Anderson Neuro Flashcards
1
Q
Internal carotid
A
goes inside head and doesn’t branch until much later
- not blood supply to anything in face or head and neck
2
Q
arterial vs venus system
A
arterioles branch
venus goes here and there
3
Q
branches of external carotid
Some Anatomists like Fucking, Others Prefer S&M
A
- Sup thyroid
- Asc pharyngeal
- Lingual
- Facial
- Occipital
- Posterior Auricular artery
- Superficial temporal
- Maxillary
4
Q
terminal branches of external carotid
A
maxillary artery
superficial temporal artery
5
Q
Are communicating arteries blood supply?
A
no
6
Q
When internal carotid finally branches what does it branch to?
A
opthalamic
7
Q
Where is dividing line between circle of willis and vertebral basilar system?
A
Post cerebral and superior cerebellar
8
Q
where do vertebral arteries come from?
A
subclavian
9
Q
What do vertebral arteries go through?
A
C6 foramen to C1
out atlantooccipital junction
10
Q
spinal arteries are branches of what?
everything else branches off what?
A
vertebral
basilar
11
Q
berry aneurism: which arteries
sx
A
anterior communicating
post communicating
middle cerebral
sudden excruciating HA
12
Q
AVM: which arteries
sx
A
may occur anywhere
chronic HA
13
Q
When does Hypertensive encephalopathy occur?
sx
A
diastolic BP above 120
confusion, drowsiness, ha, nausea
14
Q
toxic encephalopathy
A
liver and kidney can’t get rid of toxins
15
Q
deepest jugular vein that drains everything inside and most outside head
A
internal jugular
16
Q
external jugular drains what?
A
backside of skull
17
Q
confluens of sinuses
A
transverse sinus, superior and inferior saggital sinuses come together here
18
Q
confluens forms what?
A
inion (bump on back of head)
19
Q
most of brain blood comes from
A
sigmoid sinus
20
Q
cavernous sinus and pterygoid plexus are what and what can they cause?
A
communicating areas with external face and neck
infections leading to encephalitis
21
Q
cowdry bodies common in
A
herpes
22
Q
negri bodies common in
A
rabies
23
Q
intracranial pressure leads to
A
papilledema
24
Q
cerebral edema
A
too much pressure going in
brain hypoxic and acidotic = brain damage
*common after injury, radiation, long term HTN
25
Hydrocephalus
enlarged ventricles
26
carbon dioxide buildup =
acidosis which can lead to necrosis
27
low O2/low pH =
hypoxia/ischemia
28
encephalomalacia
necrosis
29
CN1
olfactory
sensory
smells
30
CN2
optic
sensory
see
31
CN3
oculomotor
motor
superior oblique muscle
32
mneumonic for cranial nerves sensory or motor
```
Some
Say
Marry
Money
But
My
Brother
Says
Be
Brave
Marry
Me
***B = mixed
```
33
what does CN 12 do?
motor to tongue
34
What does CN 11 do?
motor to trap and SCM
35
What does CN5 do?
feels the face, chews
36
What does CN6 do?
L.R. muscle
37
What does CN 7 do?
moves face, taste, cry, salivate
38
What does CN9 do?
glossopharyngeal
| taste, saliva, swallow, baroreceptors
39
What does CN10 do?
taste, swallow, talk, lift palate
40
Nuclei distribution for PONs
CN 5,6,7,8
41
Nuclei distribution for Midbrain
CN 3,4
42
Nuclei distribution for Medulla
CN 9,10,11,12
43
Nuclei distribution for diencephalon
CN 1,2
44
what order does brainstem go in?
```
top down:
midbrain
pons
medulla
spinal cord
```
45
sense of touch inside nose
CN5
46
anosmia due to
noxious chemicals or tumors or fractures of cribriform plate
47
sense of smell uses
| vision uses
```
smell = cAMP
vision = cGMP
```
48
where are cones/ high sensitive area?
fovea of macula
49
embryonically, eye grows out of
brain
50
sclera is
outer area, CT/same as dura
51
all of nerve fibers, receptive tissue
retina (same as brain)
52
blood vessels of eye are in
choroid (same as arachnoid)
53
lens is a ___ muscle and it gets ___ when pull it
round
| smaller
54
when ciliary muscle contracts it goes from ____ to ___
| relaxed ciliary muscle associated with ______ vision and when it is contracted it is associated with ____ vision.
thin to plump
far
near
55
aqueos humor is the same as and drains where?
extracellular fluid with no blood, etc.
| canal of flegm
56
afferent vs efferent
afferent: coming in
efferenet: going out
57
disease with degeneration of pigment cell layer that leads to blindness
macular degeneration
| light goes in, but can't see
58
lesion at chiasm
bitemporal hemianopsia
59
optic nerve problem before pathways cross leads to
complete blindness in that eye
60
lesion behind chiasm
homonomous hemianopsia (seen in brain tumor patients)
61
where are cones
fovea of macula
central (rods periphery)
make you see color (cones = color)
62
parasympathetic activity of eye nemonic
```
(beauty under a bright light) = small pupil, thick lens
contracted muscle
constricted pupil
fatter lens
near sight
```
63
sympathetic
relaxed ciliary muscle
dilated pupil
far sight
64
facial nerve does more than facial expression
salivation
tearing
taste (ant2/3)
motor to post digastric and strapedius
65
What are first and second holes that facial nerve goes through?
1st: internal acustic meatus
2nd: styloid mastoid foramen
66
who goes through styloid mastoid foramen?
motor branch of facial nerve
67
styloid mastoid foramen is important for which disease?
bells paulsy (all branches involved)
68
***which cranial nerves are involved with anterior and posterior tongue taste?
ant: 7 taste (5 for touch)
post: 9 is back two thirds taste and touch
69
****what muscle is innervated by CN9?
stylopharyngeus
70
what hole does CN9 go through?
medulla through foramen to target areas
71
what nerve operates parotid gland?
CN9
72
ability of tongue to touch roof of mouth is what CN?
CN10 (every other motion of tongue is CN12)
73
salty, sweet, sour, bitter are innervated with which CNs?
7 because they are tasted on anterior tongue
| sour and bitter are 9 (post)
74
optokinetic nystagmus
looking out of a train
| - nystagmus improves image
75
vestibular nystagmus
move head to quickly or put cold water in ear
76
most common cause of pathologic nystagmus
horizontal nystagmus due to vestibular nerve swelling (hearing and balance issues)
77
endolymph
| perilymph
intracellular (K rich)
| extracellular (Na rich)
78
organ of corti
in basilar membrane
| perilymph and endolymph associated
79
lateral and medial geniculate bodies
auditory is medial (internal)
| vision is lateral (external)
80
gag reflex
CN 9 is sensory
| CN 10 motor
81
speech is which CN?
CN 12 (hypoglossal)
82
Wernicke's area
```
sensory aphasia (word salad)
- difficulty understanding written/spoken language
```
83
Broca's area
motor aphasia
| - understanding is intact
84
parasympathetic ganglia come from
brainstem
85
sympathetic ganglia come from
from thoracic nerve roots
| - goes to heart and bronchi
86
from chest through half of abdomen have
vagal influence: parasympathetic
87
sexual response cycle uses
```
both parasympathetic (arousal) and sympathetic (climax)
- all come from lower sacral nerve roots
```
88
sympathetic bronchial response
dilates
| constricts with parasympathetic
89
saliva secretion is
parasympathetic
90
how does PNS interact with spinal cord?
sensory input from dorsal horn
| motor input from ventral
91
what horn is involved with Polio?
sensory dorsal horn issues
92
grey matter and white in spinal cord
grey synaptic in center
| white is outer tracts
93
spinal level reflexes
```
C-5 bicep
C-6 brachioradialis
C-7 triceps
C-8 finger flex
L-4 patellar
L-5 foot
```
94
```
fiber types
A- alpha
B- beta
A- gamma
A- delta
B
C
```
A- alpha: biggest fastest (motor neurons)
B- beta: touch and pressure
A- gamma: slower motorneurons
A- delta: touch, pressure, fast, pain
B: preganglionic autonomic fibers
C: smallest slowest (yes or no) pain and temp
95
Golgi Tendon Organ
measures tension and inhibits alpha to protect against over stretch
96
anterolateral system
lower sensitivity: anything shared with dorsal column:
- pain
- thermal
- crude touch
- tickle and itch
- sexual sensation
97
Upper vs lower motor neurons
```
UMN defects (hyper): spastic paralysis, hyerreflexia, pos babinski
LMN (hypo): atrophy, flaccid paralysis, fibrillations, hyporeflexia, neg babinksi
```
98
what are the 3 sensory pathways?
spinothalamic: pain and temp
fasciculus cuneatus, gracilis: concious proprioception
spinothalamic and medial leminiscus: light touch
99
diancephalon
anything with the word thalamus
| hypothalamus, thalamus, epithalmus
100
fast vs slow pain fibers
slow: end at diencephalon
fast: sensory humunculus (give specific info)
101
what can cross BBB?
lipid soluble, gases, water
| BBB maintains constant env for neurons, prevents escape of neurotransmitters.
102
CSF
extracellular fluid and plasma
| created by choroid plexus
103
what amino acid does the main membrane transport system use?
glutathione
104
what hormones enhance cellular AA uptake?
GH and insulin
105
excitatory neurotransmitters
glutamate and aspartate
106
inhibitory neurotransmitters
```
GABA
glycine
serine
alanine
cystathione
```
107
inactive neurotransmitters
glutamine
lysine
threonine
leucine
108
brain transmitter uppers
```
serotonin
ACTH
norepi
epi
dopamine
glycine (also downer)
```
109
downers
```
GABA
nitric oxide
histamine
neurosteroids
glycine (also upper)
```
110
primary sulfur containing amino acids and
| what does it do?
cysteine
| helps make glutathione and taurine
111
what form of sulfur is toxic?
sulfite (not sulfate)
| sulfate used in brain to get rid of junk
112
What helps get rid of sulfites by turning them into sulfate?
Mo intermediary
113
Methylation or methyl step involves what?
folic acid and B12
114
what enzyme creates and enzyme that breaks down acetyl choline
choline acetylase
| acetylcholine esterase breaks down
115
reason muscle don't go into muscle tetany
acetlycholine esterase
116
most pesticides are
choline esterase inhibitors
| would cause prolonged muscle tetany
117
tryptophan makes _____ by hydroxylating tryptophan with _____
seratonin
| 5HTP
118
** Seratonin can be turned into _____ in the diencephalon
melatonin
* depression = can't sleep either because no seratonin = no melatonin
119
tryptophan is ____ dependent
| deficiency in ____ can lead to seratonin deficiency
B6
| B6
120
circadian rhythm is driven by?
suprachiasmatic nucleus of hypothalamus which receives input from retina.
121
primary circadian rhythm hormones
melatonin (sleep)
| cortisol (wake)
122
What leads to cortisol surge?
| What leads to melatonin release?
- ACTH
| - low light leads to increased activity of retina-hypothalamic pathway which leads to pineal gland melatonin release
123
high doses of corticosteroids leads to
sleeplessness (brain thinks it is awake constantly)
124
***phenylalanine converts to? what enzyme is used?
```
tyrosine
phenylalanine hydroxylase (deficeint in children with phenylketonuria (PKU))
```
125
number one cause of mental retardation?
| caused by what?
PKU
| deficiency of phenylalanine hydroxylase
126
tyrosine is used for:
base for thyroid hormone syntheses
used in TCA cycle for energy
makes melanin
hydroxylated to L-DOPA and then to Dopamine
127
difference between PNS and CNS catecholamine producing neurotransmitters
N-Methyl-Transferase (final step for formation of EPI)
128
L-Dopa to Dopamine is dependent on what?
B6 and B1
129
Dopamine to NE inhibited by and stimulated by?
inhibited by: gluatathione, cysteine, B-5
| stimulated by: copper and vit c
130
If you don't get rid of catecholamines what happens
| What disease has this?
go into hyper metabolic state
(increased HR, manic/psychotic rage, PNS breaks down)
- pheochromocytoma
131
Two enzyme reactions critical for getting rid of catecholamines
MAO
COMT
VMA (most important intermediate) tested in urine to see if overproducing catecholamines.
132
what is tested in urine to see if overproducing catecholamines?
VMA
133
what is donor of NO and what enzyme
arginine
| NO synthase
134
NO associated with
| what does it do?
GMP (vision)
| vascular smooth muscle dilation (control HTN, erectile tissues, etc) dependent on GMP
135
histadine is bioconverted to ____ using ____
histamine
| B1 and histadine decarboxylase
136
purposes of histamine
peripherally: part of cytokine system to trigger immune response (good)
137
first step to get histamine out of the body
next step
final step
1) methylate
2) MAO (monoamine oxydase: also used to get rid of catecholamines, seratonin, etc.)
3) removed through liver
138
what converts glutamine to GABA?
| why is this important
```
GABA decarboxylase (B1 dependent)
important because GABA (primary inhibitory neurotransmitter) is formed by same thing that makes glutamate (primary excitatory neurotransmitter)
```
139
basal nuclei do what?
filter info to and from motor cortex
talk to cerebellum
= purposeful normal movement
140
vestibulocerebellum
pontocerebellum
spinocerebellum
- balance and eye movement coordination
- planning and initiation of movement
- synergy, which controls rate, force, range of movement
141
diseases from basal nuclei
parkinsons and hutingtons
142
choreaform/hutington's chorea
jerky uncontrolled movements
younger
progress to death
143
Parkinson's is damage to
sx
cause
```
substantia nigra (dopaminergic system)
festinating gait, cog-wheel rigidity, pill-rolling, resting tremor
autoimmune or drug-induced
```
144
ALS/Lou Gerhig's
```
loss of UMN or LMN
muscle atrophy
weakness
hyper-reflexia
death due to resp complication
```
145
most common organisms for 0-4 weeks infxn
Group B strep, E. coli, Listeria
146
most common organism 4 weeks->50
S pneumoniae
147
difference between encephalitis and meningitis
presence of neurologic deficit in encephalitis due to inflammation of brain
148
clinical signs of brain tumors
drowsiness, lethargy, personality changes, psychosis, seizures, HA, N/V, papilledema (same for most issues with brain)
** new seizures could be due to tumor
149
neuroglial tumors
```
all called astrocytomas up to grade 3.
glioblastoma multiforme (grade 4 astrocytoma): most common brain tumors of adults
```
150
peripheral nerve tumors
schwannoma = benign
acoustic neuroma = CN8
neurofibroma = benign if solitary
neurofibromatosis = autosomal dominant (Von Recklinghausens)
151
Demyelinating disorders
MS is biggest: glove and stalking parasthesias (CNS)
| Guillain-Barre Syndrome (PNS): first flu-like illness, then ascending paralysis
152
Dysmyelination disorders (CNS)
leukodystrophy
| abnormal myelin
153
B1 deficiency due to alcoholism
Wernicke-Korsakoff syndrome
154
dementia, dermatitis, diarrhea, death (4D's)
Pellegra/niacin def (B3)
| *used to be mental hospitals filled with people who just had B3 deficiency
155
macrocytic anemia, degeneration of spinal cord, not cured by folate
vit B12 def
156
folate does not cure what in B12 def
neurologic component
157
diffuse cortical atrophy, neurofibrillary tangles, senile plaques in cortex, abnormal tau proteins, microglia, astrocytes
alzeimer's
158
```
lysosomal storage disease
progressive neurodegenerative disorder
paralysis, dementiamia, seizures follow dev retardation
def of hexosaminidase A
death by age 4
```
Tay-Sachs
159
* def of what enzyme in Tay-Sachs
hexosaminidase A
160
alpha-glucosidase deficiency
Pomp's
161
lack of what enzyme in PKU
phenylalanine hydroxylase
162
toxic levels of copper storage
| liver, brain, eye (Kaiser-Fleisher rings)
Wilson's Disease
