01 Kutkot Kokote

Question 1

a single discrete neuroanatomical locus that can account for all the signs and symptoms

Answer 1

focal lesion

Question 2

involves more than one locus, but loci remain discrete

Answer 2

multifocal lesion

Question 3

indicates widespread dysfunction of a part of the nervous system

Answer 3

diffuse localization

Question 4

negative symptoms

Answer 4

reduction of function (weakness, numbness)
complete loss (paralysis, analgesia)

Question 5

positive symptoms

Answer 5

brief and very intense/paroxysmal (seizures)

episodic and recurrent (hemifacial spasm)

Question 6

loss of function that may be defined on examination

Answer 6

deficit

Question 7

spell

Answer 7

transient and self-limited abnormality

Question 8

sudden/ abrupt/ acute onset

Answer 8

seconds to hours

can be vascular, traumatic, or physiologic

Question 9

subacute onset

Answer 9

days to weeks

can be infectious, toxic, or metabolic

Question 10

insidious, gradual onset

Answer 10

months to years

can be degenerative, neoplastic, or nutritional

Question 11

recurrent-remittent onset

Answer 11

episodic attacks with recovery in between

Question 12

chronic progressive onset

Answer 12

months to years

implies gradual deterioration

Question 13

umn weaknesses

Answer 13

due to interruption of corticospinal/bulbar tracts
increased tone (spastic)
increased reflexes
(+) babinski
(-) atrophy
(-) fasciculation

Question 14

lmn weaknesses

Answer 14

due to involvement of spinal anterior horn (or CN) itself and all distal parts
dec tone
dec reflexes
(-) babinski
(+) atrophy
(+) fasciculation

Question 15

in central lesions ___ is interrupted and ___ is weak

Answer 15

corticobulbar fibers, contralateral lower face

Question 16

in peripheral lesions ___ is interrupted and ___ is weak

Answer 16

nucleus/CN itself, ipsilateral forehead and lower face

Question 17

tract for position and vibration sensation

Answer 17

ipsilateral posterior column

Question 18

tract for pain, non-discriminating touch, and temp

Answer 18

contralateral spinothalamic tract

Question 19

transient monocular blindness is also known as __ and caused by ___

Answer 19

amaurosis fugax, thromboembolism of the retinal artery

Question 20

cerebellar truncal ataxia

Answer 20

manifests as broad based gait or titubation

associated with involvement of vermis

Question 21

middle peduncle of cerebellum is:

Answer 21

Largest peduncle, largest pathway, largest part of the pons, ends in the largest lobe of cerebellum
Lateralest
Latest phylogenetically
Simplest (pontocerebellar fibers)

Question 22

rules of 4 in the brainstem: 4 structures in midline

Answer 22

motor pathway
medial lemniscus
medial longitudinal fasciculus
motor nucleus and nerve

Question 23

rules of 4 in brainstem: 4 motor nuclei in midline

Answer 23

CN 3, 4, 6, 12

Question 24

rules of 4 in the brainstem: 4 structures to the side

Answer 24

spinocerebellar pathway
spinothalamic tract
sensory nucleus of cn V
sympathetic pathway

Question 25

rules of 4 in brainstem: CNs

Answer 25

4 cn in medulla (9, 10, 11, 12) 4 cn in pons (5, 6, 7, 8) 4 cn above pons (1, 2, 3, 4)

Question 26

t/f generalized impaired attention and cooperation are specific signs

Answer 26

false

Question 27

what is being tested in memory?

Answer 27

(james) papez circuit He-Man Ate a Cat EH

Question 28

musical component of languaage

Answer 28

prosody

Question 29

anomia points to a damage in ___

Answer 29

left arcuate nucleus

Question 30

repetition deficit points to __

Answer 30

transcortical aphasia

Question 31

dejerine syndrome invovles the __

Answer 31

left posterior cerebral artery

Question 32

agraphia or dysgraphia points to a lesion in ___

Answer 32

left parietal region (supramarginal gyrus)

Question 33

Gesrtmann's syndrome symptoms

Answer 33

right-left confusion agraphia acalculia finger agnosia

Question 34

loss of ability to plan or complete motor actions that rely on semantic memory

Answer 34

ideomotor apraxia

Question 35

inability to select and carry out an appropriate motor program

Answer 35

ideational or conceptual apraxia

Question 36

constructional apraxia

Answer 36

inability to draw or construct simple configurations

Question 37

difficulty making precise movements with arm/legs

Answer 37

limb-kinetic apraxia

Question 38

(rezso) balint's syndrome symptoms

Answer 38

oculomotor apraxia simultagnosia optic ataxia

Question 39

an abnormality in attention to one side of the universe that is not due to a primary sensory or motor disturbance

Answer 39

hemineglect

Question 40

deficit of self-awareness

Answer 40

anosognosia

Question 41

brief oscillations of pupillary size that normally occur in response to light

Answer 41

hippus

Question 42

marcus gunn pupil

Answer 42

when pupils fail to constrict fully aka relative afferent pupillary defect hallmark of optic nerve disease

Question 43

adie's pupil

Answer 43

slow and prolonged accomodation poor or absent response to light affected pupil is larger then becomes smaller over time

Question 44

argyll robertson pupil

Answer 44

quick accomodation absent response to light bilateral small pupils associated with neurosyphilis

Question 45

laws of diplopia

Answer 45

false image is always hazier false image appears peripheral to true image false image projects in the opposite direction of the eye deviation false image projects toawrd the normal direction of pull of paretic muscle

Question 46

5 major eye movement systems

Answer 46

``` saccades (frontal) fixation (occipital) smooth pursuit (occipital) vergence (occipital) counter rolling (vestibular and neck proprioceptive) ```

Question 47

horizontal gaze center

Answer 47

paramedian pontine reticular formation

Question 48

vertical gaze center

Answer 48

rostral interstitial nucleus of the mlf

Question 49

signs and symptoms of mlf syndrome

Answer 49

sx: diplopia and oscillopsia si: heterotropia and monocular nystagmus appear only when the patient attempts to look away from the side of interruption of the mlf

Question 50

parinaud's syndrome

Answer 50

dorsal compression of the midbrain that will selectively impair upward vertical eye movements

Question 51

when the eyeballs automatically rotate upward and outward but closure of the orbicularis oculi muscle obscures it

Answer 51

bell's phenomenon

Question 52

in ___ lesions the eyes move toward the lesion in ___ lesions the eyes move away from the lesion

Answer 52

destructive irritative

Question 53

auditory pathways (aclima)

Answer 53

``` auditory nerve cochlear nuclei superior olivary complex lateral lemniscus inferior colliculus medial geniculate body auditory complex ```

Question 54

HINTS 2 step eye exam

Answer 54

head impulse (right and leftward) nystagmus (gaze testing) test of skew (alternate cover test)

Question 55

INFARCT stroke findings

Answer 55

``` impulse normal (bilaterally normal) fast-phase alternating (direction changing) relaxation on cover test (skew deviation) ```

Question 56

wernicke vs broca's aphasia

Answer 56

wernicke: can articulate but cannot understand (hamburger) | broca's: can understand but not articulate (wuhdaudau)

Question 57

only truly objective sensory test

Answer 57

joint position sense

Question 58

a to-and-fro, 5-8 cycles per second rhythmic oscillation of a body part elicited by a quick stretch

Answer 58

clonus