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NeuroBlock > Neuro 1 > Flashcards

Neuro 1 Flashcards

1
Q

Which vascular structure provides blood supply to the brainstem?

A

basilar artery

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2
Q

A patient complains of a loss of temperature sensation to a distinct area of the body. This could be due to a lesion in which of the following?

A

spinothalamic tract

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3
Q

A known characteristic of upper motor neurons is which of the following?

A

they never leave the central nervous system

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4
Q

A patient undergoes lumbar puncture, is found to have predominantly lymphocytes, leading to a presumptive diagnosis of viral meningitis. Which of these is most likely involved?

A

enteroviruses

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5
Q

Which amino acid-derived neurotransmitter plays a predominantly inhibitory role in the brain?

A

gamma amino butyric acid (GABA)

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6
Q

A target organ system effect of norepinephrine is which of the following?

A

decreased GI motility

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7
Q

Parasympathetic stimulation results in which of the following end organ effects?

A

pupil constriction

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8
Q

Which symptom is part of the classic spectrum for muscarinic receptor activation, such as one might see in mushroom poisoning?

A

diarrhea

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9
Q

Which artery is part of the circle of Willis?

A

posterior cerebral

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10
Q

A patient experiences a sharp stabbing pain that radiates over the mandible and extends around the temporomandibular joint and then deep into the ear. The pain is triggered by smiling and touching his face. Which cranial nerve is involved?

A

CN V

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11
Q

Which objective finding is consistent with right unilateral blindness with normal sympathetic and parasympathetic innervations to both irises?

A

a light directed in the left eye produces a consensual reaction in the right eye

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12
Q

A patient is diagnosed with a disease in which autoantibodies ‘inactivate’ receptors at the neuromuscular junction. This patient would most likely derive benefit from an agent that inhibits which of the following enzymes?

A

acetylcholinesterase

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13
Q

Which factor will aid in the ability of a molecule to penetrate the blood-brain barrier?

A

high lipid solubility

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14
Q

Which risk factor is most closely associated with intraparenchymal brain hemorrhage?

A

hypertension

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15
Q

Sympathetic pre-ganglionic nerve terminals generally release which neurotransmitter?

A

acetylcholine

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16
Q

Which choice represents the correct order of events in synaptic transmission?

A

neurotransmitter synthesis; vesicular storage; release

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17
Q

Which enzyme degrades the principal neurotransmitter found at the neuromuscular junction?

A

acetylcholinesterase

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18
Q

A 44 year old male patient presents with flaccid paralysis of the lower extremities. Which of the following choices is most likely related to this problem?

A

a lower motor neuron lesion

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19
Q

Which substance can be converted to glucose to supply the needs of the brain during starvation?

A

amino acids

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20
Q

Which spinal tract is a motor pathway?

A

corticospinal tract

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21
Q

A 31 year old female patient presents to clinic with blurry vision and dizziness. She also reports an unusual tingling feeling in the calf of her right leg. Which of the following would be highest on your differential list?

A

multiple sclerosis

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22
Q

During surgical removal of an invasive glioma from the skull base, cranial nerves IX and X are accidentally cut bilaterally. What would be the immediate change in the patient’s hemodynamic condition?

A

tachycardia with hypertension

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23
Q

Which amino acid neurotransmitter plays a predominantly excitatory role in the central nervous system?

A

glutamate

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24
Q

Which of the following end-organ effects would be due to parasympathetic stimulation?

A

increased urination

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25
Q

Why is peristalsis considered an intrinsic neuronal reflex?

A

all neurons are contained within the gut wall

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26
Q

An unusual patient presents to your neurology clinic. He has fluent speech but he uses incorrect words, inserts nonexistent words into his speech, and strings normal words together randomly. Where in the brain might you expect to find a lesion?

A

left temporal lobe

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27
Q

A 56 year old woman presents with burning and tingling in the thumb, index finger, and middle finger of her right hand. She states the pain is worse at night and after working on her keyboard. Her symptoms are most likely caused by entrapment of which nerve?

A

median

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28
Q

Commissure fibers joining the cerebral hemispheres are located in which structure?

A

corpus callosum

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29
Q

A patient with hyperactive knee and ankle reflexes and upward plantar reflex is likely to have a problem in which spinal tract?

A

corticospinal tract

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30
Q

A possible upper motor neuron deficit would be suggested by which finding?

A

spasticity

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31
Q

Blood supply to the anterior brain

A

internal carotids

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32
Q

blood supply to the posterior brain

A

vertebral arteries, basilar

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33
Q

cranial nerve III emerges between these two arteries

A

PCA, SCA

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34
Q

cranial nerve VI emerges anterior to this artery

A

Basilar

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35
Q

Functions of dorsal columns, medial lemniscus

A

discriminative touch (two-point), conscious proprioception, vibration sensitivity

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36
Q

functions of spinothalamic tract

A

pain and temperature

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37
Q

function of dorsal spinocerebellar tract

A

unconscious proprioception

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38
Q

corticospinal tract function

A

voluntary movement (cortex to cord, upper motor neurons)

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39
Q

spinothalamic first order neurons

A

body part into dorsal roots

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40
Q

spinothalamic second order neurons

A

cross over in spinal cord, ascend to thalamus

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41
Q

spinothalamic third order neurons

A

thalamus to somatosensory cortex for conscious awareness

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42
Q

upper motor neurons are contained entirely within

A

the central nervous system

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43
Q

lower motor neurons innervate

A

skeletal muscles

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44
Q

damage to upper motor neurons leads to

A 
spastic paralysis
hyperreflexia
increased muscle tone
upward Babinski
loss of fine voluntary movements
45
Q

damage to lower motor neurons leads to

A 
flaccid paralysis
decreased superficial reflexes
decreased tone
fasciculations or fibrillations
severe muscle atrophy
46
Q

corticospinal decussation (define and location)

A

crossover of upper motor neurons, lower medulla

47
Q

red nucleus location

A

central midbrain, next to substantia nigra

48
Q

decorticate posture (define and location of lesion)

A

flexor posture, lesion above red nucleus

49
Q

decerebrate posture (define and location of lesion)

A

extensor posture, lesion below red nucleus

50
Q

sympathetic eyes

A

dilate, increased acuity

51
Q

sympathetic skin

A

vasoconstriction, piloerection, sweaty

52
Q

sympathetic cardiovascular

A

increased cardiac output

53
Q

sympathetic pulmonary

A

bronchodilation, maximum air exchange

54
Q

sympathetic renal

A

constrict renal vessels, decrease urine production

55
Q

sympathetic hepatic

A

glycogen breakdown

56
Q

sympathetic reproductive

A

ejaculation

57
Q

sympathetic adrenals

A

release adrenaline

58
Q

parasympathetic eyes

A

constrict pupil

59
Q

parasympathetic skin

A

not directly innervated by PNS

60
Q

parasympathetic cardiovascular

A

decrease rate and strength of cardiac contraction

61
Q

parasympathetic pulmonary

A

bronchoconstriction, increase bronchial secretion

62
Q

sympathetic gastrointestinal

A

decrease motility

63
Q

parasympathetic gastrointestinal

A

stimulates motility and secretion

64
Q

parasympathetic bladder

A

facilitates urination

65
Q

parasympathetic hepatic

A

promotes glycogen production, conservation, increased bile secretion

66
Q

parasympathetic reproductive

A

increase blood flow to erectile tissues

67
Q

parasympathetic adrenals

A

not directly innervated by PNS

68
Q

how to penetrate the blood-brain barrier (4)

A

high lipid solubility
low molecular weight
low ionic charge
activate transport receptors

69
Q

processes that open the blood-brain barrier (4)

A

Ischemia
vessel exposure to inflammatory cytokines or factors produced by tumors
hypertension
hyperosmolar solution arterial injections

70
Q

consequences of opening the blood-brain barrier (4)

A

vasogenic cerebral edema
wbc in brain or CSF
toxins into brain
infectious organisms into brain

71
Q

CSF made in

A

choroid plexuses

72
Q

CSF glucose : Blood glucose

A

60-70% (~55)

73
Q

contraindications for LP (4)

A

mass in CNS with elevated ICP
obstructive hydrocephalus
overlying lumbar skin infection
bleeding disorder or thromboctopenia

74
Q

major neurotransmitter in ANS

A

acetylcholine (only preganglionic in SNS)

75
Q

symptoms of muscarine intoxication

A

Salivation
Lacrimation
Urination
Defecation

76
Q

Acetylcholine acts on cardiac, eye, bronchioles, GI tract, bladder, and glands like

A

parasympathetic

77
Q

ACh in CNS function

A

cognition

78
Q

ACh in PNS function

A

voluntary movement

79
Q

dopamine function

A

drug abuse, parkinson, schizophrenia

80
Q

norepinephrine function

A

attention and arousal

81
Q

serotonin, other name

A

5HT

82
Q

serotonin function

A

mood, sleep, pain, temperature

83
Q

histamine function

A

arousal, pain threshold, gut secretion, allergic reaction

84
Q

glutamate function

A

learning and memory, epilepsy

85
Q

GABA function

A

sedation

86
Q

Glycine function

A

inhibitory transmitter in spinal cord

87
Q

two types of primary glaucoma

A

narrow angle, wide angle

88
Q

narrow angle glaucoma

A

requires drug treatment for management of acute attack

89
Q

wide angle glaucoma

A

gradual, insidious

requires chronic drug therapy

90
Q

drug for narrow angle glaucoma attack

A

pliocarpine, miotic action, reverses mydriasis from atropine

91
Q

high pressure in the baroreceptors turns on

A

parasympathetic

92
Q

total blindness of right eye lesion location

A

right optic nerve

93
Q

right nasal hemianopsia lesion location

A

right optic nerve at junction with optic chiasm

94
Q

define homonymous and heteronymous hemianopsia

A

homonymous - both eyes lose same (directional) visual field

heteronymous - both eyes lose nasal or temporal visual field

95
Q

left homonymous hemianopsia lesion location

A

right optic tract

96
Q

bitemporal heteronymous hemianopsia lesion location

A

optic chiasm

97
Q

CN ? brings light in for pupillary response

CN ? elicits response

A

II, III

98
Q

classic clinical features of meningitis (4)

A

fever
headache
stiff neck
relative preservation of mental status

99
Q

glucose in CSF, viral vs bacterial meningitis

A

low in bacterial, normal in viral

100
Q

3 cardinal features of myasthenia gravis

A

weakness
fatigability of skeletal muscles
normal reflexes and sensory function

101
Q

5 clinical features of Guillain-Barre

A

symmetrical ascending flaccid motor paralysis
limb parestesias
loss of deep tendon reflexes
facial and respiratory weakness (sometimes)
autonomic dysfunction

102
Q

treatment of Guillain-Barre

A

good nursing
plasmaphoresis, IVIG
physical therapy for contractures, strength

103
Q

5 cardinal signs of parkinson’s

A 
resting tremor (pill-rolling)
posture instability
cogwheel rigidity
bradykinesia
micrographia
104
Q

3 types of parkinson syndromes

A

primary, secondary, parkinson-plus

105
Q

GI side effects of L-dopa

A

nausea

106
Q

cardiovascular side effects of L-dopa

A

tachycardia, a-fib

107
Q

psych side effects of L-dopa

A

nightmares, hallucinations

108
Q

kinetic side effects of L-dopa

A

dyskenesia (like parkinsons)

109
Q

5 signs of Horner’s syndrome

A 
Pseudoptosis (drooping of upper eyelid)
Miosis (constriction of pupil)
Enophthalmos
Anhidrosis
Dilation of skin arterioles

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