First Aid Flashcards
1
Q
What are Chiari I malformations associated with?
A
Syringomyelia
2
Q
What’s a Chiari II malformation?
A
Herniation of low-lying cerebellar vermis and tonsils through foramen magnum?
3
Q
What’s a Chiari II malformation associated with (2)?
A
- Hydrocephalus
2. Lumbosacral meningomyelocele
4
Q
What condition involves agenesis of cerebellar vermis with cystic enlargement of 4th ventricle, filling the enlarged posterior fossa?
A
Dandy-Walker Syndrome
5
Q
What is Dandy-Walker Syndrome associated with?
A
- Noncommunicating hydrocephalus
2. Spina bifida
6
Q
What condition leads to a cystic cavity within the central canal of the spinal cord, leading to a “cape-like” bilateral loss of pain and temperature sensation in upper extremities, and is associated with Chiari malformations, trauma, and tumors?
A
Syringomyelia
7
Q
What 3 cranial nerves are involved in taste?
A
7, 9, 10
8
Q
What 3 cranial nerves are involved in tongue pain?
A
V3, 9, 10
9
Q
What 2 cranial nerves are involved in tongue motor?
A
10, 12
10
Q
Myelin is on which cells?
A
Oligodendrocytes in CNS and Schwann cells in PNS
11
Q
What part of the brain is involved in thirst, water balance, hormones, circadians, temperature?
A
Hypothalamus
12
Q
Which part of the hypothalamus synthesizes ADH and oxytocin?
A
Supraoptic and paraventricular nuclei
13
Q
Where is ACh produced?
A
Basal nucleus of Meynert
14
Q
Where is Dopamine produced?
A
Ventral tegmentum, SNc
15
Q
Where is GABA produced?
A
Nucleus accumbens
16
Q
Where is NE produced?
A
Locus ceruleus
17
Q
Where is Serotonin produced?
A
Raphe nucleus
18
Q
Which 2 diseases have decreased ACh?
A
- Alzheimer’s
2. Huntington’s
19
Q
Which disease has increased ACh?
A
Parkinson’s
20
Q
Which 2 diseases have decreased GABA?
A
- Anxiety
2. Huntington’s
21
Q
Which EEG waveform is associated with awake eyes open?
A
Beta
22
Q
Which EEG waveform is associated with awake eyes closed?
A
Alpha
“Blind people are alpha”
23
Q
Which EEG waveform is associated with light sleep (N1)?
A
Theta
24
Q
Which EEG waveform is associated with deeper sleep with bruxism (N2)?
A
Sleep spindles and K complexes
25
Which EEG waveform is associated with slow-wave sleep, nightwalking, night terrors, and bedwetting (N3)?
Delta
26
Which EEG waveform is associated with loss of motor tone, increased brain O2 use, variable pulse and BP, increased ACh, dreaming, nightmares, penile/clitoral tumescence, memory processing (REM)?
Beta
27
Depression ________ total REM sleep, but _________ REM latency?
Increases; decreases
28
What structure in the brain is associated with extraocular movements in REM sleep?
PPRF
29
Which nucleus receives input from the spinothalamic and dorsal column/medial lemniscus, and is involved in vibration, pain, pressure, proprioception, light touch, and temperature, and its destination is the primary somatosensory cortex?
Ventral Postero-lateral Nucleus (VPL)
30
Which nucleus receives input from the trigeminal and gustatory pathway, and is involved in face sensation and taste, and its destination is the primary somatosensory cortex?
Ventral Postero-medial Nucleus (VPM)
31
Which nucleus receives input from CN2 and is involved in vision, and its destination is the calcarine sulcus?
Lateral Geniculate Nucleus
32
Which nucleus receives input from the superior olive and inferior colliculus of tectum and is involved in hearing, and its destination is the auditory cortex of the temporal lobe?
Medial Geniculate Nucleus
33
Which nucleus receives input from the basal ganglia and cerebellum, is involved in motor function, and its destination is the motor cortex?
Ventral Lateral Nucleus
34
Which system is involved in the 5 Fs?
The limbic system
35
Which dopamine pathway, if its activity is decreased, leads to negative sx?
Mesocortical
36
Which dopamine pathway, if its activity is increased, leads to positive sx?
Mesolimbic
37
Which dopamine pathway, if its activity is decreased, leads to extrapyramidal sx?
Nigrostriatal
38
Which dopamine pathway, if its activity is decreased, leads to increased prolactin?
Tuberoinfundibular
39
Does proprioceptive information via the inferior cerebellar peduncle from spinal cord enter the cerebellum ipsilaterally or contralaterally?
Ipsilaterally
40
Which input to the cerebellum is contralateral?
Contralateral cortex via medial cerebellar peduncle
41
What do lateral cerebellar lesions present as?
Limb voluntary movements; when injured, tendency to fall toward ipsilateral side (side of lesion)
42
What do medial cerebellar lesions present as?
Truncal ataxia, wide-based gait, nystagmus, head tilting
43
Does the excitatory dopamine pathway lead to increased motion?
Yes
44
Does the inhibitory dopamine pathway lead to decreased motion?
Yes
45
Review brain anatomy and homunculus, pg 471
Good job
46
From superiomedial to inferolateral, what are the body parts of the motor/sensory homunculus?
```
Foot
Leg
Shoulder
Wrist
Hand
Thumb
Face
Mouth
Toes
```
47
Cerebral perfusion is primarily driven by what gas?
CO2
48
Which surface of the brain does the ACA supply?
Anteromedial
49
Which surface of the brain does the MCA supply?
Lateral
50
Which surface of the brain does the PCA supply?
Posteroinferior
51
Draw the Circle of Willis
Good job
52
Which 4 CN are above pons?
1, 2, 3, 4
53
Which 4 CN are in pons?
5, 6, 7, 8
54
Which 4 CN are in medulla?
9, 10, 11, 12
55
Which 4 CN nuclei are medial?
3, 4, 6, 12 (factors of 12)
56
What does the pineal gland secrete?
Melatonin
57
What is the superior colliculi involved with?
Conjugate vertical gaze
58
What is the inferior colliculi involved with?
Auditory
59
Where are the superior colliculi?
Midbrain
60
Where is the nucleus of CN11?
Spinal cord
61
What's the mnemonic for remembering which words are motor, sensory, or both?
```
Some
Say
Marry
Money
But
My
Brother
Says
Big
Brains
Matter
Most
```
62
How many vagal nuclei are there?
3
63
What does the nucleus solitarius involve?
Visceral sensory information (taste, baroreceptors, gut distention) CNs 7, 8, 9
64
What does the nucleus ambiguus involve?
Motor innervation of pharynx, larynx, upper esophagus (swallowing, palate elevation) CNs 9, 10, 11
65
What CNs are involved in the corneal reflex?
V1 and 7
66
What CNs are involved in the lacrimation reflex?
V1 and 7
67
What CNs are involved in the jaw jerk reflex?
2 and 3
68
What CNs are involved in the gag reflex?
9 and 10
69
Which CN innervates the muscles of mastication?
V3
70
When a disc is herniated, which nerve is affected?
Usually the one below
71
Which nerves exit above the corresponding vertebrae?
C1-C7
72
How many cervical nerves are there?
8
73
At what level does the spinal cord end in adults?
L1/L2
74
What's the function of the dorsal column?
Pressure, vibration, fine touch, proprioception
75
What's the function of the spinothalamic tract?
Pain, temperature
76
What's the function of the corticospinal tract?
Voluntary movement of contralateral limbs
77
Where do the dorsal column tracts decussate?
Medulla
78
Where do the spinothalamic tracts decussate?
Anterior white commissure of spinal cord at level
79
Where do the corticospinal tracts decussate?
Caudal medulla
80
What level does the Achilles reflex test?
S1
81
What level does the patellar reflex test?
L4
82
What level does the biceps and brachioradialis reflexes test?
C5
83
What level does the triceps reflex test?
C7
84
What level does the cremasteric reflex test?
L1, L2
85
What level does the anal wink reflex test?
S3, S4
86
A lesion in which area of the brain causes re-emergence of primitive reflexes?
Frontal lobe
87
If the lesion is in the PPRF, which direction do the eyes look?
Away from lesion
88
If the lesion is in the frontal eye fields, which direction do the eyes look?
Toward the lesion
89
Which lesion presents with agraphia, acalcula, finger agnosia, and left/right disorientation?
Dominant parietal cortex
90
Which lesion presents with agnosia of the contralateral side of the world?
Nondominant parietal cortex
91
Which lesion presents with anterograde amnesia?
Hippocampus, bilateral
92
Which lesion presents with resting tremor, chorea, and athetosis?
Basal ganglia
93
Which lesion presents with contralateral hemiballismus?
Subthalamic nucleus
"Having a ball with the subwoofer"
94
Which lesion presents with Wernicke-Korsakoff syndrome (confusion, ataxia, nystagmus, opthalmoplegia, memory loss, confabulation, personality changes)?
Mamillary bodies, bilateral
95
Which lesion presents with Kluver-Bucy syndrome (hyperphagia, hypersexuality, hyperorality)?
Amygdala, bilateral (HSV-1 encephalitis)
96
Which lesion presents with Parinaud syndrome (paralysis of conjugate vertical gaze)?
Superior colliculus
97
Which lesion presents with reduced levels of arousal and wakefulness?
Reticular activating system (midbrain)
98
Which lesion presents with intention tremor, limb ataxia, loss of balance, and ipsilateral deficits?
Cerebellar hemisphere (lateral)
99
Which lesion presents with truncal ataxia and dysarthria?
Cerebellar vermis (central)
100
Which region of the brain is most vulnerable to ischemic hypoxia?
Hippo
101
Which is the most common brain artery site of a thrombus?
MCA
102
When do you administer tPA?
Within 3-4.5 hours of onset
103
Which type of intracranial hemorrhage involves the MMA, presents with a lucid interval followed by rapid expansion that can lead to transtentorial herniation or CN 3 palsy and is biconvex and does not cross suture lines?
Epidural hematoma
104
Which type of intracranial hemorrhage involves the bridging veins and is due to trauma, shaken babies, or atrophy, and can cause midline shift and crosses suture lines?
Subdural hematoma
105
Which type of intracranial hemorrhage is often due to a berry or saccular aneurysm rupture, and presents with bloody tap, worst headache of life, vasospasm days later, and can develop hydrocephalus?
Subarachnoid hemorrage
106
What do you use to prevent vasospasm in subarachnoid hemorrhages?
Nimodipine
107
Which type of intracranial hemorrhage is usually due to systemic hypertension, vasculitis, or neoplasm and usually occurs in the basal ganglia and internal capsule?
Intraparenchymal hemorrhage
108
Which artery stroke can cause contralateral hemiparesis, sensory loss, hemianopia, and either aphasia or neglect?
MCA
109
Which artery stroke can cause contralateral leg weakness and executive dysfunction?
ACA
110
Which artery stroke can cause hemianopia, pure sensory infarct (thalamus), memory impairment, and decreased level of consciousness?
PCA
111
Which (broad) level of stroke can cause crossed sensory or motor findings, nystagmus, diplopia, vertiga, and Horner's?
Brainstem
112
Which (broad) level of stroke can cause ataxia, nystagmus, vertigo, nausea, headache, or rapid deterioration in consciousness?
Cerebellar
113
Which type of stroke often has a characteristic pattern of pure motor, pure sensory, sensorimotor, ataxic hemiparesis, or clumsy hand dysarthria?
Lacunar
114
Which artery of stroke causes contralateral paralysis of face and upper limb?
MCA
| "Order MCdonalds drive-thru with your face and arm"
115
Which artery of stroke causes contralateral paralysis of lower limb?
ACA
| "Tore my ACA"
116
Which artery of stroke causes contralateral paralysis of face and body?
Lenticulostriate (lacunar)
| "Face, bodi, lenticulostri"
117
Which artery of stroke causes contralateral paralysis of upper and lower limbs?
ASA
| "Take ASA for upper and lower limb pain"
118
What's the most common site of a saccular (berry) aneurysm?
Junction of ACom and ACA
119
What's the tx for acute cluster headache?
Sumatriptan, 100% O2
120
What's the preventative tx for cluster headache?
Verapamil
121
Lewy bodies are composed of what?
Eosinophilic inclusions (a-synuclein)
122
What 2 meds can cause pseudotumor cerebri?
1. Danazol
| 2. Tetracycline
123
From low to high ....
Your pons will die (central pontine myelinolysis)
124
From high to low ...
Your brain will blow (cerebral edema/herniation)
125
Why might Guillain-Barre cause papilledema?
Elevated CSF protein
126
Where are the lesions in MS on MRI?
Periventricular
127
Which demyelinating disease is AD inheritance and associated with hammer toe, foot drop, and sensory deficits?
Charcot-Marie-Tooth
128
Which demyelinating disease is AR, involves deficiency of galactocerebrosidase (lysosomal storage), developmental delay, optic atrophy, and globoid cells?
Krabbe disease
129
Which demyelinating disease is AR, lysosomal storage, leads to buildup of sulfatides and presents with ataxia and dementia?
Metachromatic leukodystrophy
130
Which demyelinating disease involves the CNS, is seen in AIDS patients due to latent JC virus infection, and the risk is increased with natalizumab and rituxumab use?
PML
131
Which disorder is X-linked, involves VLCFA and can lead to adrenal crisis?
Adrenoleukodystrophy
132
Which neurocutaneous disorder has port-wine stain of face (CN V1/V2), leptomeningeal angioma, seizures, intellectual disability, and glaucoma?
Sturge-Weber
133
Which neurocutaneous disorder is AD, has ash-leaf spots, angiofibromas, rhabdomyoma, intellectual disability, seizures, shagreen patches, and renal angiolipoma?
Tuberous Sclerosis
134
Which neurocutaneous disorder is AD, cafe-au-lait spots, cutaneous neurofibromas, pheochromocytomas, lisch nodules (on iris)?
NF1
135
Which neurocutaneous disorder is AD, involves bilateral acoustic schwannomas, juvenile cataracts, meningiomas, and ependymomas?
NF2
136
Which neurocutaneous disorder is AD, involves hemangioblastomas in retina, brainstem, cerebellum, and spine, angiomas in skin etc, pheochromocytomas, and bilateral renal cell carcinomas?
Von Hippel-Lindau
137
Which type of herniation can compress ACA?
Cingulate (subfalcine)
138
Which type of herniation can cause rupture of basilar artery branches and is usually fatal?
Transtentorial
139
Which type of herniation can cause down and out blown pupil?
Uncal
140
Which type of herniation can cause coma and death when it compresses the brainstem?
Cerebellar tonsillar
141
Which spinal cord lesion affects UMN and LMN but does not affect sensory or bowel/bladder function?
ALS
142
What disease with asymmetric weakness (LMN only) might occur in someone unvaccinated?
Poliomyelitis
143
What vitamin deficiency causes subacute combined degeneration of spinocerebellar tracts, lateral corticospinal tracts, and dorsal columns?
B12
144
What does tertiary syphilis cause?
Tabes dorsalis (argyll robertson pupils, absence of DTRs, and positive Romberg)
145
What's an argyll robertson pupil?
It accommodates but does not react
146
Which spinal cord lesion causes ipsilateral/contralateral everything, and sometimes even Horner's if above T1?
Brown-Sequard Syndrome
147
Which AR disorder causes staggering gait, falling, kyphoscoliosis, nystagmus, diabetes, hypertrophic cardiomyopathy, and loss of DTRs during adolescence?
Friedrich Ataxia
148
Where does the jaw deviate with CNV lesions?
Toward lesion
149
Where does the uvula deviate with CN10 lesions?
Away from lesion
150
Where does weakness occur with CN11 lesions?
Shoulder droops on side of lesion
151
Where does the tongue deviate with CN12 lesions?
Toward lesion
152
The ________ is spared in an UMN face lesion?
Forehead
153
In Bell's palsy, is the forehead affected?
Yes
154
What mode of inheritance is the most common muscular dystrophy?
AD
155
What's the most common mononeuropathy in patients on hemodialysis, often caused by dialysis-related amyloidosis?
Carpal tunnel syndrome
156
What part of the spinal cord contains pain/temperature and LMN?
Anterior cord
157
What part of the spinal cord contains light touch/proprioception and some UMN?
Posterior cord
158
What part of the cord is associated with arm motor function and can be damaged during whiplash?
Central cord
159
What's the most common cause of spontaneous lobar hemorrhage in adults >60?
Cerebral amyloid angiopathy
