Neuro Flashcards
Low folic acid intake
elevated alpha-fetoprotein and acetylcholinesterase in amionotic fluid
neural tube defect
Matermnal diabetes type I
Polyhydramnios
anencephaly
Herniation of cerebellar tonsil and vermian through foramen magnum
aqueductal stenosis/hydrocephalus
Arnold Chiari malformation (Chiari II)
Enlargement of 4th ventricle with agenesis of cerebellum
Dandy-Walker
Cystic enlargement of central canal of spinal cord
damaged crossing spinothalamic tracts (loss of pain/temp on upper extremities)
Syringomyelia
assc with Chiari I malformation
degeneration of distal axon with retraction proximally
Wallerian degeneration
Cell type has GFAP
astrocyte
Pain and temp fibers, C and A(delta)
free nerve endings
Fine/light touch and position sense fibers
Meissner’s corpuscles
Vibration/pressure fibers
Pacinian corpuscles
Pressure/deep static touch/position sense fibers
Merkel’s disc
Stress/panic center of brain
locus ceruleus
Reward/pleasure center of brain
nucleus accumbens and septal nucleus
Production and release of ADH and oxytocin
made by hypothalamus
released by post pituitary
Hunger center of brain
lateral hypothalamus
Satiety center of brain
ventromedial hypothalamus
Sympathetic center of brain
post hypothalamus
Parasympathetic center of brain
ant hypothalamus
Lewy bodies (with alpha synuclein inclusions) loss of dopaminergic neurons of substantia nigra pars compacta
Parkinson’s disease
sx of tremor, cogwheel rigidity/akinesia
trinucleotide repeat AD disorder
neuronal death via glutamate toxicity
atrophy of striatal nuclei
Huntington’s disease
see chorea/athetosis
CAG expansion repeat
Hyperorality
hypersexuality
disinhibited behavior
Kluver-Bucy syndrome
lesion of amygdala
assc with HSV-1
confusion/memory loss (ant and retrograde)
ataxia
confabulation
Wernicke-Korsakoff syndrome
assc with B1 (thiamine) deficiency and EtOH use
Can follow rapid infusion correcting hyponatremia
central pontine myelinolysis
“Locked out syndrome”
Understand speech but cannot speak
Broca’s area affecdted (frontal lobe)
Can speak but cannot understand
Wernicke’s area affected (temporal lobe)
Cannot repeat phrases but is fluent and can understand
Arcuate fasciulus area affected (connecting Broca and Wernicke)
Hyperventilation on brain
decreases ICP by decreasing PCO2 levels
Hemiparesis/hemiplegia on the R side
internal capsule/striatum infarct of L side
L hemiparesis of lower limbs and proprioception
R sided tongue deviation
Medial medullary syndrome on R side
paramedian branches of ASA/vertebral artery infarct
Nystagmus/vertigo
decreased pain/temp on face
dysphagia/hoarseness
Horner’s syndrome (ipsilateral)
Lateral medullary syndrome (Wallenbergs)
nucelus ambiguus affected by PICA infarct
Vertigo/nystagmus paraylsis of face decreased parasympathetics loss of ant taste on tongue decreased pain/temp on face
Lateral pontine syndrome
facial nucleus affected by AICA infarct
Subarachnoid hemorrhage
assc with Ehlers-Danlos/Marfans/ADPKD
Berry aneurysm at Circle of Willis Bifurcation
Middle meningeal artery
convex hemorrhage
from trauma
epidural hematoma
cannot cross suture lines
Bridging veins torn
slow bleed
crescent shaped on CT
subdural hematoma
can cross suture lines
Sign of irreversible damage of brain from ischemia
red neurons
Urinary incontinence
ataxia
cognitive dysfunction
normal pressure hydrocephalus
Wet, wobbly, wacky
Tract for crude touch and pressure
ant spinothalamic tract (cervical medial,sacral lat)
Tract for voluntary motor
lateral corticospinal tract (upper extremities med, lower lat)
Tract for pain and temp
lateral spinothalamic tract
Tracts for upper and lower body extremities
fasciculus cuneatus (upper/lat position) fasciculus gracilis (lower body/med position)
Ascends ipsilateral cord, crosses at medulla, then goes to medial lemniscus
dorsal column
Ascends contralaterall cord, crosses at ant white commissure
spinothalamic tract
Descends and crosses at caudal medulla then goes contralateral down
lateral corticospinal tract
Flaccid paralysis
destruction of ant horn
Wernig-Hoffman disease/poliomyelitis
LMN lesion only
No motor loss
superoxide dismutase I defect
atrophy of muscle
Amyotrophic lateral sclerosis
UMN and LMN lesions
aka Lou Gehrigs disease
tertiary syphilis caused
demyelination of dorsal columns/roots
Tabes dorsalis
assc with Charcot’s joints/Argyll Robertson pupil
Demyelination of dorsal columns/lat corticospinal and spinocerebellar tracts
Vit B12 or Vit E deficiency
AR trinucleotide repeat
impairment of mitochondria
staggering gait/falling
Friedreich’s ataxia
frataxin gene
GAA repeat
loss of tactile/vibration/proprioception ipsilaterally
contralateral pain/temp loss
ipsilateral LMN and UMN signs
Brown sequard syndrome
hemisection of spinal cord
Ptosis
anhidrosis of the face
miosis
Horner’s syndrome
assc with Pancoast tumor
Paralysis of conjugate vertical gaze
Parinaud syndrome
superior colliculi lesion
Pharynx/larynx upper esophagus motor center
nucleus ambiguus
parasympathetic autonomic center
dorsal motor nucleus
Holes of CN V
V1-super orbital fissure
V2-foramen rotundum
V3-foramen ovale
Nerves within cavernous sinus
CN III
CN IV
CN V1, V2
CN VI
Lack of afferent pupil reflex
Marcus Gunn pupil
optic nerve damage or retinal detachment
Inability to coordinate both eyes to the L (R eye stays straight), but can to the R
Medial longitudinal fasciculus syndrome
b/t CN VI and CN III nuclei on the R side
cannot abduct R eye
ApoE4 (19) gene assc
cortical atrophy
decreased ACh
late onset Alzheimer’s
Parietal lobe/post temporal lobe normal
dementia/aphasia/parkinsonian
Pick's disease (frontotemporal dementia) Pick bodies (tau proteins)
alpha-synuclein defect
dementia
Lewy body dementia
optic neuritis
bladder/bowel incontinence
relapsing sx
periventricular plaques
Multiple sclerosis
dx is oligoclonal bands
tx with beta-interferon
Muscle weakness starting at legs
papilledema
recent infection
Guillain-Barre syndrome
ascending paralysis
assc with CMV and campylobacter jejuni (molecular mimicry)
Destruction of oligodendroctyes
in AIDS pts
Progressive multifocal leukoencephalopathy
assc with JC virus
buildup of sulfatides
impaired myelin sheath production
AR disease
metachromatic leukodystrophy
arylsulfatase A deficiency
AR disease
buildup of galactocerebroside
destroys myelin sheath
Krabbe’s disease
Headache for about 1 hr with repetitive cycles
unilateral around the eye
cluster headached
tx with sumatriptan
Headache around 5 hrs that is constant
no photophobia
bilateral
Tension headache
Headache over 5 hrs
pulsating pain
aura
Migraine headache
tx with triptans
prophylaxis with propanolol/topriamate
Port-wine stain on face
increased epinephrine in serum
leptomeningeal angiomas
Sturge Weber syndrome
nevus flammeus/angiomas/pheochromocytoma
Small vessel involvement
Hamartomas of CNS and skin
ash-leaf spots on skin
AD disease
Tuberous sclerosis
cardiac rhabdomyoma/angiomyolipomas
Pigmented iris
Cafe-au-lait spots/skin papules
AD disease
Neurofibromatosis type I (von Recklinghausen) Lisch nodules (pigmented iris)/neurofibromas on skin/pheochromocytoma NF1 gene on chromosome 17
Cavernous hemangioma on skin
problem with eyesight
renal problems
Von Hippel-Lindau disease
cavernous hemangiomas/hemangioblastoma of retina, brain and cerebellum
VHL gene on chromosome 3 (tumor suppressor) mutated
CT with lesion crossing corpus callosum
glioblastoma multiforme
astrocytome (stains GFAP)
Growth in frontal lobes with fried egg cell appearance
oligodendroglioma
Bilateral hemianopia
lactation started recently
pituitary adenoma
pressure on optic chiasm
CT shows tumor of cerebellum compressing 4th ventricle
hydrocephalus seen
medulloblastoma
highly malignant
Homer-Wright rosettes
radiosensitive
Rathke’s pouch remnant
calcifications seen
benign
craniopharyngioma
Tx for emergency glaucoma
pilocarpine
Drug not to use with closed angle glaucoma
epinephrine (beta agonists) causes mydriasis (closes angle more)
Tx for opioid overdose
naloxone or naltrexone
acts as opioid antagonist
Tx for absence seizures
ethosuximide (blocks T type Ca2+ channels)
Tx for simple or complex seizures
carbamazepine (increased Na+ inactivation)
Tx for overdose of benzodiazepines
flumazenil (GABA antagonist)
Tx for malignant hyperthermia
dantrolene (prevents Ca2+ release from SER)
