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Neuro > Midterm > Flashcards

Midterm Flashcards

1
Q

blood supply to the brain

A

ICA

Vertebral A

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2
Q

Circle of Willis Arteries

A 
Anterior communicating A
Anterior Cerebral A
Middle Cerebral A
Posterior Cerebral A
ICA 
Posterior Communicating A
Vertebrobasilar
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3
Q

***Aneurysm

A

Ant. Communicating

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4
Q

Stroke

A

Lat. Striate of MCA

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5
Q

Dura layers

A

2 cranial

1 spinal

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6
Q

Arachnoid

A

No blood vessels

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7
Q

Spinal cord blood supply

A

2/3 Ant. Spinal A

1/3 Post. Spinal A

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8
Q

Subarachnoid contents

A

CSF

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9
Q

Subdural contents

A

bridging veins

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10
Q

***Epidural hematoma

A

Middle Meningeal A

  • lucid interval
  • lens shaped
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11
Q

Subdural Hematoma

A

no trauma/elderly
crescent shaped
(hyperdense=white/acute)
(hypodense=dark/old)

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12
Q

***Subarachnoid Hemorrhage

A

aneurysm leakage
“worst headache of life”
blood stained CSF

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13
Q

—Intracranial/Intracerebral Hemorrhage

A

lenticulostriate of MCA
loses consciousness
paralysis upon awakening

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14
Q

emissary veins

A

valveless

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15
Q

choroid plexus

A

produces CSF

formed by ependymal cells

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16
Q

***CSF circulation

A 
Lateral ventricles
   - foramen of monro
Third Ventricle
   - aqueduct of sylvius
Fourth Ventricle
   - foramen of luschka (lat.)
   - foramen of magendie (med)
Subarachnoid space 
   -> recirculation
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17
Q

lumbar puncture

A

L4/L5

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18
Q

Non-communicating Hydrocephalus

A

obstruction within ventricles
(ex. aqueductal stenosis)
enlarged head

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19
Q

—Communicating Hydrocephalus

A

blockage in subarachnoid space
no reabsorption

—Findings: arachnoid granulation

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20
Q

Normal Pressure Hydrocephalus

A

(communicatiing)
WACKY
WOBBLY
WET

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21
Q

***Bacterial Meningitis

A 
CLOUDY CSF
increased WBC
DECREASED GLUCOSE
increased protein
increased pressure

headache, fever, neck rigidity

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22
Q

Viral encephalitis

A

clear or cloudy CSF
slightly elevated protein
normal glucase

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23
Q

soma

A

nucleus
cytoplasm
NISSL BODIES

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24
Q

dendrites

A

impulses TOWARDS cell body

proximal = NISSL
distal = NO NISSL
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25
Q

Axon Hillock

A

NO NISSL

Action Potential arises here

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26
Q

Multipolar neurons

A

motor
many processes
from soma

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27
Q

Golgi type 1

A

long

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28
Q

Golgi type 2

A

short

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29
Q

glial cells in PNS

A

Schwann cells

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30
Q

Myelination

A

increases conductance
decreases energy expense
protection

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31
Q

fast anterograde

A

KINESIN

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32
Q

fast retrograde

A 
DYNEIN
neurotropic viruses (ex. herpes)
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33
Q

Neuropraxia

A

1st degree
transient block
full recovery

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34
Q

Axonotemesis

A

Axon damaged, but sheath intact
WALLERIAN DEGENERATION
functional recovery

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35
Q

Neurotemesis

A

5th degree

complete section of the nerve trunk

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36
Q

***wallerian degeneration

A

distal to the site of damage on the axon

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37
Q

chromatolysis

A

cell body swells (edema)

nucleus shifts peripherally

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38
Q

Nerve regeneration location

A

PNS ONLY

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39
Q

Axodendritic synapse

A

80% cerebral cortex

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40
Q

Axosomatic synapse

A

15% cerebral cortex

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41
Q

chemical synapse

A

one way

slow

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42
Q

electrical synapse

A

bi-directional
fast
smooth & cardiac muscle

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43
Q

small clear vesicles

A

Ach
GABA
glycine
glutamate

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44
Q

small dense core vesicles

A

catecholamines

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45
Q

large dense core vesicles

A

neuropeptide

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46
Q

T-SNARE

A

SNAP25, Syntaxin

on Terminal membrane

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47
Q

V-SNARE

A

Synaptotagmin, Synaptobrevin

on synaptic vesicle

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48
Q

Excitatory Post-synaptic

depol.

A

ACh, Nor-adrenaline

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49
Q

Inhibitory Post-synaptic

hyperpol.

A

GABA, Glycine

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50
Q

***Peripheral synapse

A

nAChR (only excitatory)

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51
Q

***Myesthenia Gravis

A

nAChR at NMJ
increased anti-MuSK Ab
thymoma

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52
Q

***Lambert Eaton

A

Ca channels at pre-synaptic terminal

SCLC

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53
Q

***Botulism

A

cleaves SNARE at pre-synaptic membrane

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54
Q

Infantile Botulism

A

associated with honey

type A&B

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55
Q

Wound Botulism

A

associated with black tar heroin

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56
Q

Tetanus

A 
protease cleaves SNARE proteins
muscle hyperexcitation (tetanic contractions)
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57
Q

neurotransmitter vs neuromodulator

A

neurotransmitter
elicits specific response

neuromodulator
not directly cause EPSP or IPSP

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58
Q

excitatory receptor

A

NMDA

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59
Q

inhibitory receptor

A

GABA

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60
Q

degradation of neurotransmitter

A

acetylcholinesterase

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61
Q

ionotropic receptor

A

ligand gated

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62
Q

metabotropic receptor

A

GCPR

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63
Q

basal plate

A

anterior/ventral horn

motor

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64
Q

alar plate

A

posterior/dorsal horn

sensory

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65
Q

Procencephalon

A

telencephalon -> cerebral hemispheres

diencephalon -> thal., hypothal., subthal., neuropit.

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66
Q

Mesencephalon

A

mibrain

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67
Q

Rhombencephalon

A

Metencephalon -> pons, cerebellum

Myencephalon -> medulla

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68
Q

cyst adjoining choroid plexus

A

roof plate

decreased CSF

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69
Q

Anencephaly

A

anterior/rostal neuropore

partial/complete absence of brain

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70
Q

Encephalocele

A

portions of anterior neuropore
sac-like protrusion
mental retardation

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71
Q

holoprosencephaly

A

failure of midline cleavage

seen in fetal alcohol & Patau

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72
Q

microcephaly

A

less than third percentile

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73
Q

Spina bifida

A

posterior/caudal neuropore

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74
Q

Spina bifida occulta

A

defect in vertebral arches

tuft of hair

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75
Q

Spina bifida cystica

A

dysraphism

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76
Q

—Spina bifida meningocele

A 
meninges project
(no mental defect)
77
Q

Spina bifida myelomeningocele

A

meninges and spinal cord project

78
Q

Spina bifida myeloschisis

A

open neural tube

79
Q

MSAFP

A 
>2.5 = neural tube defect
<0.4 = down syndrome
80
Q

—Arnold Chiari Syndrome

A

herniation of cerebellum

type 1 - asymptomatic
type 2 - lumbar myelomeningocele

81
Q

Syring(hydro)myelia

A

spinothalamic tract

loss of pain & temp

82
Q

Dandy Walker Syndrome

A

Dilated 4th ventricle
Water on the brain
Small vermis

83
Q

Meissners Corpuscle

A

fast touch
pressure
vibrations of HAIRLESS SKIN

84
Q

Merkel cells

A

slow touch

pressure

85
Q

—Pacinian corpuscle

A

fast
pressure
DEEP VIBRATION

86
Q

Ruffini endings

A

SKIN STRETCH

slow

87
Q

***free nerve endings

A

TEMPERATURE

88
Q

two point discrimination test

A

used for dorsal column medial lemniscus

proprioception

89
Q

acuity

A

less convergence = better acuity

90
Q

temporal summation

A

increase in AP ON A SINGLE FIBER

91
Q

spacial summation

A

increase in PARALLEL FIBERS

92
Q

phasic

A

fast

93
Q

tonic

A

slow

94
Q

—***Dorsal Column Medial Lemniscus

A

fine touch, vibration, proprioception

fasciculus cuneatus = arm (lateral)
fasciculus gracilis = leg (medial)

CROSSES @ MEDULLA
ipsilateral

95
Q

—Antereolateral spinothalamic tract

A

pain, temperature, crude touch

CROSSES IMMEDIATELY (@ gray matter of spinal cord) 
contralateral
96
Q

final target structure of inferior olivary nucleus and what do they terminate on

A

cerebellar cortex

terminated on purkinje fibers

97
Q

dorsal column lesion

A

positive Romberg (with eyes closed)

if eyes open = cerebellar

98
Q

spinothalamic lesion

A

contralateral loss of pain and temp

99
Q

A(gamma)

A

fast pain
myelinated
cold

100
Q

—C fiber

A

slow pain
UNMYELINATED
hot

101
Q

VR1

A

capsaicin, temps > 43 Celsius

102
Q

why do we rub an injury

A

only a finite amount of pain and touch stimuli can be processed at a time

103
Q

Gate theory

A

AB block pain

C cause excitation/pain

104
Q

interneurons inhibit pain via

A

serotonin

105
Q

Hyperalgesia

A

increased sensitivity

106
Q

hypoalgesia

A

decreased sensitivity

107
Q

analgesia

A

loss of pain sensation

108
Q

allodynia

A

excessive response to even mild stimuli

109
Q

anterior cerebral occlusion

A

homunculus -> lower limbs

110
Q

posterior spinal artery arises from

A

PICA (posterior inferior CEREBELLAR artery)

111
Q

Multiple Sclerosis (MS)

A

autoimmune, demyelinating disorder of CNS AXONS
scanning speech, intention tremor, nystagmus
increased IgG, MBP, leukocytes
MRI = multifocal plaques in white matter

112
Q

—Guillain-Barre Syndrome

A

autoimmune, demyelinating
associated with infections (ex. FLU)
no fever, ascending paralysis

increased CSF protein ->
albuminocytological disssociation

113
Q

—Charcot-Marie-Tooth disease

A

demyelinating Schwann cells (connexin)
foot deformities

preserved C FIBER

114
Q

anterior to the central sulcus

A

precentral gyrus = motor

115
Q

posterior to the central sulcus

A

postcentral gyrus = sensory

116
Q

medial homunculus

A

feet area

117
Q

UMN

A

brain stem, cerebral cortex

118
Q

LMN

A

ventral horn, cranial nerve nuclei

119
Q

***lateral corticospinal tract

A

crosses at medulla

DISTAL/LOWER LIMBS

120
Q

***ventral corticospinal tract

A

crosses at spinal cord

TRUNK/PROXIMAL LIMBS

121
Q

role of cerebellum

A

movement

122
Q

basal ganglia

A

fine tunes movement

123
Q

final common pathway

A

LMN

124
Q

vestibulospinal tract

A

EAR (balance)

125
Q

reticulospinal tract

A

posture

126
Q

rubrospinal tract

A

RED NUCLEUS

precise upper limb movement

127
Q

tectospinal tract

A

eyes

128
Q

***α motor neurons

A

make skeletal muscles CONTRACT

129
Q

***γ motor neurons

A

make muscle spindles more sensitive to STRETCH

130
Q

***α motorneurons

A

innervate EXTRAFUSAL skeletal muscle fibers

131
Q

***γ Motoneurons

A

innervate specialized INTRAFUSAL muscle fibers

132
Q

Nuclear bag fibers

A

1a, dynamic γ

larger, and their nuclei are accumulated in a central (“bag”) region

133
Q

Nuclear chain fibers

A

1a, 2, static γ

smaller, and their nuclei are arranged in rows (“chains”)

134
Q

α-γ motor coactivation

A

γ-motor discharge ↑es along with ↑ed discharge of α-MN

135
Q

***Golgi Tendon Organ

A

group Ib afferent fibers

inhibitory neurons

changes in FORCE

***inhibit the α motoneurons

136
Q

muscle spindle reflex

A

contraction -> HOLD WEIGHT

137
Q

Golgi Tendon Organ Reflex

A

muscle relaxation and load DROP

138
Q

spinal reflex

A

Stretch reflex

139
Q

cranial reflex

A

pupillary light reflex

140
Q

***monosynaptic reflex

A

single synapse between the afferent and efferent

ex. PATELLAR REFLEX

141
Q

polysynaptic reflex

A

two or more synapses

through an interneuron

142
Q

tonic stretch reflex

A

maintains posture

143
Q

S1-2 reflex

A

ankle jerk

1, 2 buckle my shoe

144
Q

L3-4 reflex

A

knee jerk

3, 4 kick the door

145
Q

C5-6 reflex

A

biceps and supinator jerks

5, 6 pick up sticks

146
Q

C7 reflex

A

triceps jerk

7, 8 shut the gate

147
Q

C8 reflex

A

finger jerk

7, 8 shut the gate

148
Q

inverse stretch reflex

A

inhibitory interneuron relaxes effector & contracts antagonist

149
Q

withdraw reflex

A

flexion of stimulated limb

150
Q

crossed extensor reflex

A

flexion of stimulated limb

extension of opposite limb

151
Q

Babinski sign

A

Normal in children under 18 months of age

after age 18 months, indicates an interruption of the corticospinal tract.

positive =
big toe extends
corticospinal tract interruption

152
Q

LMN lesion

A

peripheral nerve lesion

153
Q

UMN lesion

A

spinal cord lesion

154
Q

LMN lesion symptoms

A

** flaccid paralysis

NO BABINSKI

** areflexia (no deep tendon reflex)

fasciculations

decreased muscle tone

** atrophy of muscle(s)

loss of voluntary movements
small area of body affected

155
Q

UMN lesion symptoms

A

** spastic paresis

** hyperreflexia

** BABINSKI SIGN PRESENT

increased muscle tone

clasp knife reflex

disuse atrophy of muscles

decreased speed of voluntary movements

large area of body affected

156
Q

***Complete Spinal Sensory Syndrome

A

*loss of bladder and bowel control

Bilateral lower motor neuron paralysis and muscular atrophy (damage to the neurons in the anterior gray columns)

Bilateral spastic paralysis below the level of the lesion. A bilateral Babinski sign is present (interruption of the corticospinal tracts on both sides of the cord)

Bilateral loss of all sensations below the level of the lesion (bilateral destruction of the ascending tracts in the posterior white columns)

loss of pain, temperature, and light touch sensations (section of the lateral and anterior spinothalamic tracts on both sides)

157
Q

***Tabes dorsalis

A

tertiary syphilis or neurosyphilis

loss of vibration sensation, two-point discrimination, and conscious proprioception

Romberg sign

*Argyll Robertson pupils

158
Q

***Posterior Column Syndrome

A

Both side of dorsal column affected

Loss of sense of position & vibration

interruption to posterior spinal artery.

159
Q

Anterior Spinal Artery Syndrome

A

Bilateral lower motor neuron paralysis

Bilateral spastic paralysis below the level of the lesion

Bilateral loss of pain, temperature, and light touch sensations below the level of the lesion

Tactile discrimination and vibratory and proprioceptive sensations are preserved

160
Q

***Brown Sequard Syndrome

A

*paralysis on one side, loss of pain and temp on the other

Ipsilateral lower motor neuron paralysis in the segment of the lesion and muscular atrophy

Ipsilateral spastic paralysis below the level of the lesion

Spastic paralysis

Ipsilateral band of cutaneous anesthesia in the segment of the lesion

Ipsilateral loss of tactile discrimination and of vibratory and proprioceptive sensations below the level of the lesion

Contralateral loss of pain and temperature sensations below the level of the lesion

161
Q

***Syringo(hydro)myelic Syndrome

A
  • C8-T1
  • shawllike/ Cape and Shawl distribution (caused by the interruption of the lateral spinothalamic tracts as they cross the midline in the anterior gray and white commissures)

Tactile discrimination, vibratory sense, and proprioceptive sense are normal

LMN weakness

bilateral spastic paralysis of both legs

162
Q

***Poliomyelitis

A

Acute viral infection of the neurons of the anterior gray columns and the motor nuclei of the cranial nerves

  • respiration may be threatened
  • leads to paralysis and wasting of the muscles

Progressive infantile muscle atrophy (Werdnig Hoffmann disorder) and Juvenile Hereditary LMN disease (Kugel berg Walender disease)

163
Q

***Subacute Combined Degeneration

A

deficiency of enzymes necessary for vitamin B 12 absorption

pernicious anemia

defects in both sensory and motor function

Disturbance in motor function includes upper motor neuron

positive Babinski

Dysfunction which may include a weakness of the lower limbs and an ataxic gait

164
Q

***Amyotrophic Lateral Sclerosis Lou Gehrig’s disease

A

*disease confined to the corticospinal tracts and the motor neurons of the anterior gray columns of the spinal cord

progressive muscular atrophy, paresis, spasticity, positive BABINSKI RESPONSE and fasiculations

165
Q

brain stem central core

A

reticular formation

controls sleep

166
Q

Midbrain

A

supplied by PCA

CN 3, 4

Tectum
superior colliculi = visual
inferior colliculi = auditory

167
Q

Pons

A

supplied by basilar artery

CN 5, 6, 7, 8

168
Q

Medulla Oblongata

A

Supplied by PICA

CN 9, 10, 11, 12

169
Q

Lateral Medullary Syndrome of Wallenberg

A

supplied by PICA

  • Dysphagia and dysarthria
  • Analgesia and thermoanesthesia (ipsilateral)
  • Vertigo, nausea, vomiting, and nystagmus
  • Ipsilateral Horner syndrome
  • Ipsilateral cerebellar signs
  • Contralateral loss of sensations of pain and temperature
170
Q

***Medial Medullary Syndrome

A

supplied by Vertebral A

  • Contralateral hemiparesis
  • Contralateral impaired sensations of position and movement and tactile discrimination (medial lemniscus)
  • Ipsilateral paralysis of tongue muscles with deviation to the paralyzed side when the tongue is protruded (hypoglossal nerve)
171
Q

Pontine Hemorrhage

A

supplied by the basilar artery

    • pupils may be pinpoint
  • facial paralysis on the side of the lesion
  • paralysis of the limbs on the opposite side
172
Q

***Weber Syndrome

A

supplied by PCA

*** an ipsilateral oculomotor paralysis, coupled with a contralateral upper motor neuron paralysis

  • dilated, unresponsive pupil, a drooping eyelid, and an eye that deviates downward
173
Q

Benedikt Syndrome

A

DCML

*** ipsilateral paralysis of the oculomotor nerve as well as a tremor of the opposite limb, coupled with possible somatosensory loss in the contralateral side of the body

174
Q

Gaze Palsy (Pariaud’s Syndrome)

A
  • upward gaze paralysis, possible nystagmus with downward gaze, light-near dissociation, large pupil, abnormal elevation of the upper lid, and paralysis of accommodation
175
Q

CN I

A

Olfactory Nerve

sensory

smell

damage:
Results in anosmia (loss of olfactory sensation)

176
Q

CN II

A

Optic nerve

sensory

vision

damage:
papilledema, optic atrophy

177
Q

CN III

A

Oculomotor Nerve

eye movement*

Somatic motor (inferior oblique and superior, inferior, and medial rectus muscles) - all except SO & LR

damage:
eye cannot be moved up, down, or inward ->
At rest, eye rotates laterally (external strabismus)

178
Q

CN IV

A

Trochlear Nerve

motor

superior oblique muscle (in eye)

damage:
double vision and impairs ability to rotate eye inferolaterally ->
at rest, eye up and in

179
Q

CNV

A

Trigeminal Nerve

*sensory of face

damage:
* Trigeminal neuralgia (TN) is considered to be one of the most painful afflictions known to medical practice
(associated with dentist visit)

180
Q

CNVI

A

Abducens Nerves

*primarily motor: lateral rectus muscle (in eye)

damage:
Abducens nerve paralysis, eye cannot be moved laterally ->
At rest, eyeball rotates medially (internal strabismus)*

181
Q

CNVII

A

Facial Nerve

mixed innervation

*taste of anterior 2/3 of tongue

damage:
* Bells Palsy

182
Q

***CNVIII

A

Vestibulocochlear Nerves

sensory

*hearing and equilibrium

damage:
*ipsilateral deafness
dizziness, rapid involuntary eye movements, loss of balance, nausea, and vomiting

183
Q

CNIX

A

Glossophangeal Nerves

mixed innervation

*taste of posterior 1/3 of tongue

damage:
*impaired swallowing and taste

184
Q

CNX

A

Vagus Nerve

mixed innervation

  • motor: heart, lungs, bronchi, GIT
    sensory: heart, lungs, bronchi, trachea, *larynx, *pharynx, GIT, external ear
  • ONLY CN THAT TRAVELS BELOW BRAINSTEM

damage:
hoarseness or loss of voice
*difficulty swallowing and impaired digestive system motility

185
Q

CNXI

A

Accessory Nerves

motor

*trapezius and sternocleidomastoid muscles

damage:
Shrugging the shoulder (role of trapezius muscle) becomes difficult

186
Q

***CNXII

A

Hypoglossal Nerves

primarily motor

*movement of tongue

damage:
(points) toward affected side,
causes difficulties in speech and swallowing

187
Q

***Bell’s palsy

A

LMN

paralysis or severe weakness of the nerve that controls the facial muscles on the side of the face - the facial nerve or seventh cranial nerve

** NO FOREHEAD WRINKLES

188
Q

Supranuclear lesion

A

UMN

** FOREHEAD WRINKLES

Neuro (16 decks)

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