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Neuroscience Block 4 > Block 4 Review > Flashcards

Block 4 Review Flashcards

1
Q

Horner syndrome can be caused by lesions found where?

A

brainstem tegmentum, and upper cervical cord that interrupt the sympathetic fibers descending to the IML of the
thoracolumbar cord.

Pancoast tumor at apex of lungs

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2
Q

Anisocoria

A

unequal pupil size

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3
Q

What is the pathological basis for anisocoria?

A

Pathology in sympathetic nervous system =
constricted pupil (miosis)
Stroke: Lateral medullary syndrome (Wallenberg
syndrome)

Pathology in parasympathetic nervous system =
dilated pupil (mydriasis)

Argyll Robertson pupil
Compression: Tumors, uncal herniation,
aneurysm around CN 3
Weber’s syndrome, Benedikt’s syndrome

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4
Q

What are the common sources of diplopia?

A

Oculomotor palsy

Trochlear nerve palsy

Abducens palsy ± or lateral
gaze palsy

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5
Q

Double vision may result from what?

A

structural problems within the
orbit

disorders of extraocular
muscles

disorder of neuromuscular
junction

disorder of CN III, IV, VI
and/or their central pathways

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6
Q

Primary nociceptor reaction

A

Tissue damage in turn induces
low ECF pH, release of K+, ATP,
and synthesis of prostaglandins
(PG) and bradykinin (BK)

PG increases sensitivity
of pain terminals to BK and
other pain producing substances

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7
Q

What is secondary nociceptor induction?

A

primary nociceptor induction,
spreads to other branches
-Induce release of peptides (e.g.
Substance P, (SP)

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8
Q

Heat pain for mouth travels via what tract?

A

trigeminal thalmic tract

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9
Q

In pain modulation from central structures via peri-aqueductal gray PAG projects to what stucture in the brainstem?

A

NRM in rotstral medulla

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10
Q

What is a known endogenous substance causing nociceptor sensitization and therefore hyperalgesia?

A

Prostaglandin E

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11
Q

Relief of TP is through what?

A

antiepileptics

Valproate
carbamazepine
phenytoin
phenobarbital

and surgical intervention

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12
Q

What happens to muscles in diseases muscle myopathy?

A

number of muscle fibers in a motor unit is

reduced

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13
Q

What happens to muscles when the are denervated following nerve damage?

A

all muscle fibers in a motor unit become denervated and atrophic

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14
Q

In neurogenic diseases or myopathic diseases, the muscle is spontaneously active even at rest?

A

neurogenic

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15
Q

in neurogenic or myopathic disease there is no activity in the muscle at rest and no change in the number of motor units firing during contraction?

A

myopathic

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16
Q

Distal limb weakness indicates neurogenic or myopathy?

A

neurogenic disorder

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17
Q

Proximal limb weakness indicates neurogenic disorder or myopathy?

A

myopathy

18
Q

Fibrillations are invisible or visible twitches of muscle?

A

invisible

19
Q

Fasiclulations are visible or invisible twicthes of muscle?

A

visible

20
Q

Clinical features of hypothyroid neuropathy.

A

Sensory and motor loss

High TSH low T4

Tiredness, hair loss, weakness, voice change,
menstrual changes, depression

Carpel tunnel syndrome

Slow axonal transport

Decreased tendon reflexes

21
Q

What can present or what feelin can present in the body of those with B1 deficiency related peripheral neuropathy?

A

burning and pain in the calves

22
Q

What is a chemotherapeutic agent that can cause toxic neuropathy?

A

vincristine

23
Q

Vincrisitine symtpoms.

A

stocking glove tingling, then profound distal weakness and foot drop

24
Q

MOA of vincristine.

A

inhibits microtubule polymerization and axonal transport

25
Q

Duchenne muscular dystrophy pattern of inheritance.

A

x-linked recessive

26
Q

Duchenne muscular dystrophy has what genetic basis?

A

Caused by mutation (commonly deletion) of gene encoding dystrophin

27
Q

When is Duchenne muscular dystrophy present? (what age)

A

at birth; but manifest by ages 3 and 5

28
Q

Limb-Girdle Muscular Dystrophy earliest presentation is between what years of life?

A

10-40 years

29
Q

How is limb-girdle muscular dystrophy different than DMD?

A

intellectual function unaffected

30
Q

What is inheritance pattern dystrophia myotonica?

A

AD DM1, DM2

31
Q

What is myotonic dystrophy caused by?

A

trinucleotide repeat disorder
In DM1, affected gene - DMPK (myotonic
dystrophy protein kinase), codes for myosin
kinase.

32
Q

How does myotonic dystrophy present?

A

muscle stiffness with myotonia and hair loss (alopecia)

Manifests in third and fourth
decade

cataracts
frontal baldness
testicular atrophy
diabetes mellitus
cardiac abnormalities
intellectual changes
33
Q

Lateral sclerosis in ALS result from what?

A

proliferation of astrocytes and

scarring of the lateral columns of spinal cord

34
Q

Amyotrophic refers to what?

A

atrophy of muscle, weakness and fasciculation

35
Q

How does riluzole work?

A 
blocking TTX-sensitive
sodium channels;
 This in turn reduces calcium influx
and indirectly reduces glutamate
receptor stimulation

glutamate receptor downregulator

36
Q

Acute MS is characterized by what features?

A

plaques (lesions of varying sizes.

Disruption of BBB at sites of inflammation but vessel wall is
preserved

Demyelination through myelin specific autoantibodies

Cellular response:

Perivenular cuffing

Infiltration of inflammatory mononuclear cells (T- cells, macrophages and microglia cells that scavenge myelin debris)

Reactive astrocyte proliferation (gliosis)

Surviving oligodendrocytes attempt to remyelinate naked
axons thereby forming shadow plaques

Axonal sparing is typical, but partial or total loss may occur

37
Q

Describe features of optic neuritis in MS.

A

Diminished monocular visual acuity, dimness and reduced perception of color

38
Q

WHat is one major finding that can be assessed through MRI in a patient with MS?

A

shows multiple lestions (at white arrows) in anterior corpus callosum (usual in MS)

39
Q

Another name for Neuromyelitis optica.

A

Devics disease

40
Q

What is Devic’s disease

A

a subacute autoimmune disorder characterized by simultaneous or consecutive demyelination of optic nerve
& Spinal cord.

May be a distinct entity or variant of MS; monophasic or
recurrent disorder

Neuroscience Block 4 (6 decks)

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