Neuro 2 Flashcards
Kinesin transports organelles toward __ end of microtubules, which are __ from the nucleus
toxic insult would impair __ transport, thus leading to a deficiency of __ at the nerve terminal
plus, distant
anterograde, vesicles
__ is a disproportionate loss of pain/temp in arms and hands
formation of __ in cervical region of SC
most commonly has damage to ventral __ and __
this is decussation for fibers of __ tract for pain/temp from periperhy to somatosensory cortex
1st order neurons are in __
2nd order neurons in __
axons decussate in VWC, adn asced in contralateral __
3rd order neurons located in __ of thalamus
4th order neurons found in primary __ of parietal lobe
syringomyelia
cavity
white commisure, horn
lateral spinothlamic
dorsal root ganglia
dorsal horn
lateral funiculus
VPN
somatosensory cortex
dextrxn of VWC leads to loss of __/__ bilaterally 1/2 levels below lesions and in dermatome
other senses are ___
ventral horns contain __ that receive impulses from lateral CS tract, responsible for voluntary __
damage can occur, but does not affect __/__
example of __ lesion
pain/temp
normal
motor neurons, motor activity
pain/temp
LMN
__ transmits light touch/pressure
damage to __ cuases contralateral loss of pain/temp
__ recieves neurons of sensory input
ie __ and __ synapses
dorsal columns contain __/__ fasciculi
primary mediator for __/__/__ sensation
ventral ST
contralateral lateral funiculus
dorsal horn
lateral ST, ventral ST
cuneate/gracilis
extrapyramidal symptom assc w recent antipsychotic meds is __ reaction
sudden __ of any muscle group
may have Oculogyric crisis, O__ or L
result from high potency __ blocking D2 in NS pathway (ie h/F)
excess __ results in extrapyramidal SE
tx w M1 receptor antags like B or antihistamine D
acute dystonic
contraction
opisthotnos, laryngospasm
1st gen antipsychotic
haloperidol, fluphenazine
cholingergic activity
benztropine, diphenhydramine
Blockade of __ receptors leads to ortho hypoTN
Gaba receptor antags like __ tx benzo overdose
antagonism of __ causes sedation/weight gain
low potency antipsych like C/C/T can cause ___ SE
A1A
Flumenazil
H1
chlorpromazine, clozapine, thioradizine
long standing RA involves __ and causes joint dxn w vertebral __ subluxation
__ joint involved as atlas C1 has high degree of __
sx include neck __/__ and neuro findings
__ can worsen it, leading to __/__ compression
see __ paralysis w absent __
paralysis becomes __
cervical spine, malalignment
atlantoaxial, mobility
pain/stiffness
intubation, SC/arterial
flaccid, reflexes
spastic
__ due to IE of left sided heart valve
see acute __ findings and __/__ finding
diffuse muscle rigidity w hyperthermia and myocyte breakdown dx ___
Cerebral septic emboli
neuro
murmur, cardio
Malignant hyperthermia
__ tremor aka __
inherited __, look for family history
improves w __
tx w __ a nonslective B antag
__ anticholingergic to tx Parkinson, counterract EPSE
essential, familial
AD
alcohol
propanolol
benztropine
__ contains optic nerve from temporal part of ipsi retina and nasal part of contra retina
Optic tract lesions result in __ homonyous hemaniopsia
frontal eye fields located in __ cortex
generates __ gaze movements
damage has eyes deviate __ side of lesion
contralateral homonyous hemaniopia w intact pupillary light reflexes may damage the __
lesion in __ producess contralateral upper quadrantopia
macula recieves collateral BF from __
not affected in __ infarct
optic tract
contralateral
prefrontal
conjugate
toward
LGN
Meyer loop
MCA
posterior cerebral artery
at rest, membrane is permeable to ion w __ potential
opening of ligand gated ion channels causes __ in membrane potential
opening of voltage gated ion channels causes __ in membrane potential, meaning that membrane is permeable to __ potential ion
negative equilibrium
inc
dec, negative equilibrium
Intraplerual pressure is __ at rest due to recoil of lungs/chest
w inspiration, diaphragm contracts to make IPP __, drawing air in
w no dec in phrenic nerve activity, pt shows progressively __ diaphragm contractions
thus, pt has excessive skeletal muscle __ (COPD/IPF) or impaired __
women in post partum period are at high risk of developing ___
negative
more negatve
weakening
weakness, NT release
MG
Fracture to the __ can be damaged w direct trauma
contains the __/__
__ nerve runs along orbital surfave, before leaving infraorbital foramen
damage can result in numbness to upper __/__/__
can also see E and impaired __ gaze (trapped IR muscle)
orbital floor
zygoma, maxilla
infraorbital
cheek/lip/gingiva
exopthalmos, vertical
superior orbital fissure contains CN __/__/__/__
can lead to loss of __
hematoma over __ w periorbital eccymoses idicate fracture to __
fracture of __ can impair motor fxn of face
3/4/5/6
mastoid process, basilar skull
temporal bone
infant w delyaed motor development and flaccid paralysis has __
caused by mutation in __ gene
affects __ in LMN, impairing __ fxn
thus, __ cells degenerate
collection of snRPs and pre mRNA form a __ to remove introns from pre MRNA
spinal muscular atrrophy
SMN1
snRPs, spliceosome
anterior horn
spliceosome
first line tx of T gondii in HIV pt w ring enhancing lesions is P/S
Amphotercin and flucytosine can tx __ meningitis
Amphotercin can tx invasive ___
CNS aspergillosis presents w __ andd __ sx
this form, tx w __
__ tx listeria
CMV CNS involvement presents w P/transverse __, and E
pyrmethamine/sulfadiazine
cryptococcal
aspergillosis
abscess, pulm sx
voriconazole
listeria
polyneuro, myelitis, enceph
HIV Pt w neg t gondii serology, think __
see large, solitary lesions
origin is ___ NHL of b cells
__ infection is identified in most cases
dx w __ PCR of CSF
definitive dx w __
usually do not have __ infiltration
T cells are malignant in __ T cell lymphoma
__ is primary cell in histiocytomas
__ is precursor to glioblastoma multiforme
primary CNS lymphoma
DLBCL
EBV
EBV
brain biopsy
T cells
AIDS assc
macros
astrocytomas
varicella IgG ab and dermatome oriented, painful vesicular rash indicates __
this is a ___ w/in dorsal root ganglia
primary VZV occurs in __
typically resistant to __ later, but not __
varicella vacine induces __ for primary VZV but decreases over time
IgG is ineffective against __
herpes zoster
reactivation
childhood, chickenpox, zoster
immunity
dorsal root ganglion
polysaccharide antigens on latex agglutination test w meningitis due to __ in AIDs indiv
should see round/oval __ w india ink stain
yeast obstructs CSF outflow, leading to inc __
nonseptate hyphae branch at __ angles
seen in M/R
__ forms spherules which rupture to release endospores
cryptococcus
budding yeast
opening pressure
wide
mucor/rhizpus
coccidioides
__/__ transport Nitrogen throughout body
alanine fxn in the __/__ cycle to remove N2
alanine transported to __
there, converted to __ via ALT, as amino group trasnferred to __ to form glutamate
ammonia enters __ to form urea to get rid of N2
free ammonia then excreted in __
alanine, glutamine
glucose/alanine
liver
pyruvate, Aketoglutarate
urea cycle
urine
residual neuropathic pain in later zoster is known as __
sensitization of affarent nerves in __
tx w __ (amytriptaline) or anticonvulsants G/P
Capsaicin causes activation of __ to cause buildup of Ca to defunctionaize nerves
also depletes __ important in pain
use as __ to dec pain
__/__ activate U and K opioid receptors respectively
post herpetic neuralgia
dorsal horn
TCA
gabapentin/pregabalin
TRPV1
Substance P
topical
endorphin/dynorphin
FXS
PE finings include marco-__ and long/narrow __ w prominent __/__
N/P disorders like __ delay, A, and A develop
mutation in __ gene on long arm of X chromosome
expands during __ in oocytes
seen w >200 __ repeats, resulting in hyper__
this __ FMR1, inhibiting neural development
use __ to determine degree of methylation
orchidism, face
chin/forehead
develop, ADHD, ASD
FMR1
meiosis
CGG
methylation
inactivates
southern blot
MG is caused by antibody/complement mediated destrxn of _ receptors on NMJ
long acting ACHe inhibs like P used for tx
__ Ach in NMJ
pt may be undertreated aka __
Tensilon test w short acting __
if positive, inc __ of pyridostigamine
too high AChE inhibitor causes __
leads to muscle weakness bc NMJ is __ to acetylcholine
does not respond to __
__ pyridostigmine
nicotinic
pyridostigamine
inc
myasthenic
edrophonium
dose
cholinergic crisis
insensitive
edrophonium
discontinue
Fragile X cells will not stain in __ deficient medium
see small __ in long arm of chromosome X
Klinefelter syndrome has dec ___ secretion bc of fibrotic testes
causing __/__
folate
gap
testosterone
oligospermia/infertility
Gingival hyperplasia in phenytoin is due to inc __
macrophages stimulate __/__
regresses w ___
Phenytoin is anticonvulsant for __ seizure, __ seizure and status __
inhibits abnormal __ in brain by blocking voltage gated __ in neurons
SE A/N/H/__ anemia
induces __
avoid in __
PDGF
gingival cells, alveolar bone
dscontinue
grand mal, partial, epilepticus
electrical activity
Na channels
ataxia/nystagmus/hirsutism/macrocytic
p450
pregnancy
__ toxicity assc w coarse tremor, twitching, motor agitation, ataxia
can cause NDI, hypo___ and __ defects
__ withdrawal assc w sever depression
Cocaine blocks reuptake of __/__/__
SE of clozapine A/S
lithium
thyroid, cardiac
cocaine, depression
NE/dop/serotonin
agranulocytosis/seizure
ADPKD assc w __
AMS, focal neuro defects can indivate ___
CCB like __ can prevent SAH
SAH/berry aneurysm
cerebral vasospasm
nimodipine
Pt w cardiogenic shock w evidence of watershed necrosis suffered from __/__ encephalopathy
profound __ diminished blood flow to brain causing ischemia
neurons do not store __ and are susceptible to ischemia
Pyramidal cells of __ and perkinje cells of __ are most vulnerable
cortical watershed infarcts present as bilateral __ strips of necrosis over convexity
pt w severe carotid artery stenosis may have __ infarct
hyoxic/ischemic
hypoTN
glygogen
hippocampus, cerebellum
wedge shaped
unilateral
__ aneurysm involves hemorrhage of __ structures
cardaic embolism has __ infarcts in different territories
HA/v/confusion indicates __ encephalopathy
braid __/__ seen on autopsy
charcot bouchard
deep
multiple
hyperTN enceph
edema/hemorrhage
NF1 is mutation in __ tumor suppressor
cutaneous neurofibromas are neoplasms of __ derived from __
pt at inc risk of __ neoplasm
NF1
schwann cells, NCC
CNS
cystic degeneration of the putamen occurs in __ dz
located lateral to __/__
__ mediates fear/SNS stimulation
wilsons dz
globus pallidus/internal capsule
young woman w INO, episodes of ON should indicate __
demyelination of __
autoimmune response at __
myelin sheath aids in __ as impulse jumps between nodes of Ranvier where __ is concentrated
aids in __ up impulses
demyelination in MS results in ___
surviving oligodendrocytes partially __ neurons
loss of axons/neurons over time indicates __ MS
MS
CNS
oligodendrocytes
saltatory condxn
sodium channels
speeding up
slowed condxn
remyelinate
chronic
right sided pure hemisensory loss has suffered a __ stroke
VPLN receives input from __ tract and __ column
and VPMN (info from __ pathway ) send __ projections to cortex
damage leads to complete contralateral __ loss
no pain/temp/vibration/proprioception
may lead to __ gait
thalamic
ST/dorsal
trigeminal
somatosensory
sensory
unsteady
injury to __ assc w contra weakness/ataxia due to descending motor tracts
damage to __ seen w behavioral abnorms and chorea
most lesions to internal capsule result in combined __ defects
base of pons
caudate nucleus
somatomotor
__ are small cavity infarcts of BG/internal capsule/pons/cerebellum
result from occlusion of small __ supplying structures
usually result of __/__
__ occurs w leakage of plasma proteins through damaged endothelium
see __ thickening of vasc wall, collagen sclerosis, and __ macros
__ result from accumulation of lipid laden macrophages
both result in small vessel __ and __ necrosis w fluid filled cavity
lacunes
penetrating arterioles, HTN/DM
lipohyalinosis
hyaline, foamy
microatheromas
occlusion, liq necrosis
__ is tumor of PNS from schwann cells
appear __ w high/low cell areas
Antoni A areas coposed of __ cells in palisading pattern
nuclear free region known as __ body
usually __ positive due to NCC origin
__ is another S100 positive tumor
Schwann cells are __ insulation of axons
can occur in cranial __/spinal __
schwanomma
biphasic
spindle
Verocay
S100
melanoma
PNS
vault, canal
Schwannoma may arise in any CN except __ which is covered w oligodendrocytes
most common site of involvement is __ angle CN8
known as __ w tinnitus/vertigo/hearing loss
2
cerebellopontine
acoustic neuroma
__ is bizarre looking glial cells w mitotic figures, necrosis, hemorrhage
seen in frontotemporal __
grows across ___
__ is a slow growing tumor arising in __ cells of arachnoid
appear as cells in __ or __
may have __
L/S/B/R can metastasize to brain
usually at __ jxn
look for central __ w reactive __ and edema
__ assc NF1, made of immature __
Microcystic __ and __ fibers
glioblastoma, white matter
corpus callosum
meningioma
meningoethelial
loules/whorls
psmamomma bodies
lung, skin, bone, renal
G-W
necrosis
gliosis
optic glioma
astrocytes
degen w Rosenthal fibers
__ is seizure lasting > 5 min or occurrence of multiple seizures w incomplete __
may be due to __ brain injury, I, __ abnorms, __ noncompliance
IV __ potentiates GABA and is drug of choice
IV __ is admin concurrently, anticonvulsant to prevent __
Phenytoin inhibits ___
__ is irreversible inhibitor of GABA transaminase
used for __ resistant epilepsy
status epilepticus
recovery
structural, infection, met, med
Lorazepam
phenytoin, recurrence
Na channels
vigabitrim
__ blocks Na channels and inc Gaba
Benzo/phenobarbitol inc __ action
__ modulates gaba/glutamate release
__ blocks Thalamic T type Ca channels
valproic acid
GABA a
levetiracetam
ethosuxamide
__ is opioid analgesic for chronic pain
all opioid receptors coupled to inhibitory __ proteins
Morphine has high affinity for the __ receptor
this reduces __ influx by closing presynaptic voltage gated channels and dec __ NT release from presynaptic terminal
also bind to mu receptor on __ to open K channels allowing for __
thus producing __
morphine
G proteins
mu
Ca
excitatory
postsynapse, efflux
Fluent aphasia that cannot understand language is due to lesion in __ area
this is the posterior portion of superior temporal gyrus in __ lobe
known as the __ cortex
supplied by inferior terminal ___
superior terminal MCA supplies __ area
wernicke
temporal
auditory association
MCA
broca
__ nerve descends in obturator canal to supply __ muscle
powers muscles for __
anterior division gives of terminal cutaneous branch for __ over distal medial thigh
femoral nerve innervate __ for leg extension
extension of thigh via __ and IGN innervation
Psoas, iliacus, sartorius used to __ the thigh
obturator nerve
obturator externus
thigh adduction
sensation
quad femoris
gluteus maximus
flex
blurry vision, diplopia, weak/numb, bowel bladder dysfxn in woman <50 is __
__ is monocular visual loss w pain on eye movement and afferent light defect
look for white matter lesions in __ region
pathology is __ reacting to antigens in myelin
B cells indicate __ Ig bands in CSF
__ proliferate and form the scar after attack to oligodendrocytes
MS
optic neuritis
paraventricular
Helper T cells
oligoclonal
astrocytes
__ cells found in choroid plexus and produce CSF
__ are macrophages in CSF
___ targeted by peripheral demyelinating disorders
ependymal cells
microglia
schwann cells
loss of grey-white matter differentiation w sulcal effaceemnt indicates __ brain injury w cardiac arrest
nonreactive pupils to light folllow cardiac rest means damage has occurred to __
optic nerve transmits light to midbrain and is received by __ nucleus
bilateal occipital lesions lead to __ blindness
__ lobes process signals from other brain areas
Nondominant leads to __ and apraxia
Dominant leads to L/R __
anoxic
midbrain
pretectal
cortical
parietal
hemineglect
confusion
pons used for __ gaze and doll eye reflex
bilateral __ damage has pinpoint pupils due to lost descending symp fibers
__ lobe injury can lead to memory/speech/vision/hearing problems
horizontal
pontine
temporal
nonrhythmic conj eye movements and involuntary jerking movements in young pt should be ___
arises from __ of AM/symp ganglion
should see firm __ mass and const symptoms
__ ecchymoses possible
majority of pt have elevated __ metabolites
biopsy shows small round blue __ and __ rosettes
teset for __ amplification, which carries a poor prognosis
neuroblastoma
NCC
abdominal
periorbital
catecholamine
cells, HW
nMYC
Opsoclnus-myoclonus is paraneoplastic syndrome for
__ is common in kids
arises in __ causing ataxia
may have __ rosettes as well
neuroblastoma
medulloblastoma
HW
Lacunar stroke seen w chronic H/D/S
get hypertensive arteiolar __ and narrowing of lumen
presents w pure motor hemiparesis w __ involvement
pure sensory stroke w __/__ of thalamus
ataxia hemiplegia syndrome w ___
usually not seen by __
can turn into __
HTN/DM/smoking
sclerosis
posterior internal capsule
VPLN/VPM
posterior internal capsule
CT
lacunes
spontaneous lobar/cortical hemorrhage is most commonly due to cerebral __ angiopathy
__ aneurysm leads to intraparenchymal hemorrhage
saccular aneurysm seen w __
hyperattenuation of __/__
amyloid
CB
SAH
sulci/cisterns
__ modulates ataxia and truncal posture
coordinates w __ descending motor systems
lesion to this region results in truncal __ w unsteady/broad based gait
pt can also get V/N w involvement of lower vermis/flocculonodular lobe
limb dysmetria occurs w damage to __ and lateral descending motor system
vermis
medial
ataxia
vertigo/nystagmus
cerebellar hemispheres
optimal site for femoral nerve is the ___
anesthetize __/___ of anterior thigh/femur/knee
__ is not in the femoral canal
__ is a landmark for pudendal nerve block
inguinal crease
skin/muscles
femoral nerve
TCA like __ have strong __ properties like C and urinary __
__ is SNRI used for depression/anx/chronic pain
SE is C
amitryptaline, anticholinergic
retention
duloxetine
confusion
Putaminal hemorrhage involves ___ w contralateal hemiparesis/anesthesia
disrupted __/__ in posterior limb
leads to HA/N/V/AMS
appears as __ on CT and can result in __ w midline shift
most freq affected location is __, cerebellar nuclei, T/P
basal ganglia supplied by __ arteries from the MCA
interenal capsule
CS/somatosensory fibers
hyperdense
mass effect
basal ganglia, thalamus, pons
lenticulostriate
spontaneous deep intracerebral hemorrhage caused by __ vasculopathy
HTN
