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A_First Aid Random Memorizing > Neuro 2 > Flashcards

Neuro 2 Flashcards

1
Q

superior colliculi vs inferior colliculi

A

superior - conjugate vertical gaze
inferior - auditory

SIGHT ABOVE SOUND (EYES ABOVE EARS)

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2
Q

which CN nuclei are in midbrain

A

III, IV

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3
Q

CN nuclei in pons

A

V, VI, VII, VIII

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4
Q

CN nuclei in medulla

A

9, 10, 12

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5
Q

where do branches of CN V exit

A

Standing Room Only
Superior orbital canal v1
foramen rotundum v2
foramen ovale v3

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6
Q

where does middle meningeal artery exit

A

foramen spinosum

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7
Q

which CN exit out of superior orbital fissure

A

3, 4, 6…and v1

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8
Q

what exits out of crbiform plat3e

A

cn 1

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9
Q

what exits out of internal auditory meatus

A

cn 7 and 8

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10
Q

which bone makes up middle cranial fossa

A

sphenoid (superior orbital fissure, foramen rotundum, foramen ovale, foramen spinosum)

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11
Q

which bones makes up posterior cranial fossa

A

temporal and occiptal bone

has internal auditory meatus, jugular foramen hypoglossal canal, and foramen magnum

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12
Q

what exits through jugular foramen

A

9,10, 11 and jugular vein

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13
Q

what exits through hypoglossal canal

A

cn 12 duh

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14
Q

what exits through foramen magum

A

cn 11 and vetebral artries and brainstem

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15
Q

which nuclei handles visceral sensory information (taste, barorecepotrs, gut distension)

A

nucleus solitarius

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16
Q

which nerves are involved in nucleus solitarius

A

7, 9, 10

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17
Q

which nucleus handles motor innervation of pharnyx, laynx, upper esophagus

A 
nucleius aMbiguus (Motor)
9,10,11
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18
Q

which nucleus sends autonomic (parasympathetic ibers) to heart, lungs, upper gi

A

dorsal motor nucleus

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19
Q

corneal reflex input and output

A

v1 nasociliary branch

vii (temporal branch; obricularis oculi)

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20
Q

lacrimation reflex input and output

A

v1

viii

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21
Q

jaw jerk reflex in put and output

A

v3

v3

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22
Q

pupillary reflex input and output

A

II

III

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23
Q

gag reflex

A

IX

X

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24
Q

three muscles that closes jaw and innervation

A 
3 M's
Masster
Medial pterygoid
teMporalis
all motor innervation V3
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25
Q

what muscle opens jaw and innervation

A

lateral pterygoid V3

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26
Q

which nerves to herniated discs affect

A

nerve below disc

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27
Q

where to do spinal tap

A

l4 - l5 (cauda equina)

spinal cord ends around L1-L2

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28
Q

achilles reflex

A

s1 s2 (buckle my shoe)

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29
Q

triceps reflex

A

c7 c8 (hold them straight)

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30
Q

knee jerk reflex (patellar)

A

L3 L4 kick the door

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31
Q

anal wink reflex

A

S3 S4 (winks galore)

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32
Q

testicle reflex

A

L1 L2 (testicles move)

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33
Q

biceps/ brachioradialis reflex

A

c5 c6 pick up sticks

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34
Q

bilateral loss of pain and temp sensation upper etremity, sparing of fine touch

A

syringomyelia due to damage in anterior white commisure

associated with chiari 1 malformation

c8-t1

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35
Q

what other things can be affected form syringomyelia if it expans

A

anterior horn - signs of LMN (decreased tone, hyporeflexia, negative babainski), muscle atrophy
lateral horn - horner’s syndrome (anhydrosis, ptosis, miosis)

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36
Q

lower motor signs (flaccid paralysis, muscle atrophy, imparied reflexes, negative Bainski), increased WBC, fever

A

polio

destruciton of anterior horn

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37
Q

upper and lower motor lesions with sensation spared

A

ALS

destruction of lateral corticospinal tract and anterior horn

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38
Q

mutation in ALS

A

superoxide dismutase 1 mutation

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39
Q

treatment for ALS

A

rluzole

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40
Q

floppy baby, only LMN (not botulism) presents similarly to polio

A

werdnig hoffman
polio is typically asymmetric weakness while werdig is symmetric weakness…

due to AR degeneartion of anterior horn

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41
Q

if you lose superoxide dismutase what happens

A

increaed free radical injury from superoxide (cannot turn into hydrogen peroxide) as seen in ALS

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42
Q

ataxia with loss of ibratory sense and proprioception, muscle weakness in lower extremities

A

friedreich ataxia

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43
Q

mutation fredrich ataxia

A

unstable trinucleotide repeat GAA in FRATAXIN GENE (causes iron free radical injury in mitochondria)

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44
Q

cardiac complication of friedrich ataia

A

hypertrophic cardiomyopathy

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45
Q

UMN plus LMN plus loss of pain and temp, spares fine touch

A

occlusion of anterior spinal artery

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46
Q

progressive sensory ataxia, charcot joints, shootoing pain, argyll robertson pupils, abseence of DTRs and positive rhomberg

A

tabes dorsalis from tertiary syphillis

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47
Q

unilateral radicular pain, absent knee and ankle reflex, loss of bladder and anal sphincter control, saddle anesthesia

A

cauda equina syndrome (compression of L2 and below) from disc hernation or vertebral tumors

SURGICAL EMERGENCY

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48
Q

pupil can accomodate but cannot constrict in presence of light

A

argyll robertson pupil

tertiary syphillis

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49
Q

meningitis affects what layers of meninges

A

pia and arachnoid (weak, flexible meninges, leptomeninges)

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50
Q

3 MCC cause of meningitis in neonates

A

group B strep, E coli, listeria

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51
Q

MCC caue of meningitis in children and teenagers

A

n meningitiids (enters through nasopharynx respiratory droplets and enters blood)

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52
Q

mcc meningitis in adults and elderly

A

strep pneumo

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53
Q

mcc cause meningitis in unvaccinated children

A

h flu

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54
Q

MCC viral meningitis

A

coxsacakie

55
Q

what layers will you pass during LP

A

skin, ligament epidural space, dura, arachnoid…DO NOT PIERCE PIA

56
Q

CSF bacterial meningitis

A

neutrophils low glucose, high protein

57
Q

CSF viral meningitis

A

lymphocyte predominance, normal glucose

58
Q

CSF funga/TB meningitis

A

lymphocyte predominance low glucose, high protein

59
Q

complications meningitis besides death

A

hydrocephalus, hearing loss, seizures

mostly seen in bacterial meningitis

60
Q

how to get global cerebral ischemia

A

lower perfusion (atherscleorsis), shock, chornic hypoxia, repeated episodes of hypoglycemia (insulinoma…glucose is vital to brain nutrition)

61
Q

how does mild global ischemia present

A

mild confusion which resolves after you give glucose (insulinoma)

62
Q

vulnerable regions in moderate global ischemia

A

pyramidal region of hippocampus, pyramidal neurons in cortex (cortical laminar necrosis, lines of necrosis in layers 3,5,6)

63
Q

focal neurologic deficit less than and greater than 24 hours

A

less than - TIA

more than 24 - stroke

64
Q

thrombotic stroke vs embolic stroke

A

thrombotic - atherosclerosis, results in pale infarct athte periphery of cortex
embolic - usually frm afib, thromboemboli from left heart travels to brain and results in hemorrhagic infarct at periphery of cortex, usu. involves MCA

65
Q

lacunar stroke

A

secondary to hyaline arteriosclerosis (uncontroeld HTN, DM)

commonly afefcts lenticulostriate arteries (present in deep structures in brain)…small lake like areas in brain

66
Q

ischemic stroke leads to what kind of necrosis in brain

A

liquefactive necrosis (neutropphils release enzymes that destroy tissue)

67
Q

early finding in ischemic stroke

A

red neurons

68
Q

fluid filled cystic space surrounded by gliosis

A

late change in ischemic stroke (final stage happens months)

69
Q

red neurons are present for how long

A

first 12-24 hours after stroke

70
Q

charcot bouchard microaneurysm

A

associated with chronic hypertension affects small vessels (lenticulostriate arteries, basal ganglia, thalamus

presents as headache, nausea, vomiting, eventual coma

71
Q

sudden headachce “worst headache of my life” and nuchal rigidity

A

subarachnoid

72
Q

what does LP show on subarachnoid hemorrhage

A

xanthochromia (yellow tinge due to blood breakdown products in CSF)

73
Q

bleed on bottom of brain

A

subarachnoid hemorrhage

74
Q

MCC subarachnoid hemorrhage

A

rupture of berry aneurism

75
Q

MCC site berry aneuryms

A

anterior circle of willis (branch points of anterior communicating artery

76
Q

which layer do berry aneurysms lack

A

media = weak wall and saccular outpouching

77
Q

what inherited conditions are berry aneurysms assocaied with

A

ADPKD

marfans

78
Q

loss of pain temp and light touch on contralateral side, loss of motor function, vibration, positioin and deep touch sensation on ipsilateral side

A

brown sequard syndrome

79
Q

increased sensitivity to sound is due to injury to what nerve

A

stapedius nerve (branch of FACIAL NERVE)

80
Q

FRACTURE OF ORBITAL FLOOR LEADS TO WHAT MANIFESTATIONS

A

infraorbital nerve injury (branch of v2) which will result in paresthesia of upper cheeck/lip, also damage to inferior rectus muscle which will limit vertical gaze

81
Q

lens shaped lesion on CT NOT CROSSING SUTURE LINES

A

epidural hematoma

MMA

82
Q

what veins are involved in subdural

A

BRIDGING VEINS between dura and arachnoid usu due to trauma

83
Q

crescent shaped hemorrhage tha crosses suture lines

A

subdural

84
Q

adrenoleukodystrophy

A

disrupted metabolism of longcahin fatty acids leading to excessive buildup in nervous system adrenal gland, testse, pcan lead to coma death or ADRENAL GLAND CRISIS

85
Q

deficiency of arylsulfatase A, and buildup of sulfatides leading to destruciton of myelin sheath

A

metachromatic leukodystrophy

presents as impaired production and destruction of myelin sheath

86
Q

buildup of galactocerebroside in lysosomes

A

krabbe disease

87
Q

autommune destruction of CNS myelin and OLIGODENDROCYTES

A

multipe sclerosis

88
Q

charcot triad of MS

A

SIN
scanning speech
intention tremor (intonence, internuclear ophthalmoplegai)
nystagmus

89
Q

example of intranuclear opthamopleagia

A

mediated by cn 6 and 3

imagine looking left with both eyes
so cn 6 on left eye will pull left lateral rectus and will tell MLF of RIGHT cn3 to pull right eye to left

INO is damage to MLF so when left eye looks left, right eye cannot

90
Q

MRI of MS

A

periventricular plaques

GOLD STANDARD

91
Q

what will LP of MS show

A

increased lymphocytes, increased IG with OLIGOCLONAL IG BANDS myelin basic protein

92
Q

how to treat MS acutely and chronically

A

acute - IV steroids and sympomatic treatment
chronic - binterferon, glatiramer, natalizumab…THESE ALL SLOW DISEASE PROGRESSION

NATALIE HAS MS!!! OH NOO!!!!?!?!

93
Q

infection in infancy, neurologic signs arise years later

A

SSPE

viral inclusions in both gray and white matter

94
Q

progressive multifocal leukoencaphalopathy

A

demyelination of CNS due oto destruction of lymphocytes

assocaited with JC virus reactivation…seen in AIDS, immunosuppressed

95
Q

“locked in syndrome” after correction of hyponatremia

A

central pontine myelinolysis

96
Q

besides age what is the other risk factor for sporadic alzheimers

A

increased e4 ApoE…

this leads to more beta amyloid deposition

97
Q

what decreases risk for sporadic alzheimers

A

decreased expression E2 apo E (increased e4 is more risk(

98
Q

familial early alzheimers mutation

A

mutation in presinilin 1

99
Q

Why are down syndrome patients are icreaes risk of early Alzheiers

A

APP is on chromosome 21 so trisomy means more accumulation of beta amyloid

100
Q

pathologic features alzheimers

A

diffuse cerebral atrophy (narrowing gyri, widening sulci), increased ventricle size….hydrocephalus ex vacuo
neuritic plaque (a betaamyloid,extracellular with neuritic processes)
cerebral amyloid angiopathy (beta amyloid accumulation around blood vessels which increases risk of hemorrhage)
neurofibrillary tanglesof hyperphosphorylated TAU

101
Q

multifocal infarcton and injury due to HTN, atherosclerosis,

A

vascular dementia

2nd MCC dementia

102
Q

frontnal and temporal lobes sparng parietal occiptal lobes dementia

A

pick disease

leads to behavioral and language symptoms

103
Q

round aggregates of tau protein

A

PICK DISEASE (NOT NEUROFIBRIAILLARY TANGLES)

104
Q

histologic hallmark parkinsons

A

round eosiniophilic inclusions

LLEWY BODIES coposed of alpha synuclein

105
Q

loss of dopaminergic neurons in what part of brain during parkinsons

A

substantia nigra pars compacta

106
Q

what illegal drug contaominant is associated with parkinsons

A

MTPT (metaboliszed to MPP+)

107
Q

how long before parkinsons dementia occurs

A

LATE IN DISEASE YEARS

if dementia is seen early after development of parkinson symptoms in disease is probably Lewy body

108
Q

parksinsonian features + dementia and visual hallucinations early in disease

A

lewy body dementia

109
Q

where are lewy bodies found in LBD

A

primarily in cortex

110
Q

knockout of Gabanergic neurons in caudate

A

huntingons

111
Q

lab values in huntingtons

A

increse dopa, decrease gaba, decrease Ach

112
Q

how do neurons die in huntingonts

A

death via NMDA R bidning and glutamate excitotoxicity

113
Q

where is there atrophy in huntingtons

A

caudate and putamen with excavuo ventriculomgaly

114
Q

when does trinucleotide expansion occur

A

SPERMATOGENESIS

115
Q

trinucleutide repeat seen in huntingtons

A

CAG
Caudote loses
Ach and
Gaba

116
Q

why does urinary continence, gait instability, and dementia occur in normal pressure hydrocephalus

A

stretching of corono radiata

117
Q

what gives relief in normal pressure hydrocephalus

A

LP

ultimately treat with VP shunt

118
Q

why is there so much CSF in normal hydrocephalus

A

decreased reabsorption of CSF by arachnoid granulations

119
Q

what patholgic conformation of prion in spongiform encephalopathy

A

PrpSc BETA PLEATED SHEET resistant to proteases

120
Q

histologic hallmark spongiforme enceph

A

white SPONYGY vaculoes in brain parenchyma

121
Q

rapidly progressive dementia assocaited with ataxia and STARTLE MYOCLONUS (involuntary movement wiht little stimulus)

A

CJD

patinet dying less than 1 year

122
Q

EEG reading on CJD

A

periodic sharp waves on EEG

increased 14-3-3 proteins in CSF

123
Q

histologic hallmark Pick disease

A

ubiquinated TDP 43 and round Pick bodies

124
Q

dementia involving early personality changes, aphasia and may have associated movement disorders

A

Frontal temporal dementia

125
Q

atheosis

A

slow snake like movements, writhing, especially in fingers

126
Q

dystonia

A

sustained involuntary muscle conctraction

127
Q

how to treat high frequency tremor wiht sustained posture *outstretched arms) worsensed with movement or anxious

A

betablockers (non selective) like propanolol or pirmidone

128
Q

sudden wild flaliilng of 1 arm and contralateral leg due to injury to what structure

A

hemiballismus

contralateral subthalamic nuclues lacunar stroke)

129
Q

intention tremor due to dysfunction where

A

cerebellum

130
Q

how to characterize migrain headaches

A 
POUND
pulsatile
ONE DAY DURATION
unilateral
nausea/photophobia
Disabling
131
Q

steady headahce pain bilateral no photophobia no aura

A

tension headache

132
Q

repeptitive brief unilateral headaches associated with periorbital pain

A

cluster headaches

133
Q

prophylaxis against cluster headaches

A

verapamil

A_First Aid Random Memorizing (17 decks)

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