schizophrenia? | genetics and environment, genetics outweigh env |
| What is the lifetime prevalence for schizophrenia? | 1.5%-(males/females, blacks/whites) presents earlier in men |
| What is a schizoaffective disorder? | a combo of schizophrenia and a mood disorder |
| What is Electroconvulsive Therapy(ECT)? | a tx option for major depressive disorder refractory to other tx. It is painless and produces a seizure with transient memory loss and disorientation. |
| What complication result from ECT? | complications associated with anesthesia and retrograde amnesia |
| What are Freud's three structures of the mind | -Id-Superego-Ego |
| What thought structures is the Id responsible for? (3 things) | - Primal urges-sex-agression(Think-'I want it') |
| What thought structures is the Superego responsible for? (2 things) | - Moral values-conscience(Think-'You know you cant have it') |
| What thought structures is the Ego responsible for? | Bridge and mediator between the unconscious mind and the world (Think-Deals with conflict) |
| Define ego defenses. | automatic and unconscious reactions to phychological stress |
| What are the MATURE ego defenses? (4) | -Sublimation-Altruism-Suppression-Humor(Mneumonic: Mature women wear a SASH) |
| Define altruism. | Guilty feelings alleviated by unsolicited generosity toward others |
| What is an example of altruism? | Mafia boss makes large donation to charity |
| Define humor. | Appreciating the amusing nature of an anxiety-provoking or adverse situation |
| What is an example of humor? | Nervous medical student jokes about the boards |
| Define sublimation. | Process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with one's value system. |
| What is an example of sublimation? | Aggressive impulses used to succeed in business ventures |
| Define suppression. | Voluntary (unlike other defenses) withholding of an idea of feeling from conscious awareness |
| What is an example of suppression? | Choosing not to think about the USMLE until the week of the exam |
| What are the immature ego defenses? (12) | Acting out, Disassociation, Denial, Displacement, Fixation, Identification, Isolation, Projection, Rationalization, Reaction formation, Regression, Repression |
| Define acting out. | Unacceptable feelings and thoughts are expressed through actions |
| What is an example of acting out? | Temper tantrums |
| Define dissociation. | Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress |
| What is an example of dissociation? | Extreme forms can result in multiple personalities (dissociative identity disorder). |
| Define denial. | Avoidance of awareness of some painful reality |
| What is an example of denial. | A common reaction in newly diagnosed AIDS and cancer patients |
| Define displacement. | Process whereby avoided ideas and feelings are transferred to some neutral person or object |
| What is an example of displacement? | Mother yells at child because she is angry at her husband |
| Define fixation. | Partially remaining at a more childish level of development |
| What is an example of fixation? | Men fixating on sports games |
| Define identification. | Modeling behavior after another person |
| What is an example of identification? | Abused child becomes an abuser |
| Define isolation. | Separation of feelings from ideas and events |
| What is an example of isolation? | Describing murder in graphic detail with no emotional response |
| Define projection. | An unacceptable internal impulse that is attributed to an external source |
| What is an example of projection? | A man who wants another woman thinks his wife is cheating on him |
| Define rationalization. | Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame |
| What is an example of rationalization? | Saying the job was not important anyway, after getting fired |
| Define reaction formation. | Process whereby a warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite |
| What is an example of reaction formation? | A patient with libidinous thoughts enters a monastery |
| Define regression. | Turning back the maturational clock and going back to earlier modes of dealing with the world |
| What is an example of regression? | Seen in children under stress (eg., bedwetting) and in patients on dialysis (eg., crying) |
| Define repression. | Involuntary withholding of an idea or feeling from conscious awareness. |
| What is the basic mechanism underlying all ego defenses? | Repression |
| What term fist described by Freud is used to refer to repressed sexual feelings of a child for the opposite-sex parent, accompanied by rivalry with same-sex parent? | Oedipus comple |
| XWhat are the four factors in hopelessness? | -Sense of Impotence (powerlessness)-Sense of Guilt-Sense of Anger-Sense of loss/Deprivation leading to depression(Mnemonic IGAD!) |
| Define classical conditioning. | Learning in which a natural response is elicited by a conditioned stimulus that previously was presented in conjunction with an unconditioned stimulus |
| Give an example of classical conditioning. | Pavlov's dogs (ringing of a bell provoked salivation in dogs) |
| Which is the natural response in Pavlov's experiment? | salivation |
| Which is the conditioned (learned) stimulus in Pavlov's experiment? | ringing bell |
| Which is the unconditioned stimulus in Pavlov's experiment? | food |
| Define operant conditioning. | Learning in which a particular action is elicited because it produces a reward |
| What is positive reinforcement? | the desired reward which produces an action |
| Give an example of positive reinforcement of opperative conditioning. | a mouse presses a button to get food |
| What is negative reinforcement? | the removal of an aversive stimulus so as to increase behavior |
| Give an example of negative reinforcement of opperative conditioining. | a mouse presses a button to avoid shock (do not confuse with punishment) |
| What type of behavior requires a continuous reinforcement schedule? | behavior which shows the most rapid extinction when not rewarded |
| Give an example of continuous reinforcement schedule. | A person gets upset when a vending machine doesn't work |
| What type of behavior requires a variable ratio reinforcement schedule? | behavior which shows the slowest extinction when not rewarded |
| Give an example of variable ratio reinforcement schedules. | A person continuing to play a slot machine at a casino |
| What term is used to describe the form of insight therapy developed by Freud which is often used for changing chronic personality problems? | Psychoanalysis |
| Name 4 characteristics of psychoanalysis. | -costly-lengthy-intensive-places great demands on the patient |
| What is the topographical term used in psychoanalysis used to describe what you are aware of? | Conscious |
| What is the topographical term used in psychoanalysis used to describe what you are able to make conscious with effort? | Preconscious |
| Give an example of preconscious topography. | remembering your phone number |
| What is the topographical term used in psychoanalysis to describe what you are not aware of? | Unconscious |
| What is the central goal of Freudian psychoanalysis? | To make the patient aware of what is hidden in his/her unconscious |
| What are the two most famous forms of intelligence testing? | Stanford-Binet and Wechsler |
| What number is defined as the mean for standard IQ testing? | 100 (with a standard deviation of 15) |
| What is the IQ criteria for diagnosis of mental retardation? | IQ lower than 70 (or 2 standard deviations below the mean) |
| What are two factors with which IQ scores are correlated? | Genetics and school achievement |
| Is IQ testing more highly correlated with genetics or school achievement? | School achievement |
| According to the Homunculus man, place the following in order (from medial to lateral). hand, foot, tongue, face, trunk | foot, trunk, hand, face, tongue |
| (T or F) Can Bell's palsy occur idiopathically? | TRUE |
| (T or F) Can fasiculations be present in a LMN lesion? | TRUE |
| (T or F) Is the anterior nucleus of the thalamus part of the limbic system? | TRUE |
| (T or F) Is the cingulate gyrus part of the limbic system? | TRUE |
| (T or F) Is the Entrorhinal cortex part of the limbic system? | TRUE |
| (T or F) Is the hippocampal formation part of the limbic system? | TRUE |
| (T or F) Is the mammillary body part of the limbic system? | TRUE |
| (T or F) Is the septal area part of the limbic system? | TRUE |
| (T or F) Thoracic outlet syndrome results in atrophy of the interosseous muscles? | TRUE |
| (T or F) Thoracic outlet syndrome results in atrophy of the thenar and hypothenar eminences? | TRUE |
| (T or F) Thoracic outlet syndrome results in disappearance of the radial pulse upon moving the head to the opposite side? | TRUE |
| (T or F) Thoracic outlet syndrome results in sensory deficits on the medial side of the forearm and hand? | TRUE |
| A lesion of the globus pallidus causes what disease? | Wilson's disease |
| A lesion of the mammillary bodies (bilateraly) produces what? | Wernicke-Korsakoff's encephalopathy (confabulations, anterograde amnesia) |
| A lesion of the optic chiasm produces? | bitemporal hemianopsia |
| A lesion of the right dorsal optic radiation (parietal lesion) produces? | left lower quadrantic anopsia (a temporal lesion) |
| A lesion of the right Meyer's loop (temporal lobe) produces? | left upper quadrantic anopsia (a temporal lesion) |
| A lesion of the right optic nerve produces? | right anopsia |
| A lesion of the right optic tract produces? | left homonymous hemianopsia |
| A lesion of the right visual fibers just prior to the visual cortex produces? | left hemianopsia with macular sparing |
| A lesion of the Striatum can cause which 2 diseases? | Huntington's and Wilson's disease |
| A positive Babinski is an indicator for a (UMN or LMN) lesion? | UMN lesion |
| A rupture of the middle menigeal artery causes what type of hematoma? (epidural or subdural) | epidural hematoma |
| A rupture of the superior cerebral veins causes what type of hematoma? (epidural or subdural) | subdural hematoma |
| An aneurysm of the anterior communicating artery may cause what type of defects? | visual defects |
| An aneurysm of what artery may cause CN III palsy? | posterior communicating artery |
| Are D1 neurons in the basal ganglia inhibitory or excitatory? | Excitatory |
| Are D2 neurons in the basal ganglia inhibitory or excitatory? | Inhibitory |
| Beginning with anterior communicating artery describe the path around the circle of Willis. | ant. comm. - ACA - ICA - post. comm. - PCA - PCA - post. comm. - ICA - ACA - ant. comm. |
| Bell's Palsy is seen as a complication in what 5 things? | AIDS, Lyme disease, Sarcoidosis, Tumors, Diabetes (ALexander Bell with STD) |
| Brodmann's area 17 is? | principal visual cortex |
| Brodmann's area 22 is? | Wernicke's area (associative auditory cortex) |
| Brodmann's area 3,1,2 is? | principal sensory area |
| Brodmann's area 4 is? | principal motor area |
| Brodmann's area 41, 42 is? | primary auditory cortex |
| Brodmann's area 44, 45 is? | Broca's area (motor speech) |
| Brodmann's area 6 is? | premotor area |
| Brodmann's area 8 is? | frontal eye movement and pupilary change area |
| CN I has what function? | smell |
| CN I passes through what 'hole'? | cribriform plate |
| CN II has what function? | sight |
| CN II passes through what 'hole'? | optic canal |
| CN III has what 4 functions? | eye movement, pupil constriction, accommodation, eyelid opening |
| CN III inervates what 5 muscles. | medial rectus, superior rectus, inferior rectus, inferior oblique, levator palpebrae superioris |
| CN III passes through what 'hole'? | superior orbital fissure |
| CN IV has what function? | eye movement |
| CN IV inervates what muscle. | superior oblique |
| CN IV passes through what 'hole'? | superior orbital fissure |
| CN IX has what 4 functions? | posterior 1/3 taste, swallowing, salivation (parotid), monitoring carotid body and sinus |
| CN IX passes through what 'hole'? | jugular foramen |
| CN V has what 2 functions? | mastication, facial sensation |
| CN V1 passes through what 'hole'? | superior orbital fissure |
| CN V2 passes through what 'hole'? | foramen rotundum |
| CN V3 passes through what 'hole'? | foramen ovale |
| CN VI has what function? | eye movement |
| CN VI inervates what muscle. | lateral rectus |
| CN VI passes through what 'hole'? | superior orbital fissure |
| CN VII has what 4 functions? | facial movement, anterior 2/3 taste, lacrimation, salivation(SL, SM glands) |
| CN VII passes through what 'hole'? | internal auditory meatus |
| CN VIII has what 2 functions? | hearing, balance |
| CN VIII passes through what 'hole'? | internal auditory meatus |
| CN X has what 5 functions? | taste, swallowing, palate elevation, talking, thoracoabdominal viscera |
| CN X passes through what 'hole'? | jugular foramen |
| CN XI has what 2 functions? | head turning, shoulder shrugging |
| CN XI passes through what 'hole'? | jugular foramen (descending) -- foramen magnum (ascending) |
| CN XII has what function? | tounge movements |
| CN XII passes through what 'hole'? | hypoglossal canal |
| Complete the muscle spindle reflex arc by placing the following in order: alpha motor, Ia afferent, muscle stretch, extrafusal contraction, intrafusal stretch. | muscle stretch - intrafusal stretch - Ia afferent - alpha motor - extrafusal contraction |
| Extrafusal fibers are innervated by what motor neuron? | alpha motor neuron |
| From which 3 spinal roots does long thoracic nerve arises? | C5, C6, C7 |
| General sensory/motor dysfunction and aphasia are caused by stroke of the? (ant. circle or post. circle) | anterior circle |
| Give 3 characteristics of a LMN lesion. | atrophy, flaccid paralysis, absent deep tendon reflexes |
| Give 3 charateristics of internuclear ophthalmoplegia (INO) | medial rectus palsy on lateral gaze, nystagmus in abducted eye, normal convergence. |
| Give 4 characteristics of an UMN lesion. | spastic paralysis, increased deep tendon reflexes, + Babinski, minor to no atrophy |
| Golgi tendon organs send their signal via what nerve? | group Ib afferents |
| Horner's Syndrome is present if the lesion in Brown-Sequard is above what level? | T1 |
| How are the fibers of the corticospinal tract laminated? (legs/arms medial or lateral?) | arms- medial, legs-lateral |
| How are the fibers of the dorsal column laminated? (legs/arms medial or lateral?) | legs-medial, arms-lateral |
| How are the fibers of the spinothalmic tract laminated? (sacral/cervical medial or lateral?) | cervical-medial, sacral-lateral |
| How do glucose and amino acids cross the blood-brain barrier? | carrier-mediated transport mechanism |
| How does the hypothalamus control the adenohypophysis? | via releasing factors (ie. TRH, CRF, GnRF, etc.) |
| Huntington's patients typically have what type of movements? | Chorea |
| If the radial nerve is lesioned, what 2 reflexes are lost? | triceps reflex and brachioradialis reflex |
| If you break your humerus mid-shaft, which nerve would likely injure? | radial nerve |
| If you break your medial epicondyle of the humerus, which nerve would likely injure? | ulnar nerve |
| If you break your supracondyle of the humerus, which nerve would likely injure? | median nerve |
| If you break your surgical neck of the humerus, which nerve would likely injure? | axillary nerve |
| In a lesion of the radial nerve, what muscle is associated with wrist drop? | extensor carpi radialis longus |
| Intrafusal fibers are encapsulated and make up muscle spindles that send their signal via what nerve? | group Ia afferents |
| Intrafusal fibers are innervated by what motor neuron? | gamma motor neuron |
| Is Bell's palsy an UMN or a LMN lesion? | LMN |
| Is the Babinski reflex (positive or negative) when the big toe dorsiflexes and the other toes fan-out? | positive (pathologic) |
| Name 2 locations for lesions in Syringomyelia? | ventral white commissure and ventral horns |
| Name 3 locations for lesions in Vit.B12 neuropathy(Friedreich's ataxia)? | dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts |
| Name 7 functions of the hypothalamus? | Thirst/waterbalance, Adenohypophysis control, Neurohypophysis control, Hunger/satiety, Autonomic regulation, Temperature regulation, Sexual emotions. TAN HATS |
| Name the 4 foramina that are in the posterior cranial fossa? | internal auditory meatus, jugular foramen, hypoglossal canal, and foramen magnum. |
| Name the 5 foramina that are in the middle cranial fossa? | optic canal, superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum. |
| Name the 5 functions of the Limbic system? | Feeding, Fighting, Feeling, Flight, sex (F--K) [the famous 5 F's] |
| Name the 5 segments of the brachial plexus in order from proximal to distal. | roots - trunks - divisions - cords - branches |
| Name the type of movement with slow writhing movements (esp. the fingers)? | Athetosis |
| Name the type of movement with sudden, jerky, purposeless movements? | Chorea |
| Name the type of movement with sudden, wild flailing of one arm? | Hemiballismus |
| Neurons from the globus pallidus have what action on the ventral anterior nucleus? | Inhibitory |
| Neurons from the striatum have what action on the globus pallidus? | Inhibitory |
| Place the following in order (from light entering the eye to reflex). Pretectal nuclei, pupillary constrictor muscle, retina, ciliary ganglion, Edinger-Westphal nuclei, CN II, CN III. | retina, CN II, pretectal nuclei, Edinger-Westphal nuclei, CN III, ciliary ganglion, pupillary constrictor muscle |
| Stimulation from the paraventricular nucleus cause the release of what hormone? | oxytocin |
| Stimulation from the supraoptic nucleus cause the release of what hormone? | ADH (vasopressin) |
| The Blood-Brain Barrier is formed by what 3 structures? | choriod plexus epithelium, intracerebral capillary endothelium, astrocytes. (First Aid says Arachnoid but the brains say thatТs a typo) |
| The central retinal artery is a branch off what larger artery? | ophthalmic artery |
| The embryologic defect of having a cervical rib can compress what 2 structures? | subclavian artery and inferior trunk of the brachial plexus |
| The fasciculus cuneatus contains fibers from the upper or lower body? | upper extremities |
| The fasciculus gracilis contains fibers from the upper or lower body? | lower extremities |
| The hippocampal formation is connected to the mammillary body and septal area via what structure? | fornix |
| The hippocampus has input from what two areas? | entorhinal cortex, septal area |
| The hippocampus has output to what two areas? | mammillary body, septal area |
| The infraorbital nerve is a branch off what larger nerve? | CN V2 |
| The Nucleus Ambiguus has fibers from what 3 CNs? | CN IX, X, XII |
| The Nucleus Solitarius has fibers from what 3 CNs? | CN VII, IX, X |
| Traction or tear of the superior trunk of the brachial plexus causes what syndrome? | Erb-Duchenne palsy (waiter's tip) |
| Vertigo, ataxia, visual deficits, and coma are caused by stroke of the? (ant. circle or post. circle) | posterior circle |
| Visual fibers from the lateral geniculate body terminate on the upper and lower banks of what fissure? | Calcarine fissure |
| What 1 nerve root is assoc. with the achilles reflex? | S1 |
| What 1 nerve root is assoc. with the biceps reflex? | C5 |
| What 1 nerve root is assoc. with the patella reflex? | L4 |
| What 1 nerve root is assoc. with the triceps reflex? | C7 |
| What 2 areas have sensation deficit in a lesion of the median nerve? | lateral palm/thumb and the radial 2 1/2 fingers |
| What 2 areas have sensation deficit in a lesion of the ulnar nerve? | medial palm and the ulnar 1 1/2 fingers |
| What 2 cutaneus nerves are lost in a lesion of the radial nerve? | posterior brachial cutaneous and posterior antebrachial cutaneous |
| What 2 spinal roots make up the inferior trunk of the brachial plexus? | C8, T1 |
| What 2 spinal roots make up the superior trunk of the brachial plexus? | C5, C6 |
| What 2 structures pass through the internal auditory meatus? | CN VII, VIII |
| What 2 symptoms are seen with a lesion of the musculocutaneus nerve? | difficulty flexing the arm, variable sensory loss |
| What 2 symptoms are seen with a lesion of the ulnar nerve? | weak intrinsic muscles of the hand, Pope's blessing |
| What 3 blood barriers does the body have? | blood-brain, blood-gas, blood-testis |
| What 3 muscles are lost in a lesion of the musculocutaneous nerve? | coracobrachialis, biceps brachii, and brachialis |
| What 3 muscles are lost in a lesion of the radial nerve? | triceps brachii, brachioradialis, and extensor carpi radialis longus |
| What 3 structures pass through the foramen magnum? | spinal roots of CN XI(ascending), brainstem, vertebral arteries |
| What 3 structures pass through the optic canal? | CN II, ophthalmic artery, central retinal vein |
| What 4 'muscles' does the radial nerve innervate? | Brachioradialis, Extensors of the wrist and fingers, Supinator, Triceps. (BEST) |
| What 4 areas is there decreased output in Parkinson's? | substantia nigra pars compacta, globus pallidus, ventral anterior nucleus, cortex |
| What 4 movements are limpaired in a lesion of the ulnar nerve? | wrist flextion, wrist addduction, thumb adduction, and adductiont of the 2 ulnar fingers |
| What 4 movements are lost in a lesion of the median nerve? | forearm pronation, wrist flexion, finger flexion, and several thumb movements |
| What 4 structures pass through the jugular foramen? | CN IX, X, XI(descending), jugular vein |
| What 4 things do the lateral striate arteries supply? | internal capsule, caudate, putamen, globus pallidus |
| What 5 spinal nerves that make up the brachial plexus? | C5, C6, C7, C8, T1 |
| What 5 structures pass through the supperior orbital fissure? | CN III, IV, V1, VI, ophthalmic vein |
| What 5 types of cells make up the suportive cells of the CNS/PNS? | Astrocytes, Microglia, Oligodendroglia, Schwann cells, Ependymal cells. |
| What are 2 characteristics of Tabes Dorsalis? | impaired proprioception and locomotor ataxia |
| What are 3 clinical findings of the arm in Erb-Duchenne palsy? | arm hangs by the side, medially rotated, forearm is pronated |
| What are the 2 classic causes of Erb-Duchenne palsy? | blow to the shoulder and trauma during birth |
| What are the 3 classic symptoms of Horner's syndrome? | ptosis, miosis, anhydrosis |
| What are the 4 classic findings of Brown-Sequard syndrome? | ipsi motor paralysis(spastic), ipsi loss of dorsal column, contra loss of spinothalamic, ipsi loss of ALL sensation at the level of the lesion |
| What are the input and output of the anterior nucleus of the thalamus? | input - mammillary body, output - cingulate gyrus |
| What are the input and output of the cingulate gyrus? | input - anterior nucleus of the thalamus, output - entorhinal cortex |
| What are the input and output of the entorhinal cortex? | input - cingulate gyrus, output - hippocampal formation |
| What are the input and output of the mammillary body? | input - hippocampal formation, output - anterior nucleus of the thalamus |
| What are the input and output of the septal area? | input - hippocampal formation, output - hippocampal formation |
| What artery do the lateral striate branch off of? | internal carotid artery |
| What artery does the anterior inferior cerebellar artery branch off of? | basilar artery |
| What artery does the anterior spinal artery branch off of? | vertebral artery |
| What artery does the posterior inferior cerebellar artery branch off of? | vertebral artery |
| What artery does the superior cerebellar artery branch off of? | basilar artery |
| What artery supplies Broca's and Wernicke's speech areas? | middle cerebral artery |
| What artery supplies the medial surface of the brain (foot-leg area)? | anterior cerebral artery |
| What bone do all the foramina of the middle cranial fossa pass through? | sphenoid bone |
| What CN arises dorsally? | CN IV trochlear |
| What CN is the afferent limb of the pupillary light reflex? | CN II |
| What CN is the efferent limb of the pupillary light reflex? | CN III |
| What CNs lie medially at the brain stem? | CN III, VI, XIII (3 - 6 - 12) |
| What CNS/ PNS supportive cell has the following functions: central myelin production? | Oligodendroglia |
| What CNS/ PNS supportive cell has the following functions: inner lining of the ventricles? | Ependymal cells |
| What CNS/ PNS supportive cell has the following functions: peripheral myelin production? | Schwann cells |
| What CNS/ PNS supportive cell has the following functions: phagocytosis? | Microglia |
| What CNS/ PNS supportive cell has the following functions: physical support, repair, K+ metabolism? | Astrocytes |
| What disease does Tabes Dorsalis result from? | tertiary syphilis |
| What disorder results from a lesion in the medial longitudinal fasciculus (MLF). | Internuclear ophthalmoplegia (INO) |
| What embryologic defect is thoracic outlet syndrome caused by | by having a cervical rib. |
| What happens if a swinging light test is performed on a Marcus Gann pupil (afferent pupil defect)? | results in pupil dialation of the defective eye as the light is swung from the normal eye to the defective eye |
| What happens if you illuminate one pupil in a normal patient? | both eyes constrict (consensual reflex) |
| What hypo/hyper-kinetic disorder is marked by decreased serum ceruloplasm and Keyser-Fleischer rings in the eyes. | Wilson's disease |
| What is a Argyll Robertson pupil? | the eyes DO NOT constrict to light, but DO accommodate to near objects |
| What is affected in a central VII lesion (lesion above the facial nucleus - UMN)? | paralysis of the contralateral lower quadrant |
| What is affected in a peripheral VII lesion (lesion at or below the facial nucleus - LMN)? | paralysis of the ipsilateral face both upper and lower. |
| What is the common name for a peripheral VII lesion? | Bell's palsy |
| What is the consequence when your CNS stimulates the gamma motor neuron and the intrafusal fibers contract? | increased sensitivity of the reflex arc |
| What is the direct pathway from the striatum to the cortex? | The striatum to the substantia nigra pars reticularis /medial globus pallidus to the thalamus to the cortex (excitatory path) |
| What is the embryologic tissue origin of Microglia (ecto/meso/edo)? | Mesoderm |
| What is the indirect pathway from the striatum to the cortex? | The striatum to the lateral globus pallidus to the subthalamic nucleus to the substantia nigra/medial globus pallidus to the thalamus to the cortex (inhibitory pathway but still increases the thalamic drive) |
| What is the lesion in Brown-Sequard syndrome? | hemisection of the spinal cord |
| What is the most common circle of Willis aneurysm? | anterior communicating artery |
| What is the name for the small muscle fiber type that regulates muscle length? | Intrafusal fibers |
| What lesion produces coma? | reticular activating system |
| What lesion produces conduction aphasia, poor repetition w/ poor comprehension, and fluent speech? | Arcuate fasiculus |
| What lesion produces Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)? | Amygdala (bilateral) |
| What lesion produces motor(expressive) aphasia with good comprehension? | Broca's area (motor speech) |
| What lesion produces personality changes and deficits in concentration, orientation, judgement? | frontal lobe - these are frontal release signs |
| What lesion produces sensory(fluent/receptive) aphasia with poor comprehension? | Wernicke's area (associative auditory cortex) |
| What lesion produces spatial neglect syndrome? | right parietal lobe -- contralateral neglect. |
| What lobe of the brain is the Broca's area in? | frontal |
| What lobe of the brain is the frontal eye movement and pupillary change area in? | frontal |
| What lobe of the brain is the premotor area in? | frontal |
| What lobe of the brain is the primary auditory cortex area in? | temporal |
| What lobe of the brain is the principal motor area in? | frontal |
| What lobe of the brain is the principal sensory area in? | parietal |
| What lobe of the brain is the principal visual cortex area in? | occipital |
| What lobe of the brain is the Wernicke's area in? | temporal |
| What midbrain structure is important in mitigating voluntary movements and making postural adjustments? | Basal Ganglia |
| What mineral causes the pathology of Wilson's disease | copper |
| What muscle depresses and extorts the eye? | inferior rectus |
| What muscle elevates and intorts the eye? | superior rectus |
| What muscle extorts, elevates, and adducts the eye? | inferior oblique |
| What muscle fiber type makes up the muscle bulk and provides the force for contraction? | Extrafusal fibers |
| What muscle intorts, depresses, and abducts the eye? | superior oblique |
| What muscle sensor senses tension and provides inhibitory feedback to alpha motor neurons? | golgi tendon organs |
| What muscular disorder is a medial longitudinal fasciculus syndrome associated with? | Multiple Sclerosis (MLF=MS) |
| What nerve is known as the great extensor nerve? | radial nerve |
| What neurotransmitter is decrease in Parkinson's disease | dopamine |
| What nucleus if typically lesioned in hemiballismus? | contralateral subthalamic nucleus |
| What nucleus of the hypothalamus controls circadian rhythms? | suprachiasmatic nucleus |
| What nucleus of the hypothalamus controls hunger? | lateral nucleus |
| What nucleus of the hypothalamus controls satiety? | ventromedial nucleus |
| What nucleus of the hypothalamus controls sexual emotions? | septate nucleus |
| What nucleus of the hypothalamus controls thirst and water balance? | supraoptic nucleus |
| What part of the hypothalamus (ant./post.) controls autonomic regulation? | anterior hypothalamus |
| What part of the hypothalamus (ant./post.) controls cooling when hot? | anterior hypothalamus |
| What part of the hypothalamus (ant./post.) controls heat conservation when cold? | posterior hypothalamus |
| What part of the ventral spinal cord is spared with complete occlusion of the ventral artery? | dorsal columns |
| What passes through the cavernous sinus? (nerves and artery | CN III, IV, V1, V2, VI, post-ganglionic SNS and the Internal carotid artery |
| What reflex is lost in a lesion of the musculocutaneous nerve? | biceps reflex |
| What structure passes through the foramen ovale? | CN V3 |
| What structure passes through the foramen rotundum? | CN V2 |
| What structure passes through the foramen spinosum? | middle meningeal artery |
| What structure passes through the hypoglossal canal? | CN XII |
| What symptom is seen with a lesion of the axillary nerve? | Deltoid paralysis |
| What symptom is seen with a lesion of the median nerve? | decreased thumb function |
| What syndrome is seen with a lesion of the long thoracic nerve? | Winged scapula |
| What syndrome is seen with a lesion of the lower trunk of the brachial plexus? | Claw hand |
| What syndrome is seen with a lesion of the posterior cord of the brachial plexus? | Wrist drop |
| What syndrome is seen with a lesion of the radial nerve? | Saturday night palsy |
| What syndrome is seen with a lesion of the upper trunk of the brachial plexus? | Waiter's tip (Erb-Duchenne palsy) |
| What two bones do all the foramina of the posterior cranial fossa pass through? | temporal and occipital bones |
| What two hypothalamic nuclei does the posterior pituitary(neurohypophysis) receive neuronal projections from? | supraoptic nucleus and paraventricular nucleus. |
| What type of fibers do the corticospinal tracts carry? | motor |
| What type of fibers do the dorsal columns carry? | sensory - pressure, vibration, touch, proprioception |
| What type of fibers do the spinothalmic tracts carry? | sensory - pain and temperature |
| What type of function does CN I have? (sensory, motor, or both) | sensory |
| What type of function does CN II have? (sensory, motor, or both) | sensory |
| What type of function does CN III have? (sensory, motor, or both) | motor |
| What type of function does CN IV have? (sensory, motor, or both) | motor |
| What type of function does CN IX have? (sensory, motor, or both) | both |
| What type of function does CN V have? (sensory, motor, or both) | both |
| What type of function does CN VI have? (sensory, motor, or both) | motor |
| What type of function does CN VII have? (sensory, motor, or both) | both |
| What type of function does CN VIII have? (sensory, motor, or both) | sensory |
| What type of function does CN X have? (sensory, motor, or both) | both |
| What type of function does CN XI have? (sensory, motor, or both) | motor |
| What type of function does CN XII have? (sensory, motor, or both) | motor |
| What type of lesion is seen in Amyotrophic Lateral Sclerosis? | combo of UMN and LMN lesions with no sensory deficit |
| What type of lesion is seen in Multiple Sclerosis? | random asymmetric lesions in mostly white matter of the cervical region |
| What type of lesion is seen in Poliomyelitis and is it genetic or acquired? | acquired LMN lesion causing flaccid paralysis |
| What type of lesion is seen in Werdnig-Hoffmann disease and is it genetic or acquired? | genetic LMN lesion causing flaccid paralysis (aka. Floppy infant disease) |
| What type of molecule can cross the blood-brain barrier most easily? (lipid/nonlipid, polar/nonpolar) | Lipid-soluable/nonpolar molecules |
| What vagal nuclei controls motor innervation to the pharynx, larynx, and upper esophagus? | Nucleus Ambiguus (Motor=aMbiguus) |
| What vagal nuclei controls visceral sensory in formation like taste and gut distention? | Nucleus Solitarius (Sensory=Solitarius) |
| What vagal nuclei sends parasympathetic fibers to the heart, lungs, and upper GI? | dorsal motor nucleus of CN X |
| What would happen temperature regulation if you lesioned your posterior hypothalamus? | lose the ability to conserve heat |
| What would happen temperature regulation if you lesioned your ventromedial nucleus of the hypothalamus? | have hyperphagia and become obese |
| When is a positive Babinski a normal reflex? | during the first year of life |
| Where is the lesion in a patient with hemiballismus? | Subthalamic nucleus |
| Where is the lesion in Parkinson's? | Substantia nigra pars compacta |
| Which CN is the only nerve that does not abut the wall in the cavernous sinus? | CN VI (abducens) |
| Which CNs pass through the middle cranial fossa? | CN II - VI |
| Which CNs pass through the posterior cranial fossa? | CN VII - XII |
| Which division of the facial motor nucleus has duel innervation? (upper or lower) | upper division |
| Which thalamic nucleus has a visual function? | Lateral Geniculate Nucleus (LGB) |
| Which thalamic nucleus has an auditory function? | Medial Geniculate Nucleus (MGB) |
| Which thalamic nucleus has pre-motor function? | Ventral Anterior Nucleus (VA) |
| Which thalamic nucleus has the function of body senses(proprioception, pressure, pain, touch, vibration)? | Ventral Posterior Lateral Nucleus (VPL) |
| Which thalamic nucleus has the function of facial sensation and pain? | Ventral Posterior Medial Nucleus (VPM) |
| Which thalamic nucleus is the primary motor cortex? | Ventral Lateral Nucleus (VL) |
| Which way does the head deviate in a unilateral lesion (LMN) of CN XI? (toward or away) | toward the lesion -- note: First-Aid is wrong in the book) |
| Which way does the jaw deviate in a unilateral lesion (LMN) of CN V? (toward or away) | toward the lesion |
| Which way does the patient tend to fall in a unilateral lesion (LMN) of the cerebellum? (toward or away) | toward the lesion |
| Which way does the tongue deviate in a unilateral lesion (LMN) of CN XII? (toward or away) | toward the lesion |
| Which way does the uvula deviate in a unilateral lesion (LMN) of CN X? (toward or away) | away from the lesion |
| Why does the arm hang by the side in Erb-Duchenne palsy? | paralysis of shoulder abductors |
| Why is L-dopa use for parkinsonism instead of dopamine? | L-dopa crosses the blood-brain barrier while dopamine does not. |
| Why is the arm medially rotated in Erb-Duchenne palsy? | paralysis of the lateral rotators |
| Why is the forearm pronated in Erb-Duchenne palsy? | loss of the biceps brachii |
| Name 4 possible routes of herniation in the brain | 1. Cingulate herniation under the falx cerebri 2. Downward transtentorial (central) herniation 3. Uncal herniation 4. Cerebellar tonsillar herniation into the foramen magnum |
| Name 3 herniation syndromes that can cause either coma or death when the herniations compress the brainstem | 1. Downward transtentorial (central) herniation 2. Uncal herniation 3. Cerebellar tonsillar herniation into the foramen magnum |
| How often do primary brain tumors undergo metastasis? | Very rarely |
| Are the majority of adult tumors supratentorial or infratentorial? | Supratentorial |
| Are the majority of childhood tumors supratentorial or infratentorial? | Infratentorial |
| What is the second most common primary brain tumor? | Meningioma |
| Where do meningiomas most commonly occur? | Convexities of hemispheres and parasagital region |
| From what cells do meningiomas most commonly arise? | Arachnoid cells external to the brain |
| Are meningiomas resectable? | Yes |
| What are a common histopathological finding of meningiomas? | Psammoma bodies. These are spindle cells concentrically arranged in a whorled pattern. |
| What is the most common primary brain tumor? | Glioblastoma multiforme (grade IV astrocytoma) |
| What is the prognosis for Glioblastoma multiforme? | Prognosis is grave. Usually only have a year life expectancy. |
| Where are Glioblastoma multiformes found? | Cerebral hemispheres |
| What is the common histopathology found in Glioblastoma multiforme? | Pseudopalisading' tumor cells border central areas of necrosis and hemorrhage |
| What is an oligodendroglioma? | A relatively rare, slow growing, benign tumor. |
| Where do oligodendrogliomas most often occur? | Most often found in the frontal lobes |
| What is the common histopathology associated with oligodendrogliomas? | Fried egg' appearance of cells in tumor. Often calcified. |
| What is the third most common primary brain tumor? | Schwannomas |
| What is the origin of the Schwannoma? | Schwann cell origin. Often localized to the 8th cranial nerve (acoustic schwannoma). Bilateral schwannoma found in NF2. |
| What is the common histopathology associated with schwannoma? | Antoni A=compact palisading nuclei; Antoni B=loose pattern |
| What is the most common type of pituitary adenoma? | Prolactin secreting |
| Name two presenting sequelae of a pituitary adenoma. | 1. Bitemporal hemianopsia (due to pressure on the optic chiasm) 2. Hypopituitarism |
| What is the origin of a Pituitary adenoma? | Rathke's pouch |
| Name 5 primary brain tumors with peak incidence in adulthood. | 1. Meningioma 2. Glioblastoma multiforme 3. Oligodendroglioma 4. Schwannoma 5. Pituitary adenoma |
| Name 5 primary brain tumors with peak incidence in childhood. | 1. Medulloblastoma 2. Hemangioblastoma 3. Ependymomas 4. Low-grade astrocytoma 5. Craniopharyngioma |
| What is a medulloblastoma? | Highly malignant cerebellar tumor. A form of primitive neuroectodermal tumor (PNET). Can compress 4th ventricle causing hydrocephalus |
| What is the common histopathology associated with medulloblastomas? | Rosettes or perivascular pseudorosette pattern of cells |
| What is a Hemangioblastoma? | Most often a cerebellar tumor. Associated with von Hippel Lindau syndrome when found with retinoblastoma. |
| What is the common histopathology associated with Hemangioblastoma? | Foamy cells and high vascularity are characteristic. Can produce EPO and lead to polycythemia. |
| What are ependymomas? | Ependymal cell tumors most commonly found in the 4th ventricle. May cause hydrocephalus |
| What is the common histopathology associated with Ependymomas? | Characteristic perivascular rosettes. Rod-shaped blepharoblasts (basal ciliary bodies) found near the nucleus. |
| What is a low-grade astrocytoma? | Diffusely infiltrating glioma. In children, it is most commonly found in the posterior fossa. |
| What is a craniopharyngioma? | Benign childhood tumor. Often confused with pituitary adenoma because both can cause bitemporal hemianopsia. Calcification of the tumor is common. |
| What is the origin of a craniopharyngioma? | Derived from the remnants of Rathke's pouch |
| Approximately what percentage of brain tumors arise from metastasis? | 0.5 |
| Name 5 sites from which tumor cells metastasize to the brain. | 1. Lung 2. Breast 3. Skin (melanoma) 4. Kidney (renal cell carcinoma) 5. GI |
| What is a helpful mnemonic to remember the site of metastasis to the brain? | Lots of Bad Stuff Kills Glia |
| Name two of the most common sites of metastasis after the regional lymph nodes | The liver and the lung |
| Name the 5 primary tumors that metastasize to the liver | 1. Colon 2. Stomach 3. Pancreas 4. Breast 5. Lung |
| Which is more common: metastasis to the liver or primary tumors of the liver? | Metastasis to the liver is more common |
| What is a helpful mnemonic to remember the types of cancer that metastasize to the liver? | Cancer Sometimes Penetrates Benign Liver |
| What are 6 primary tumors that metastasize to bone? | 1. Kidney 2. Thyroid 3. Testes 4. Lung 5. Prostate 6. Breast |
| What is a helpful mnemonic to remember what tumors metastasize to bone? | BLT with a Kosher Pickle |
| Out of the 6 primary tumors that metastasize to bone, which two are the most common? | Metastasis from the breast and prostate are the most common |
| Which is more common: metastasis to bone or primary tumors of bone? | Metastatic bone tumors are far more common than primary tumors |
| What is the most common organ to receive metastases? | Adrenal glands. This is due to their rich blood supply. The medulla usually receives metastases first and then the rest of the gland. |
| What is the most common organ to 'send' metastases? | The lung is the most common origin of metastases. The breast and stomach are also big sources. |
| What causes the paraneoplastic effect of Cushing's disease? | ACTH or ACTH-like peptide (secondary to small cell lung carcinoma) |
| What causes the paraneoplastic effect of SIADH? | ADH or ANP (secondary to small cell lung carcinoma and intracranial neoplasms) |
| What causes the paraneoplastic effect of hypercalcemia? | PTH-related peptide, TGF-a, TNF-a, IL-2 (secondary to squamous cell lung carcinoma, renal cell carcinoma, breast carcinoma, multiple myeloma, and bone metastasis) |
| What causes the paraneoplastic effect of Polycythemia? | Erythropoietin (secondary to renal cell carcinoma) |
| What causes the paraneoplastic effect of Lambert-Eaton syndrome? | Antibodies against presynaptic Ca2+ channels at NMJ (Thymoma, bronchogenic carcinoma) |
| What causes the paraneoplastic effect gout? | Hyperuricemia due excess nucleic acid turnover (secondary to cytotoxic therapy of various neoplasms) |
| What is the most common cause of dementia in the elderly? | Alzheimer's disease |
| What are 2 degenerative diseases of the cerebral cortex? | 1. Alzheimer's2. Pick's disease |
| What is the pathology of Alzheimer's? | Associated with senile plaques (beta-amyloid core) and neurofibrillary tangles |
| What are neurofibrillary tangles? | Abnormally phosphorylated tau protein |
| What genes is the familial form of Alzheimer's associated with? | Genes are chromosomes 1, 14, 19 and 21 |
| Where is the aopE-4 allele located? | Chromosome 19 |
| Where is the p-App gene located? | 21 |
| What is the pathology of Pick's disease? | Associated with Pick bodies, intracytoplasmic inclusion bodies |
| Where is Pick's disease specific for? | The frontal and temporal lobes |
| What is the second most common cause of dementia in the elderly? | Multi-infarct dementia |
| What are 2 degenerative diseases that affect the basal ganglia and brain stem? | 1. Huntington's disease2. Parkinson's disease |
| How is Huntington's disease inherited? | Autosomal dominant |
| What are the clinical symptoms of Huntington's disease? | Dementia, chorea |
| What is the pathology of Huntington's disease? | Atrophy of the caudate nucleus |
| What is the pathology of Parkinson's disease? | Associated with Lewy bodies and depigmentation of the substantia nigra |
| What chemical can Parkinson's disease be linked to? | MPTP, a contaminant in illicit street drugs |
| What are the clinical symptoms of Parkinson's disease? | TRAP= Tremor (at rest)cogwheel RigidityAkinesiaPostural instability(you are TRAPped in your body) |
| What is a degenerative disorder of the Spinocerebellar tract? | Friedrich's ataxia (olivopontocerebellar atrophy) |
| What are 3 degenerative disorders of the motor neuron? | 1. Amyotrophic lateral sclerosis (ALS)2. Werdnig-Hoffman disease3. Polio |
| What is the common name for ALS? | Lou Gehrig's disease |
| What neurons are affected in ALS? | Both the upper and lower motor neurons |
| How does Werdnig-Hoffman disease present? | At birth as a 'floppy baby' |
| What is another symptom of Werdnig-Hoffman disease? | Tongue fasciculations |
| What neurons are affected in Polio? | Lower motor neurons only |
| What are 2 common organisms that target the brain in AIDS pts? | 1. Toxo!Toxo!Toxo!2. Cryptococcus |
| What damage does toxoplasma cause in the brain? | Diffuse (intracerebral) calcifications |
| What damage does cryptococcus cause in the brain? | Periventricular calcifications |
| Where are most brain tumors located in adults? | 70% are supratentorial (cerebral hemispheres) |
| What is the incidence of brain tumors in adults? | Metastases> Astrocytoma (including glioblastoma)> Meningioma |
| What are the pathological signs of glioblastoma multiforme (GBM)? | -Necrosis-Hemorrhage-Pseudo-palisading |
| What is the shape of GBMs? | Butterfly' glioma |
| What is the prognosis for a pts diagnosed with a GBM? | Very poor |
| Where are most childhood brain tumors located? | 70% below tentorium (cerebellum) |
| What is the incidence of brain tumors in children? | Astrocytoma> Medulloblastoma> Ependymoma |
| What are the 4 types of intracranial hemorrhages? | 1. Epidural hematoma2. Subdural Hematoma3. Subarachnoid hemorrhage4. Parenchymal hematoma |
| What artery is compromised in an epidural hematoma? | Middle meningeal artery |
| What event is the rupture of the middle meningeal artery secondary to? | Temporal bone fracture |
| What blood vessels are affected in subdural hemorrhages? | Rupture of bridging veins |
| What is the course of a subdural hemorrhage? | Venous bleeding (less pressure) with delayed onset of symptoms |
| In what persons is subdural hemorrhage often seen? | Elderly individuals, alcoholics, and blunt trauma |
| What is the usual cause of a subarachnoid hemorrhage? | A: |
| How do patients present with a subarachnoid hemorrhage? | Worst headache of my life' |
| What does the spinal tap show in a subarachnoid hemorrhage? | Bloody or xanthochromic |
| What causes a parenchymal hematoma? | -HTN-Amyloid angiopathy-Diabetes Mellitus-Tumor |
| Where do berry aneurysms occur? | At the bifurcations in the Circle of Willis |
| What is the most common site for a berry aneurysm? | The bifurcation of the anterior communicating artery |
| What does rupture of a berry aneurysm lead to? | Stroke |
| What is the most common complication of a berry aneurysm? | Rupture of the aneurysm |
| What diseases are berry aneurysms associated with? | -Adult polycystic kidney disease-Ehlers-Danlos syndrome-Marfan's syndrome |
| What are some demyelinating and dysmyelinating diseases? | 1. Multiple sclerosis (MS)2. Progressive multifocal leukoencephalopathy (PML)3. Postinfectious encephalomyelitis4. Metachromatic Leukodystrophy5. Guillain-Barre syndrome |
| What is the classic triad of MS? | SIN1. Scanning speech2. Intention Tremor3. Nystagmus |
| How is the prevalence of MS geographically distributed? | Higher prevalence with greater distance from the Equator |
| What is the pathology of MS? | -Periventricular plaques-Preservation of axons-Loss of oligodendrocytes-Reactive astrocytic gliosis-Increased protein (IgA) in CSF |
| What is the course of MS? | In most pts, the course is remitting and relapsing |
| How do pts present with MS? | -Optic neuritis (sudden loss of vision)- MLF syndrome (internuclear ophthalmoplegia)-Hemiparesis-Hemisensory symptoms-Bladder/bowel incontinence |
| What is PML associated with? | JC virus |
| Which demyelinating disease is seen in 2-4% of AIDS patients? | PML |
| What is another name for Guillain-Barre syndrome? | Acute idiopathic polyneuritis |
| What is the pathogenesis of Guillain-Barre syndrome? | Inflammation and demyelination of peripheral nerves and motor fibers of ventral roots (sensory effect less severe than motor) |
| What clinical symptoms are present? | -Symmetric ascending muscle weakness beginning in the distal lower extremities-Facial diplegia in 50% of cases-Autonomic fx may be severely affected |
| What are the lab findings in Guillain-Barre syndrome? | Elevated CSF protein with normal cell count ('albumino-cytologic dissociation') |
| What are associated with Guillain-Barre? | 1. Infections (herpesvirus or C. jejuni)2. Inoculations3. Stress |
| What causes poliomyelitis? | Poliovirus |
| How is the polio virus transmitted? | Fecal-oral route |
| Where does it initially replicate? | The oropharynx and small intestine |
| How does it spread? | Through the bloodstream to the CNS |
| What is the pathology of poliomyelitis? | Destruction of anterior horn cells, leading to LMN destruction |
| What are the symptoms of poliomyelitis? | -Malaise-Headache-Fever-Nausea-Abdominal pain-sore throat |
| What are the signs of LMN lesions seen in poliomyelitis? | -Muscle weakness and atrophy-Fasciculations-Fibrillation-Hyporeflexia |
| What are the lab findings in poliomyelitis? | -CSF with lymphocytic pleocytosis with slight elevation of protein-Virus recovered from stool or throat |
| What do partial seizures affect? | One area of the brain |
| What seizures are categorized as simple partial? | Awareness intact-Motor-Sensory-Autonomic-Psychic |
| What is a complex partial seizure? | Impaired awareness |
| What area of the brain is affected by generalized seizures? | Diffuse area |
| What are the 5 types of generalized seizures? | 1. Absence2. Myoclonic3. Tonic-clonic4. Tonic5. Atonic |
| Describe an absence seizure. | A blank stare (petit mal- it's in 1st aid this way!!) |
| Describe a myoclonic seizure. | Quick,repetitive jerks |
| Describe a tonic-clonic seizure. | Alternating stiffening and movement (grand mal) |
| Describe a tonic seizure. | Stiffening |
| Describe an atonic seizure. | drop' seizures |
| Define epilepsy. | Epilepsy is a disorder of recurrent seizures. |
| T/F. Partial seizures can not generalize. | False- Partial seizures can generalize. |
| What are the common causes of seizures in children? | -Genetic-Infection-Trauma-Congenital-Metabolic |
| What are the common causes of seizures in adults? | -Tumors-Trauma-Stroke-Infection |
| What are the common causes of seizures in the elderly? | -Stroke-Tumor-Trauma-Metabolic-Infection |
| What is another term for Broca's aphasia? | Expressive aphasia |
| What is another term for Wernicke's aphasia? | Receptive aphasia |
| Describe Broca's aphasia. | Broca's is nonfluent aphasia with intact comprehension. BROca's is BROken speech. |
| Describe Wernicke's aphasia. | Wernicke's is fluent aphasia with impaired comprehension.Wernicke's is Wordy but makes no sense. |
| Where is Broca's area located? | Inferior frontal gyrus |
| Where is Wernicke's area located? | Superior Temporal Gyrus |
| Describe Horner's syndrome. | Sympathectomy of face (lesion above T1). Interruption of the 3-neuron oculosympathetic pathway. |
| What are the symptoms of Horner's? | 1. Ptosis 2. Miosis3. Anhidrosis and flushing of affected side of face |
| What is ptosis? | Slight drooping of the eyelids |
| What is miosis? | Pupil constriction |
| What is anhidrosis? | Absence of sweating |
| What tumor is Horner's syndrome associated with? | Pancoast's tumor |
| Where does the 3 neuron oculosympathetic pathway project from? | The hypothalamus |
| Where does the 3 neuron oculosympathetic pathway project to? | 1. Interomediolateral column of the spinal cord2. Superior cervical (sympathetic) ganglion3. To the pupil, smooth muscles of the eyelids and the sweat glands |
| Where is the most common site of syringomyelia? | C8-T1 |
| What is the pathology of syringomyelia? | Softening and cavitation around the central canal of the spinal cord. |
| What neural tracts are damaged? | Crossing fibers of the spinothalamic tract |
| What clinical symptoms are present with syringomyelia? | Bilateral pain and temperature loss in the upper extremities with preservation of touch sensation |
| What congenital malformation is often associated with syringomyelia? | Arnold Chiari Malformation |
| Define syrinx. | Tube, as in syringe |
| What is the pathogenesis of Tabes dorsalis? | Degeneration of the dorsal columns and dorsal roots due to tertiary syphilis. |
| What are the clinical symptoms of Tabes dorsalis? | -Charcot joints-Shooting pain-Argyll-Robertson Pupils-Absence of deep tendon reflexes |
| What neural deficits are present in Tabes dorsalis? | Impaired proprioception and locomotor ataxia |
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