General Review

Question 1

Cingulate herniation under falx cerebri

compresses?

Answer 1

ACA

Question 2

Downward transtentorial herniation (central)
compresses?
Sx?

Answer 2

Brainstem, can cause impaired vertical gaze, bilateral miosis, –> coma/ death

Question 3

Classical uncal herniation can cause?

Answer 3

ipsilateral CN IIII palsy

contra/ipsi hemiparesis

Question 4

Cerebellar tonisillar herniation thru foramen magnum can cause?

Answer 4

respiratory depression

Question 5

brain tumor - adults
GFAP+
Butterfly glioma, crosses corpus callosum

Answer 5

Glioblastoma Multiform

Question 6

Brain tumor
Arise from arachnoid cells, usually benign, resectable, spindle cells in a whirled pattern w/ calcifications, = psommoma bodies

Answer 6

Meningioma

Question 7

Brain tumor
S100+, a/wNF-2
presents w/ hearing loss/ tinnitis, ataxia, dizziness

Answer 7

Schwannomas

Question 8

Brain tumor
Frontal lobes, rare, slow growing
Chicken wire capillaries, fried egg cells, often calcified

Answer 8

Oligodendroglioma

Question 9

MC locations for pediatric brain tumors?

Answer 9

cerebellum and brainstem

Infratentorial > supratentorial > midline

Question 10

Infratentorial tumors cause ICP because?

Answer 10

compression of 4rth ventricle

Question 11

MC childhood brain tumor
most in the posterior fossa
hyalinization of blood vessels 
BRAF: cerebellar 
V600E: extra-cerebellar

Answer 11

pilocytic astrocytoma

Question 12

Highly malignant childhood brain tumor 
Primitive neuroectoderm 
can compress 4rth ventricle > increasing ICP 
can send drop mets 
Homer Write rosettes

Answer 12

Medulloblastoma

Question 13

Perivascular pseudorossettes int he 4rth ventricle
Rod shaped plepharaplasts
Poor prognosis

Answer 13

Ependymoma

Question 14

cerebellar tumor
a/w VHL, retinal angiomas
Can produce EPO
Foamy cells, high vascularity

Answer 14

Hemangioblastoma

Question 15

Rathke’s pouch, calcification

MC supratentorial tumor

Answer 15

Craniopharynioma

Question 16

Pain transmission in migraine:
CN?
Nucleus?
Release of what causes what?

Answer 16

CN V1 - innervates dura, meninges, cerebral arteries/ veins
CN VII: Superior Salivatory Nucleus: vasodilation’

Increase in CGRP acts on CRL receptor causing mast cell degranulation and vasodilation

Question 17

Extreme severe headache over one eye, conjunctival injection, rhinorrhea, non-pulsing

Acute tx: oxygen, sumatriptan (blocks CRGP release)

Answer 17

cluster headache

Question 18

Bandlike/ occipital, steady, no photo/phono phobia

Answer 18

Tension

Question 19

Light inhibits the retinal ganglion cells w/ melanopsin

Darkness stimulates the retinal ganglion cells which signal the?

Answer 19

suprachiasmatic nucleus (Master clock)

Question 20

Master clock signals?

Answer 20

Paraventrcular nucleus –> SNS in superior cervical ganglion –> pineal gland to release melatonin into the brainstem

Question 21

Awake brain activity

Answer 21

alpha and beta

Question 22

stage 1 & 2 sleep

Answer 22

theta, sleep spindles

Question 23

Stage 3 & 4 sleep

Answer 23

delta, increased amplidude

Question 24

frequency > 13 Hz

Answer 24

Beta (cholinergic)

Question 25

frequency 8-13 Hz

Answer 25

Alpha

Question 26

frequency 4-7

Answer 26

Theta

Question 27

frequency <4

Answer 27

Delta

Question 28

REM sleep components

Answer 28

Beta and Theta increases in frequency & duration toward the morning lost as we age

Question 29

Cholinergic neurons in the PPT and LDT Active? Inactive?

Answer 29

Active in wakefulness and REM sleep Not active in NREM Beta waves

Question 30

Noradrenergic: Locus cereleus

Answer 30

Neurons most active in wakefulness, some in NREM sleep, none in REM sleep

Question 31

DA neurons

Answer 31

Active during wakefulness | SIlent during REM

Question 32

Seratonergic neurons from raphe nucleus:

Answer 32

Wake: highest activity NREM: some REM: none

Question 33

Histaminergic | Tuberomamillary nucleus

Answer 33

Wake: highest NREM: some REM: none

Question 34

Orexin/ Hypocretn Lateral hypothalamus Suprachiasmatic/ paraventricular nucleus (light/dark)

Answer 34

excitatory, increases wakefulness Narcopleptics have decreased orexin

Question 35

Role of VPLO?

Answer 35

Inhibits nuclei that promote arousal Lesions of the VPLO > insomnia