Basic Neuro

Question 1

What is the tumor commonly found in the cerebellum of children?
It stains positive for what marker?

Answer 1

astrocytoma
GFAP

Question 2

The JC virus infects what neurological cell types?
Usually CD4+ below?

Answer 2

astrocytes & oligodendrocytes (severe demyelinating disease)
CD4+ below 200

Question 3

What is the name of the macrophages of the CNS?

Answer 3

microglia

Question 4

HIV can hide out in what CNS cell type and cause chronic HIV encephalitis?

Answer 4

microglia

Question 5

Oligodendrocytes vs. Schwann cells:

location

how many axons they myelinate

Answer 5

• Oligodendrocytes
  
  • CNS
  • myelinate multiple axons
• Schwann Cells
  
  • PNS
  • myelinate ONE axon

Question 6

What cell type is destroyed in MS?

This causes a decrease in what variables?

Answer 6

oligodendrocytes

conduction velocity and length constant

Question 7

What cell type is affected in Guillan-Barre?

What structure is inflamed?

Answer 7

Schwann cells

endoneurium is inflamed

Question 8

What is the other name for schwannomas? Why?

Answer 8

acoustic neuroma

classically affects CNVIII

Question 9

What are the two major factors of saltatory conduction?

Answer 9

• conduction velocity
• length constant
  
  • how far you can go along the neuron until the strength of the AP has decreased to 1/3 its original strength

Question 10

Classify the different nerve fibers by diameter, myelination & type of signal taht they transmit

Answer 10

• A-alpha
  
  • large, myelinated
  • efferent motor fibers
  • touch, vibration, position
• A-delta
  
  • small, myelinated
  • cold, pain
• C
  
  • small, unmyelinated
  • warm, pain

Question 11

What neuron cell types are most sensitive to ischemia?

How many minutes of ischemia can cause irreversible damage?

Answer 11

hippocampus

purkinje cells

neocortex

straitum (basal ganglia)

4-5 minutes

Question 12

What are the differences in symptoms between a patient with bulbar palsy and pseudobulbar palsy?

Answer 12

• bulbar palsy (LMN)
  
  • absent jaw / gag reflex
  • tongue flaccid / wasted
• pseudobulbar palsy (UMN)
  
  • exaggerated gag reflex
  • tongue spastic (no wasting)
  • spastic dysarthria

Question 13

What area is particulary important when considering patients with nausea in response to chemotherapy?

Answer 13

area of postrema: caudal end of 4th ventricle in medulla

outside of blood brain barrier & send signal to central vomit center in the medulla

Question 14

Where does the brain sense the osmolarity of the blood?

Answer 14

OVLT (organum vasculosum of the lamina terminis)

anterior wall of the third ventricle

Question 15

What aspect of the pituitary is outside of the blood brian barrier? It releases waht hormones?

Answer 15

posterior pituitary- oxytocin & ADH

Question 16

Where is NE produced in the brain?

Answer 16

locus cerulus - in the posterior pons near the 4th ventricle

Question 17

What area of the brain is very active in opiate withdrawl?

Answer 17

locus ceruleus - producing NE

Question 18

Where is dopamine produced in the central nervous system?

Answer 18

ventral tegmentum (midbrain)

substantia nigra (midbrain)

Question 19

Where is GABA produced in the brain?

It is produced & broken down by what enzymes? They require what cofactor?

Answer 19

nuceus acumbens

(produced) glutamate decarboxylase

(broken down) GABA transaminase

both require B6

Question 20

What are the type of GABA receptors and where are they located?

Answer 20

GABA- A & GABA-B (brain)

GABA-C (retina)

Question 21

Where is serotonin produced in the CNS?

Answer 21

raphe nucleus (pons)

Question 22

What is the classic triad of serotinin syndrome?

Answer 22

mental status changes

autonomic hyperactivity

neuromuscular abnormalities

Question 23

How can you differentiate between serotonin syndrome & neuroleptic malignant syndrome?

Answer 23

Both: muscle rigidity, fever, change in mental status, autonomic instability

Serotinin Syndome: clonus

Neuroleptic malignant syndrome: “lead pipe” rigidity, increase CK

Question 24

Where is Acetylcholine produced in the central nervous system?

Answer 24

basal nucleus of Meynert (subcortex)

Question 25

The phrenic nerve includes what nerve roots?

What medical conditions can irritate this nerve?

Answer 25

C3-C5

innervates diaphragm

referred shoulder pain

gallbladder or lower lung mass - leads to hiccups or dyspnea

Question 26

Appendicitis sends referred pain to what nerve root?

Answer 26

T10

umbilicus

Question 27

Biceps reflex?

Answer 27

C5

Question 28

Triceps reflex?

Answer 28

T7

Question 29

Pateller reflex?

Answer 29

L5?

Question 30

Achiles reflex?

Answer 30

S1?

Question 31

What are the symptoms of a L4/L5 nerve root problem?

Answer 31

• back pain down lateral leg
• foot strencth reduced
• reflexes normal

Question 32

What are the symptoms of a L4/S1 nerve root problem?

Answer 32

• pain down back of leg
• weakness plantar flexion
• ankle reflex lost

Question 33

What is the Moro Reflex?

Answer 33

“Startle Reflex”

lie baby on back

left slightly off back

let go

3 phases: spreading of arms, unspreading of arms, crying

Question 34

Primitive reflexes should go away within what time frame?

They can re-emerge in adults with what type of pathology?

Answer 34

1 year

frontal lobe pathology

Question 35

What is the rooting reflex?

Answer 35

Stroke cheek & baby turns toward side of stroke

Question 36

What is the sucking reflex?

Answer 36

baby will suck on anything that touches the roof of mouth

Question 37

What is the palmar reflex?

Answer 37

strok babys palm & fingers will grasp

Question 38

What is the plantar reflex?

Answer 38

“babinski reflex”

Question 39

What is the galant reflex?

Answer 39

stroke skin along babys back & they will swing their legs to the side