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Neurology > cerebral > Flashcards

cerebral Flashcards

0
Q

reticular activating system

A

reduced level of arousal and wakefulness, coma

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1
Q

parietal lesion right

A

hemineglect: agnosia of the contralateral side of the world
difficulty synthesizing sensory information
sterenosis
graphesthesia
anosognosia
construction apraxia: difficulty outline object

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2
Q

Temporal lobe lesion

A

*memory&emotion
1.amygdala:emotion response: cannot tell if sad or happy
2. hippocampus:memory formation
*social appropriateness
kluver-bucy syndrome: hypersexual;oral exploration of items

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3
Q

hyperorality, hypersexuality, disinhibited behavior

A

amygdala
Kluver-Bucy syndrome
associated with HSV－1

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4
Q

Frontal lobe

A

disinhibition and dificits in concentration,
orientation and judgment
may have reemergence of primitive reflexes
Pick’s and frontal temporal dementias

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5
Q

Wernicke-korsakoff syndrome

A

mammillary body, bilateral

confusion, ophthalmoplegia, ataxia; memory loss(anterograde and retrograde amnesia), confabulation, personality changes

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6
Q

tremor at rest

A

basal ganglion

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7
Q

intension tremor, limb ataxia, loss of balance, fall toward side of lesion

A

damage to cerebellum result in ipsilateral deficits;

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8
Q

truncal ataxia,

dysarthria

A

cerebellar vermis

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9
Q

contralateral hemiballism

A

subthalamic nucleus

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10
Q

anterograde amnesia-inability to make new meories

A

hippocampus

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11
Q

eyes look away from side of lesion

A

paramedian pontine reticular formation

PPRF

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12
Q

eyes look toward lesion

A

frontal eye fields

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13
Q

reinforcement of behavior

A

nucleus accumbens
reinforcement of behavior
addiction: cocaine

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14
Q

gerstmann syndrome

A

angular gyrys, left parietal, 出问题的德国人，不会计算
alexin:unaware a loss of ability to comprehend just written language
agraphia: and to write it
acalculia: cannot do simple math
finger anosia：recognize finger and R/L dis orientation
learning disorders (cerebellum & parital)

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15
Q

Anton syndrome

A

occlusion bilateral artery
blindness+denial(all imagine from inside)
can’t see a camouflaged object

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16
Q

6 layers of cerebral cortex cells

A 
molecular layer-rick in axon, cell of Cajal
external granular layer-small pyramidal cell
external pyramidal ( thick in motor area)-large pyramidal cell
internal granular layer (thick in sensory context)-stellate cell
internal pyramidal layer (motor: upper motor neurons)-large pyramidal
multiform layer (polymorphic)-fusiform cell
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17
Q

pyramidal cell

A

apical dend
obliq. dend.
basal dend.
Betz cell is the largest in layer V(internal pyramids layer)Golgi I cell

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18
Q

Stellate cell

A

all layers, excepy layer I
greatest concentration in layer IV
golgi II cell, short axon

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19
Q

fusiform cell

A

spindle-shaped neuron lying within the deeper lamina

layer VI

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20
Q

Martinotti cell

A

all layers except I

directed toward layer I

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21
Q

horizontal cell of Cajal

A

layer 1

axons run parallel

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22
Q

visual agnosia

A

damage temporal lobe involved in cone stream

inability to re cognize visual patterns, including objects in absence of visual field deficit

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23
Q

prosopagosia

A

damage to occipital lobal
cannot recognize faces
can read and name object

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24
Q

apraxia

A

lesion in premotor cortex: 我怕洗呀，不会做这个动作
disruption of the patterning &exection of learned motor movement
lack of understanding how to organize movement

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25
Q

astereognosia

A

lesion in somatosensory association cortex
inability to recogniaze object by touch
integration of visual and somatosensory information is impaired
我死touch know 啥？

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26
Q

asomatonosia/neglect

A

ignore half of the body fail to dress, wash the other half

no visual deficit but ignore things on the left visual field

27
Q

transcortical apraxia

A

ACA occlusion
right motor cortex is disconnected with left due to corpus callosum
verbal command to move left arm, but do not move, NO WEAKNESS

28
Q

alexia without apraxia

A

left PCA, corpus callosum
see in right and read;
but cannot process and cross to reach angular gyrus
can still write

29
Q

central ontine myelinolysis

A

acute paralysis, dysarthria, dysphagia, diplopia
loss of consciousness, locked in syndrome
demyelination in pontine white matter tracts
overly rapid correction of Na level(hyponatremia)补液不可以太快

30
Q

broca’s aphasia

A

nonfluent aphasia with intact comprehension

Broca’s area-inferior frontal gyrus of frontal lobe

31
Q

Wernicke’s

A

fluent aphasia with imaired comprehension
Wernicke’s area-superior temoral gyrus of temporal lobe
unaware, can’t repeat

32
Q

Global aphasia

A

non fluent aphasia with impaired comprehension

Both Broca’s and Wernicke’s area affected

33
Q

Conduction aphasia

A

Poor repetition but fluent speech
intact comprehension
caused by damage to arcuate fasciculus

34
Q

water shed zone

A

between anterior cerebral/middle cereral,
posterior cerebral/middle cerebral arteries
severe hypotension->upper leg/upper arm weakness
defects in higher-order visual processing

35
Q

brain perfusion is controlled by?

A

PCO2 level in the blood

36
Q

MCA stroke

A

motor cortex-upper limb and face-contralateral paralysis
sensory cortex-upper limb and face-contralateral loss of senstaion
temporal lobe (Wernicke’s area)
frontal lobe (Broca’s area)
Aphasia id in dominant side
Hemineglect if nondominant

37
Q

ACA

A

motor cortex-lower limb- contralateral paralysis

sensory cortext-lower limb-contralateral loss of sensation

38
Q

lateral striate artery

A

striatum, internal capsule-contralateral hemiparesis/hemiplegia
common location of lacunar infarcts, 2ndary to unmanaged HTN

39
Q

ASA

A

Lateral corticospinal-contralateral hemiparesis-lower limb
medial lemniscus-decrease contralateral proprioception
caudal medulla-hypoglossal nerve-ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally) XII
stroke commonly bilateral

40
Q

medial medullary syndrome

A

infarction of paramedian brach of ASA and vertebral arteries

41
Q

PICA

A

lateral medulla:VIII, IX, X
vestibular nuclei-vomit, vertigo, nystagmus
lateral spinothalamic tract-pain and temp decrease
spinal trigeminal nucleus-sensation to limbs/face
nucleus ambiguus-dysphagia, hoarseness, decrease gag
sympathetic fibers-ipisilateral horner’s,
inferior cerebellar peduncle-ataxia, dysmetria.

42
Q

AICA

A

lateral pons:位置较medulla高, V VII VIII
vestibular nuclei-vomit, vertigo, nystagmus
spinal trigeminal nucleus-sensation to limbs/face
facial nuclei-paralysis of face, decrease lacrimation, salivation,taste from anterior 2/3 tongue.decrease corneal reflex
cochlear nuclei-decrease ipsilateral hearing
sympathetic fibers-ipisilateral horner’s,
medial and inferior cerebellar peduncle-ataxia, dysmetria.

43
Q

PCA

A

occipital cortex
visual cortex
contralateral hemianopia with macular sparing

44
Q

AComm

A

common site of saccular(berry) aneurysm–>impingement on cranial nerve
visual field defects
lesions are typically aneurysm, not stroke

45
Q

PComm

A

common site of saccular(berry)aneurysm
CN III palsy-eye is down and out with ptosis and pupil dilation
lesions are typically aneurysm not strokes
CNIII cross between PCA and superior cerebellar artery

46
Q

berry aneurysm

A

circle of willis
rupture-subarachnoid hemorrhage-worst headache of life
bitemporal hemianopia via compression of optic chiasm
ADPKD, Ehlers-Danlos syndrome, and Marfan’s syndrome
advanced age, HTN, smoking(higher risk in Black)

47
Q

Chatcot-Bouchard microaneurysm

A

chronic HTN,lacunar infarction-lipohyalinosis
affects small vessels
basal ganglia, thalamus

48
Q

basilar artery

A

lesion of ventral pons
descending corticospinal fibers are interrupted->speech&movement disabled->lock in
tegmentum of pons is spared->awared of surrounding

49
Q

epidural hematoma

A

rupture of middle meningeal artery, maxillary artery
secondary to fracture of temporal bone
lucid interval
rapid expansion ->transtentorial herniation CN III palsy
CT shows biconvex(lentiform), hyperdense, not cross suture line, can cross falx, tentorium

50
Q

subdural hematoma

A

rupture of bridging vein
slow venous bleeding(lesser pressure=hematoma develops over time)
seen in elderly individuals, alcoholics, blunt trauma, shaken baby (brain atrophy, shaking, whiplash)
crescent-shaped hemorrhage that crosses suture lines, midline shift
cannot cross falx, tentorium

51
Q

subarachnoid hemorrhage

A

rupture of aneurysm
seen in Marfan, ADPKD, Ehlers-Danlos or AVM
rapid time course
patients complain of worst headache of my life
bloody or yellow on spinal tap
vasospasm 2-3 dys after due to breakdown(nimodipine) and rebleed

52
Q

Intraparenchymal(HTN) hemorrhage

A

most commonly caused by systemic HTN also seen with amyloid angiopathy, vasculitis, and neoplasm,
typically occurs in basal ganglia and internal capsule
charcot-bouchard aneurysm of lenticulostriate vessels
can be lobar (parietal lobe, amyloid deposition)

53
Q

irreversible damage begins? in brain

A

after 5 mins of hypoxia
most vulnerable- hippocampus, neocortex, cerebellum, watershed
irreversible neuronal injury-red neurons(12-48hrs),
necrosis+neut(24-72hrs), macrophages (3-5 days),
reactive gliosis+vascular proliferation(1-2 wks),
glial scar (>2wk)

54
Q

stroke on imagining

A

bright on diffusion-weighted MRI in 3-30 min and remains bright for 10 days,
Dark on noncontrast CT in-24 hrs
Bright on noncontrast CT indicates hemorrhage(tPA)

55
Q

AS of brain

A

thrombi lead to ischemic stroke with subquent necrosis

form cystic cavity with reactive gliosis

56
Q

hemorrhagic stroke

A

intracerebral bleeding,
often due to hypertension, anticoagulation and cancer(abnormal vessels can bleed).
May be secondary to ischemic stroke followed by reperfusion

57
Q

transient ischemic attack

TIA

A

brief, reversible episode of focal neurologic dysfunction typically lasting<1 hrs without acute infarction(-MRI)
deficits due to focal ischemia

58
Q

dural venous sinuses

A 
superior sagittal sinus
inferior sagittal sinus
straight sinus
confluence of the sinuses-occipital sinus
transverse sinus-sigmoid sinus
sphenoparietal sinus-cavernous sinus
59
Q

ventricular system

A

lateral ventricle–>3rd ventricle via right and left intraventricular foramina of Monro
3rd centricle–>4th ventricle via cerebral aqueduct (sylvius)
4th ventricle–>subarachnoid space via
Foramina Luschka-lateral
Foramen of magende-Medial

60
Q

CSF

A

made by ependymal cell of choroid plexus

reabsorbed by arachnoid granulations and then drains into dural venous sinuses

61
Q

Intraventricular bleeding

A

complication of prematurity
lead to long term neurodevelopmental impair
occur in the first 5 days, from germinal matrix

62
Q

Communicating hydrocephalus

A

decrease absorption by arachnoid granulation
lead to increase intracranial presssure,
papilledema,
herniation (arachnoid scarring post-meningitis)

63
Q

Normal pressure hydrocephalus

A

result increase subarachnoid space volume but no increase in CSF pressure
expansion of ventricle distorts the fibers of the corona radiata and leads to the clinical triad(urinary incontinence, ataxia, cognitive dysfunction)–>wet, wobbly, wacky

64
Q

hydrocephalus ex vacuo

A

appearance of increase CSF in atrophy (alzheimer’s disease, HIV, Pick’s disease), decrease neural tissue
intracranial pressure is normal
triad not seen

65
Q

noncommunicating hydrocephalus

A

caused by structural blockage of CSF circulation within the ventricular system, stenosis of aqueduct of sylvius
papilledema
N/V headache nuclear rigidity mental status change
infant: poor feeding, muscle hypertonicity&hyperreflexia
caused by type II arnold-chiari syndrome

Neurology (7 decks)

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