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USMLE Neurology > Cerebral perfusion, brain anatomy and reflexes > Flashcards

Cerebral perfusion, brain anatomy and reflexes Flashcards

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USMLE® Step 1 flashcards
1
Q

Cerebral perfusion is primarily driven by what?

A

PCO2

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2
Q

At what oxygen pressure will O2 influence CPP?

A

Severe hypoxemia < 50 mmHg

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3
Q

What is the cerebral perfusion pressure equal to (what is the equation)?

A

CPP = MAP - ICP

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4
Q

What are the signs of Increased ICP (cushing reflex)?

A
  • Hypertension
  • Bradycardia
  • Respiratory depression
  • Wide pulse pressure
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5
Q

When does CPP not become proportional to PCO2?

A

When PCO2 is > 90 mmHg

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6
Q

What symptoms will an ACA-MCA watershed infarct cause?

A

Proximal upper and lower extremity weakness (“man-in-a-barrel” syndrome)

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7
Q

What symptoms will a PCA-MCA watershed infarct give?

A

Higher-order visual dysfunction

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8
Q

How is CSF drained?

A

Into cerebral veins from arachnoid granulations

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9
Q

A venous sinus will present with what?
- Additionally what risk factors may they have

A

Signs/symptoms of increased ICP
- Headache
- Seizures
- Papilloedema
- Focal neurological deficits

Risk factors are hypercoagulable states e.g:
- OCP use
- Pregnant
- Factor V Leiden

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10
Q

Where is the nucleus of CNXI found?

A

Spinal cord

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11
Q

What is the pineal gland responsible for?

A
  • Melatonin secretion
  • Circadian rhythms
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12
Q

What are the superior colliculi responsible for?

A

Direct eye movemtns tostimuli (noise/movements) or objects of interest

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13
Q

What are the inferior colliculi responsible for?

A

Auditory

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14
Q

Name the vagal nuclei

A
  • Nucleus tractus solitarus
  • Nucleus ambiguus
  • Dorsal motor nucleus
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15
Q

What is the function of the nucleus tractus solitarus?

A
  • Visceral sensory info (taste, baroreceptors, gut distension)
  • May play a role in vomitinfg
  • CN VII, IX, X
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16
Q

What is the function of the nucleus ambigus?

A
  • Motor innervation of pharynx, larynx, upper esophagus (e.g swallowing, palate elevation)
  • CN IX, X, XI (cranial portion)
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17
Q

What is the function of the dorsal motor nucleus?

A

Sends autonomic (parasympathetic) fibers to heart, lungs, upper GI
- CN X

18
Q

What cranial nerve innervates the stylopharyngeus (elevation of pharynx/larynx)?

A

CN IX

19
Q

What are the mastication muscles?

A
  • Masseter
  • Temporalis
  • Medial pterygoid (all close the jaw)
  • Lateral pterygoids (protrude the jaw)
20
Q

What are the mastication muscles innervated by?

A

V3

21
Q

What are the 9 structures a needle must pass through in a lumbar puncture?

A
  • Skin
  • Fascia and fat
  • Supraspinous ligament
  • Intersponous ligament
  • Ligamentum flavum
  • Epidural space (epidural anaesthesia occurs here)
  • Dura mater
  • Arachnoid mater
  • Subaracnoid space (CSF collection occurs here)
22
Q

When may primitive reflexes be seen in adults?

A

When a frontal lobe lesion occurs

23
Q

Describe the Moro reflexx

A

Abduct/extend arms when startled, then draw together

24
Q

Describe the Rooting reflex?

A

Movement of head toward one side if cheek or mooth is stroked (nipple seeking)

25
Q

Describe the sucking reflex

A

Sucking response when roof of mouth is touched

26
Q

Describe the palmar reflex

A

Curling of fingers if palm is stroked

27
Q

Describe the plantar reflex

A

Dorsiflexion of large toe and fanning of other toes with plantar stimulation
- Babinski sign

28
Q

Descrbe the Galant reflex

A

Stroking along one side of the spine while newborn is in ventral suspension face down) causes lateral flexion of lower body toward stimulated side

29
Q

What dermatomes cover the peni;e and anal zones?

A

S2, 3, 4

30
Q

Where is the T10 dermatome?

A

Umbilicus

31
Q

Where is the T7 dermatome?

A

xiphoid process

32
Q

Where is the C4 dermatome?

A

Low collar shirt

33
Q

Where is the C2 dermatome?

A

Posterior half of the skull

34
Q

Where is the C3 dermatome?

A

High turtleneck shirt

35
Q

What nerves innervate the achilles reflexx?

A

S1, 2

36
Q

What nerves innervate the Pattelar reflex?

A

L2, 3, 4

37
Q

What nerves innervate the biceps and brachiradialis reflexes?

A

C5, 6

38
Q

What nerves innervate the tricpes reflex?

A

C6, 7, 8

39
Q

What nerves innervate the anal wink relfex?

A

S3, 4

40
Q

What nerves innervate the cremasteric reflex?

A

L1, 2

41
Q

When do the primitive reflexes disappear?

A

Within 1st year of life

USMLE Neurology (19 decks)

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