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Neuroscience > midterm review > Flashcards

midterm review Flashcards

1
Q

increased tone leading to spastic paralysis

A

UMN

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2
Q

decreased tone leading to a flacid paralysis

A

LMN

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3
Q

is the anterior horn cell only found in the spinal cord?

A

YAAAS

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4
Q

which tract crosses in the spinal cord

A

spinothalamic tract

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5
Q

tell me about suspended sensory loss

A

when there is something wrong with the anterior white commissure causing a loss of pain and temp. at one or couple of segments in the body

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6
Q

Brown sequard syndrome… what is wrong with it?

A
  • contralateral pain and temperatures (spinothalamic) - ipsilateral issues with position, vibration (dorsal column pathway) and motor (CST)
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7
Q

a motor or sensory level involvement means what?

A

that it is a spinal cord disease because the spinal cord is segmented

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8
Q

Sensory levels:

T2 =

T4 =

T10 =

L1 =

L3 =

L5 =

S4-S5 =

A

T2 = clavicle

T4 = nipple line

T10 = umbilicus

L1 = inguinal crease

L3 = medial thigh

L5 = lateral calf

S4-S5 = perianal (“saddle”) area

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9
Q

Muscle innervation

Biceps brachii =

Triceps =

Intrinsic hand muscles =

Quadriceps femoris =

Gastrocnemius =

A

Biceps brachii = C5,

Triceps = C7

Intrinsic hand muscles = C8

Quadriceps femoris = L3

Gastrocnemius = S1

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10
Q

In spinothalamic tract, sacral fibers are _______, cervical fibers are ______

A

In spinothalamic tract, sacral fibers are lateral, cervical fibers are medial

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11
Q

sacral sparing is considered a

A

intrinsic disease

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12
Q

syringomyelia

A

suspended sensory loss of pain and temp. leads to weakness and atrophy

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13
Q

ALS

A

combined UMN and LMN

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14
Q

Tabes Dorsalis

A

Dorsal column

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15
Q

Subacute combined degeneration

A

B12 deficiency dorsal column and corticospinal tracts

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16
Q

spinocerebellar degneration–> Friedreich’s ataxia

A
  • dorsal column - spinocerebellar - CST
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17
Q
  • spinal muscular atrophies - motor neuron disease -local damage, trauma - ischemia, tumors and infections
A

diseases of motor neurons

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18
Q
  • axonal degneration - segmental demyelination
A

diseases of peripheral nerves

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19
Q
  • MG
  • Eaton-Lambert syndrome
A

Diseases of NMJ

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20
Q
  • destructive myopathies
  • dystrophies
  • polymyositis
  • dermatomyositis
A

primary muscle disease

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21
Q

mitochondria, glycogen lipids, ion channels, deamin related proteins

A

disorders of intracellular organelles, structural proteins, and enzymes

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22
Q

dying back

A

axonal neuropathy

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23
Q

Axonal neuropathies

  • affects proximal or distal?
  • most common causes?
  • what do we see on NCV?
A
  • distal - toxic and metabolic -decreased amplitudes
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24
Q

charcot-marie-tooth type 1 is a

A

herditary,chronic demyelinating neuropathies

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25
Q

example of an acute demyelinating neuropathy

A

guillain-Barre

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26
Q

Tell me about Guillain-Barre?

  • causes?
  • motor < or > sensory
  • CSF increased or decreases? what about cell count?
  • fast or slowed conduction velocity
  • tx,
  • what is more rapid in recovery? remyelination or axonal regeneration
A
  • autoimmune disorder after a viral or bacterial illness
  • motor > sensory
  • CSF increased with normal cell count
  • slowed conduction velocity
  • tv.: plasma exchange but no steroids
  • recovery by remyelination
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27
Q

Chronic inflammatory demyelinating neuropathy can be treated by

A

steroids

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28
Q

_____ mediated in chemical transmission

A

ACh

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29
Q

Myasthenia Gravis:

  • what is happening here?
  • what is usually present in terms of symptoms?
  • common system affected
  • how do we dx?
  • 10% of cases have
  • tx?
A
  • post-synaptic autoimmune mediated AChR dysfunction
  • fatigable weakness is usually present
  • most common system affected is ocular
  • tensilon test, Ab levels
  • 10% have thymomas
  • acetylhonesterase inhibitors or immunosuppressive medications
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30
Q

lambert- eaton syndrome

  • what is it?
  • what do we see?
  • tell me about the reflexes?
  • common paraneoplastic syndrome
  • tx?
A
  • autoimmune presynaptic VGCC dysfunction
  • slowly progressive proximal weakness with dry mouth
  • hyporeflexic
  • small cell lung cancer
  • prednisone, 3,4diam
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31
Q

what are these features suggestive for?

  • proximal distribution of weakness
  • symmetric muscle weakness
  • normal or enlarged muscles
  • deep tendon reflex reductions that parallel muscle strength
A

myopathy

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32
Q

these features really do not fit with ________

  • UMN
  • distal weakness
  • fasciculations
  • tremor
  • sensory abnormalities
  • fatigable muscle weakness
  • early loss of deep tendon relfexes
A

myopathy

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33
Q

what type of muscle enzyme testing we can do to dx myopathies?

A

creatine kinase

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34
Q

dx that involves finger flexors and quads

A

inclusion body myositis

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35
Q

inflammatory myopathies [3]

what do all three show?

what about tx?

A
  • polymyositis
  • dermatomyositis
  • inclusion body myositis
  • elevated CK
  • PM and DM respond to immunosuppresive tx. but IBM does not
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36
Q

inherited muscle disease largely due to abnormal structural muscle proteins

A

muscular dystrophies

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37
Q

muscular dystrophies diseases?

[3] how are two inherited?

A
  • Duchenne’s
  • Becker’s
  • fascioscapulohumeral dystophy

Duchenne’s/ Becker’s are x-linked but beckers’ is less severe as in-frame mutation

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38
Q

broad group of inherited disorders of muscle energy metabolism largely presenting with exercise intolerance

A

metabolic myopathies

39
Q

Cranial nerve determines level:

midbrain =

pons =

medulla =

A

midbrain = III,IV

pons = V, VI, VII, VIII

medulla = IX, X, XI, XII

40
Q

medial disease localization of the brainstem

A

CST and medial lemniscus

41
Q

lateral disease localization of the brainstem

A

Spinothalamic and descending V

42
Q

Medial cranial nerves

  • derived from ____ ______ column

III =

VI =

XII =

A

Medial cranial nerves:

  • derived from somatic motor column

III = midbrain

VI = pons

XII = medulla

43
Q

Lateral cranial nerves - ______ and _____ arch muscles

IX, X, XI =

VII, VIII, V =

A

Lateral cranial nerves - sensory and branchial arch muscles

IX, X, XI = medulla

VII, VIII, V = pons

44
Q

lateral brainstem syndromes:

Contralateral loss of pain and temperature in body: ___________

Ipsilateral loss of pain and temperature in face: ______________

Laterally exiting cranial nerves to branchial arch muscles:

Medulla-

Lower pons-

Upper pons-

A

Contralateral loss of pain and temperature in body: Spinothalamic tract

Ipsilateral loss of pain and temperature in face: Descending nucleus of V

Laterally exiting cranial nerves to branchial arch muscles:

Medulla- nucleus ambiguous

Lower pons- facial nerve

Upper pons- trigeminal nerve (main sensory, motor)

45
Q

lateral medullary syndrome:

Sensory: [2]

Motor [1]

Other [2]

A

Sensory: pain and temp

  • Ipsilateral face
  • Contralateral body Motor
  • Ipsilateral palatal weakness (nucleus ambiguus); contralateral uvulal deviation

Other - Ipsilateral

Horner’s syndrome - Ipsilateral dyscoordination/ataxia

46
Q

What is the difference between the lateral pontine syndrome and lateral medullary syndrome?

A

there is different motor components in the pontine syndrome there is facial weakness due to CN VII affected lateral medullary syndrome affects the nucleus ambiguus so we see palate weakness and contralateral uvula deviation

47
Q

Medial brainstem syndromes:

Contralateral hemiparesis:

involvement of somatic motor nerves exiting medially:

Medulla =

Pons =

Midbrain =

Contralateral loss of position and vibratory sense (which levels of brainstem)

A

Contralateral hemiparesis:

Corticospinal tract Ipsilateral

involvement of somatic motor nerves exiting medially:

Medulla = XII

Pons = VI

Midbrain = III

Contralateral loss of position and vibratory sense: Medial lemniscus (medulla, lower pons)

48
Q

medial medullary syndrome:

Sensory what type of sensory and where is the deficit?

Motor (be specific in what happens)

A

Sensory (touch/vibration)

  • Contralateral body Motor
  • Ipsilateral tongue weakness (CN XII); deviates ipsilaterally
  • Contralateral weakness (spares face)
49
Q

medial pontine syndrome and medial medullary are very different.

What happens in medial pontine syndrome?

we know that in medial medullary we are going to have a sensory loss of pain and temp contralateral in the body and ipsilateral in the face. we are also going to see tongue deviated to the week side and contralateral body weakness

A

For medial pontine syndrome:

  • there is loss of touch and vibration in contralateral body
  • contralateral weakness and will include face if above facial nucleus ipsilateral weakness
  • ipsilateral eye abduction weakness CN VI
50
Q

what the heck is ventral midbrain syndrome? please be specific of what happens with the involved CN

A
  • there will be contralateral weakness of the body and ipsilateral weakness of the face
  • ipsilateral CN III.

this leads to a deviated down and out, dilated and unreactive pupil

51
Q

Talk to me about the importance of the cerebellopontine angle:

what CN nerve signs are involved?

early vs late what type of symptoms show up later?

A
  • extrinsic compression of tumors
  • begins with CN VIII with vestibular before cochlear
  • later involvement of V and VII later when the tumor is bigger it starts to affect:
  • middle cerebellar peduncles leading to ataxia
  • CST leading to hemiparesis
52
Q

nerves in the cavernous sinus? what is the artery?

A

CN III, IV, VI, V1 and V2 CN VI closest to the ICA

53
Q

basilar artery occluions involves what motor and sensory tract?

what is variable?

what happens if the reticular system is affected? or not?

A
  • bilateral hemiparesis
  • bilateral sensory loss
  • variable CN nerve signs
  • reticular system:
  • if involved: coma
  • if spared- “locked- in- syndrome”
54
Q

normal lateral gaze involves

A

CN 6 and 3

55
Q

conjugate nerve palsy

A

lesion to CN6

56
Q

internuclear opthalmoplegia

A

lesion to MLF

57
Q

one and a half syndrome

A

lesion to both CN 6 and MLF

58
Q

input to the cerebellum all have to pass through the granule cell layer

A

false all except from inferior olives

59
Q

purkinje cells are found deep to the

A

cerebellar nuclei

60
Q

how does inferior olive project directly to purkinje cells?

A

climbing fibers

61
Q

tell me about the inferior cerebellar peduncle. where is it found? why is it important?

A

found in medulla it receives input from all except cerebral cortex

62
Q

tell me about the middle cerebellar peduncle. where is it found? why is it important?

A

found in the pons receives only imputs from cerebral cortex (pontocerebellar)

63
Q

tell me about the superior cerebellar peduncle. where is it found? why is it important?

A

found in the midbrain receives output from cerebellar cortex

64
Q

vestibulocerebellum or also flocculonodular is involved in

A

balance and oculomotor control

65
Q

spinocerebellum (vermis) involved in

A

truncal incoordination and leg incoordination

66
Q

neocerebellum (lateral hemispheres) involved in

A

upper limb ataxia/incoordination

67
Q

Dysdiadochokinesis-

A

trouble performing rapidly alternating movements

68
Q

tumors, infarct and hemorrhages are unilateral or bilateral?

A

unilateral

69
Q

cerebellar degenerations are unilateral or bilateral

A

bilateral

70
Q

what does dopamine do in the direct pathway? what about indirect?

A

direct- stimulates indirect- inhibits

71
Q

subthalamic nucleus is part of the direct or indirect pathway

A

indirect

72
Q

where is a loss of dopamine producing cells in substantia nigra located

A

pars compacta

73
Q

which part of the basal ganglia does HNT affect

A

caudate nucleus, cortex

74
Q

describe the movement: tremor

A

oscillatory

75
Q

describe the movement:

myoclonus

A

jerky

76
Q

describe the movement:

chorea

A

random

77
Q

describe the movement:

hemiballismus

A

violent

78
Q

describe the movement:

dystonia

A

sustained

79
Q

describe the movement:

tics

A

stereotyped but can be suppressible

80
Q

where is this found?

substantia gelatinosa

A

all

81
Q

where is this found?

clarke’s nucleus

A

T1-L2

82
Q

where is this found?

intermediolateral column

A

T1- L3

83
Q

where is this found?

Parasympathetic nucleus

A

S2-S4

84
Q

where is this found?

Acessory nuleus

A

medulla- C5

85
Q

What is most medial and lateral in the somatotopic organization of Dorsal column Pathway?

A

Most medial- sacral most lateral is cervical

86
Q

the spinocerebellar are _____ in the body

A

ipsilateral

87
Q

centers for regulation of HR and respiration found in

A

medulla and Pons

88
Q

reticular activating system found in

A

rostral pons and midbrain

89
Q

what level is this at?

A
90
Q

what level is this at?

A
91
Q

Cerebellum blood supply

A
  • posterior inferior cerebellar artery (PICA)
  • anterior inferior cerebellar artery (AICA)
  • superior cerebellar artery (SCA)
92
Q

Medulla blood supply

A
  • vertebral arteries
  • PICA
93
Q

Pons blood supply

A
  • Basilar artery
  • AICA
94
Q

Midbrain blood supply

A
  • posterior cerebral artery (PCA)
  • Superior Cerebellar artery

Neuroscience (35 decks)

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