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Neuro Flashcards

1
Q

cells that line the ventricles & central canal of spinal cord, are ciliated and direct flow of CSF

A

ependymal cells

derived from neuroectoderm

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2
Q

embryonic derivation of peripheral nervous system structures: DRG, cranial nerves, melanocytes, chromaffin cells (adrenal medulla), C cells of thyroid, odontoblasts, pia & arachnoid

A

neural crest

Not CNS but PNS

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3
Q

midline sulcus of the pons contains what?

A

basilar artery

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4
Q

cranial nerves that exit the midbrain

A

CN III and IV

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5
Q

connects the two hemispheres of the brain

A

corpus callosum

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6
Q

comprise the striatum

A

caudate nucleus & putamen

bridge that connects them is the nucleus accumbens

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7
Q

responsible for the emotional significance of experiences

A

amygdala

Note: seizures involving the amygdala cause powerful emotions of fear and panic

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8
Q

surrounds the third ventricle

A

thalamus

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9
Q

connects the third and fourth ventricles

A

cerebral aqueduct

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10
Q

channel between the lateral ventricles and third ventricle

A

foramen of Munro (interventricular foramen)

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11
Q

produces CSF

A

choroid plexus

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12
Q

spatial awareness of surroundings, taste, somatosensation

A

parietal lobe

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13
Q

hearing, language comprehension (Wernicke’s area), object and face recognition

A

temporal lobe

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14
Q

vision, visual spacial awareness, color perception

A

occipital lobe

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15
Q

movement (primary motor), speech (Broca’s area), motor association cortex

A

frontal lobe

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16
Q

dominant hemisphere -> speech comprehension and production

A

left hemisphere

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17
Q 
bilateral damage to the amygdala producing the inability to perceive situations as dangerous
other features:
-visual agnosia
-place objects in mouth
-increased sexual behavior
-decreased facial expressions
A

Kluver-Bucy syndrome

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18
Q

long-term memory

A

hippocampus

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19
Q

caudate nucleus, putamen, and globus pallidus

A

basal ganglia
function: initiation and maintenance of actions
damage to basal ganglia results in movement disorders

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20
Q

suspicious for neural tube defects

A

elevated AFP in amniotic fluid and maternal serum

elevated AChE in amniotic fluid

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21
Q

failure of bony spinal canal to close
intact dura
tuft of hair or dimple

A

spina bifida occulta

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22
Q

meninges herniate through spinal canal defect

AFP normal

A

meningocele

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23
Q

meninges and spinal cord herniate through spinal canal defect

A

meningomyelocele

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24
Q

no forebrain
open calvarium -> looks “frog-like”
elevated AFP
polyhydramnios

A

anencephaly

associated with maternal type 1 DM

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25
Q

herniation of cerebellar tonsils through foramen magnum
aqueductal stenosis
paralysis below defect

A

Arnold-Chiari malformation (Chiari II)

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26
Q

parts of cerebellar vermis develop abnormally
hydrocephalus & macrocephaly within first year
delayed: crawling, walking, coordinated movements
cystic enlargement of 4th ventricle

A

Dandy-Walker

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27
Q
  • cystic cavity within spinal cord
  • capelike bilateral loss of pain and temperature sensation in the upper extremities
  • preservation of fine touch
  • most common at C8-T1
A

syringomyelia
Associated with Chiari I malformation (headaches & cerebellar symptoms in presentation but usually asymptomatic in childhood)

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28
Q

syrinx in the central canal

A

hydromyelia

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29
Q

motor innervation of the tongue

A

CN XII

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30
Q

taste and sensation innervation of the tongue

A

Taste: CN VII (ant), CN IX (post)
Sensation: V3 (ant), CN IX (post)

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31
Q

degeneration of axon distal to injury and axonal retraction proximally

A

Wallerian degeneration

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32
Q

Group of infections transmitted from the mother to the fetus with similar clinical manifestations.
Involves skin, heart, eye, CNS & causes chorioretinitis

A 
TORCH complex:
Toxoplasma
Rubella
CMV
Herpes
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33
Q

GFAP

A

astrocyte marker

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34
Q

phagocytes of CNS that are scavenger cells; when activated these become antigen-presenting cells and produce cytokines

A

microglia

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35
Q

physical support cells of CNS

  • repair
  • potassium metabolism
  • remove excess NT
  • component of BBB
  • glycogen fuel reserve
  • perform reactive gliosis in response to injury (scar tissue)
A

astrocytes

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36
Q

produce myelin in the CNS; can myelinate several axons

A

oligodendrocytes

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37
Q

produce myelin in the PNS; myelinates a single axon

A

Schwann cells

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38
Q

Where are there high concentrations of sodium channels?

A

nodes of Ranvier

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39
Q

derived from neuroectoderm

A
  1. astrocytes

2. oligodendrocytes

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40
Q

derived from mesoderm

A

microglia

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41
Q

derived from neural crest

A

schwann cells

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42
Q

injured in multiple sclerosis, PML, & leukodystrophies

A

oligodendocytes

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43
Q

destroyed in Guillain-Barre

A

schwann cells

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44
Q

myelinated fibers that sense Pressure & Vibration

  • deep skin layers
  • ligaments
  • joints
A

Pacinian corpuscles

Pacinian = Pressure

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45
Q

myelinated fibers in hairless skin
dynamic, fine/light touch
position sense

A

Meissner corpuscles

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46
Q

myelinated fibers in basal epidermal layer & hair follicles

Senses pressure, deep static touch, position sense

A

Merkel discs

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47
Q

direct outgrowth of the hypothalamus

A

posterior pituitary

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48
Q

regulates:

  • sleep-wake cycles
  • thermoregulation
  • fluid intake
  • growth
  • metabolic energy expenditure
  • reproduction
A

hypothalamus

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49
Q

hypothalamic nucleus that controls circadian rhythms via connections with the pineal gland

A

suprachiasmatic nucleus

“you need to sleep to be charismatic”

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50
Q

thirst centers nucleus

A

supraoptic nucleus

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51
Q

divisions of the Peripheral Nervous System

A
  1. somatic nervous system

2. autonomic nervous system

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52
Q

hemisection of spinal cord resulting in ipsilateral loss of sensation and voluntary muscle movement at level of the injury (stab or gunshot); ipsilateral spastic paresis below level of lesion; ipsilateral loss of light touch, vibration & proprioception below level of lesion; contralateral loss of pain & temperature below level of the lesion

A

Brown-Sequard syndrome

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53
Q

Mean Arterial Pressure - ICP

A

Cerebral Perfusion Pressure

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54
Q

metabolic mechanisms regulate arteriole size to maintain constant cerebral blood flow over a pressure range of 60-150 mm Hg

A

autoregulation

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55
Q

cause increased cerebral blood flow

A

hypoxia

hypercarbia

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56
Q

decreases cerebral blood flow

A

hypocarbia

causes cerebral vasoconstriction

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57
Q

How does too much oxygen produce deleterious effects on brain cells?

A

formation of free radicals

oxidation of NTs

58
Q

major cerebral branches of the internal carotid arteries

A

MCA & ACA
These supply 80% of blood to the brain.
MCA receives 80% of carotid blood flow

59
Q

Which arteries supply the spinal cord? From what arteries?

A

Anterior and Posterior spinal arteries.

Branches of Vertebral arteries which branch from the brachiocephalic (on R) and subclavian (on L)

60
Q

Functional areas of the posterior cerebral arteries

A
  1. Visual cortex
  2. hippocampus
  3. thalamus
  4. hypothalamus
61
Q

most important cause of ischemic stroke

A

atherosclerosis

62
Q

most common site for hypertensive intracerebral hemorrhage

A

basal ganglia

63
Q

mechanisms of brain death in ischemia

A

excitotoxicity, inflammation, programmed cell death
brain hypoxia -> decreased ATP -> Na+ pumps fail -> sodium enters cell -> depolarization -> more sodium influx & water = edema
-extracellular K+ rise causes depolarization ->glutamate release -> activation of NMDA receptor -> calcium influx -> free radical generation & apoptosis pathway activation

64
Q

hyperreflexia
spasticity
positive Babinski

A

upper motor neuron damage

Note: + Babinski is normal in children up to age 2 yr

65
Q

Which cranial nerve? shrug shoulders or turn face to each side against resistance

A

CN XI

66
Q

ATPases which are motor molecules for anterograde transport

A

kinesin and kinesin-related proteins

67
Q

positive membrane potential

A

depolarization

68
Q

membrane potential that is more negative

A

hyperpolarization

69
Q

What produces neuronal resting membrane potential?

A

continual efflux of K+
The membrane is only permeable to potassium under normal resting conditions. It becomes transiently permeable to sodium during rising phase and overshoot phase of action potential.

70
Q

What causes papilledema?

A

increased ICP

71
Q

What prevents backward propagation of the action potential?

A

inactivation of sodium channels = refractory period

72
Q
  • two or more deficits separated in neuroanatomical space and time
  • autoimmune inflammation & demyelination of brain & spinal cord while sparing PNS
  • white matter lesions
  • oligoclonal bands in CSF**
  • MRI is gold standard
  • Marcus Gunn pupils
  • nystagmus
A 
Multiple sclerosis
Presentation:
-female: age 20-30
-vision loss
-internuclear ophthalmoplegia
-hemiparesis
-bladder/bowel incontinence
-relapsing/remitting
73
Q
  • autoimmune destruction of Schwann cells triggered by Campylobacter jejuni & CMV
  • molecular mimicry
  • symmetric ascending weakness/paralysis
  • majority recover completely after weeks or months
A

Guillain Barre

Acute Inflammatory demyelinating polyradiculopathy

74
Q

virus that infects and kills oligodendrocytes, causing demyelination
associated with immunocompromised (10% AIDS pts)
Causes progressive multifocal leukoencephalopathy PML)
virus replicates in the epithelial cells of the capillaries

A

JC virus

75
Q

reward nucleus

A

nucleus accumbens

76
Q

slow progressive demyelination in CNS ending in death
Persistence of defective measles virus in brain
most prevalent in children who were infected before age 2
lack of M component of measles virus, which is required for extracellular spread -> slow infection -> no anti-M antibodies present
monoclonic jerks, blindness, spasticity

A

Subacute Sclerosing Panencephalitis (SSPE)

77
Q

California encephalitis virus spread by mosquitos
reservoir: chipmunk or squirrel
seizures in 50%

A

LaCrosse Virus

78
Q

amyloid plaques in CNS
PrP resistant to degradation -> no DNA or RNA
small cysts in gray matter with absence of inflammatory response
long incubation period
progressive dementia, ataxia, myoclonus & death in 5-12months
Host is cattle

A

Creutzfeldt-Jakob disease
spongiform encephalopathies
Note: CJD can be transmitted by corneal transplant

79
Q

anterograde amnesia vs retrograde amnesia

A

anterograde: inability to make new memories after neuro insult
retrograde: inability to retrieve memories prior to neuro insult

80
Q

Forms BBB

A
  1. tight junctions of capillary endothelial cells
  2. basement membrane
  3. astrocyte foot processes
81
Q

region of the hypothalamus that stimulates appetite

A

lateral

“I have to go out laterally to find food when I’m hungry”

82
Q

area of the hypothalamus that dissipates heat

A

anterior

the posterior conserves heat -> “hot posterior!”

83
Q

functions of limbic system: HOME

A

Homeostatic functions -> autonomic & neuroendocrine
Olfaction
Memory
Emotions and drives

84
Q

nucleus that contains the major cholinergic innervation of the cerebral cortex

A

nucleus basalis

85
Q

What lobe contains the amygdala?

A

temporal

86
Q

loss of emotional expression in speech

A

aprosodia

Emotion is lateralized to the right hemisphere

87
Q

contains medium spiny neurons that modulate the influence of dopamine

A

nucleus accumbens

Receives projections from the ventral tegmental area (VTA)

88
Q

which hemisphere is involved in attention to both sides of the body?

A

Right (typically parietal lobe)

lesion to the right hemisphere can result in Left hemineglect.

89
Q

areas not protected by the BBB

A

OVLT

area postrema

90
Q

motor deficit

A

apraxis

91
Q

area for planning, control and execution of actions

personality

A

Frontal Association Cortex

92
Q

term and area for difficulty recognizing and NAMING objects

A

agnosia -> mismatch of verbal or cognitive symbols with sensory stimuli
temporal association cortex

93
Q

inability to recognize and identify faces

A

prosopagnosia

94
Q

What is thought to be defective in understanding the intentions of others by a child with autism?

A

mirror neurons

95
Q

separates the outer ear from the middle ear

A

tympanic membrane

96
Q

muscles that move the malleus, incus & stapes

A 
tensor tympani (trigeminal nerve)
tensor stapedius (facial nerve)
97
Q

part of the ear involved in balance

A

vestibular apparatus

Balance receptors are located within the semicircular canals & vestibule

98
Q

auditory receptor organ

A

organ of Corti

has hair cells with stereocilia

99
Q

main auditory nucleus of the thalamus

A

medial geniculate nucleus

The inferior colliculus projects to this

100
Q

inability to carry out an action in response to a verbal command

A

apraxia

101
Q

nonfluent effortful speech
right hemiparesis
comprehends language (simple)

A

Broca’s aphasia

102
Q

fluent speech but nonsense

impaired comprehension

A

Wernicke’s aphasia

103
Q

inability to understand written words

A

alexia

104
Q

crossed eyes

A

esotropia

105
Q

wall eyes

A

exotropia

106
Q

two eyes cannot be aligned

A

strabismus

107
Q

critical period for language

A

0-12 years

children can speak a second language with fluent grammar until age 7-8 yr

108
Q

unilateral hearing loss indicates

A

damage to the ipsilateral nerve or ear
damage to the cortex or thalamus presents as poor speech discrimination, poor sound localization, poor selective attention

109
Q

in newborns: hydrocephalus, mental retardation
on radiograph: periventricular calcifications
Sites of involvement: cortex, basal ganglia, retinae, heart, lungs & liver
mom ingested food contaminated by animal urine or feces

A

Toxoplasmosis

110
Q

infection of the meninges
fever, headache, nuchal rigidity
CSF: increased lymphocytes, mod increased protein, normal glucose

A

VIRAL meningitis

111
Q

Degeneration and necrosis of anterior horn cells or spinal cord
fecal-oral transmission
replicates in oropharynx and small intestine
hematogenous spread
Presents with weakness, hypotonia, flaccid paralysis, fasciculations, hyporeflexia, muscle atrophy

A

poliomyelitis

CSF: increased protein, increased WBCs, normal glucose

112
Q

AD
numerous benign neuromas & optic nerve gliomas
neuromas can develop later into malignant peripheral nerve sheath tumors
mutation of NF1 (encodes neurofibromin -> loss results in active RAS signaling -> expressed in all tissues but especially brain, spinal cord and PNS)
“two hit” hypothesis

A

neurofibromatosis 1
• Criteria for diagnosis of NF1 (need at least 2)
○ Six or more café au lait spots measuring 5 mm in diameter prepubertal or 15 mm postpubertal
○ Two or more neurofibromas of any type
○ One plexiform neurofibroma
○ Axillary of inguinal freckling
○ Optic glioma
○ 2 or more Lisch nodules
○ Sphenoid dysplasia or thinning of long bone cortex with or without pseudoarthrosis
○ First-degree relative with NF1

113
Q

AD
bilateral benign schwannomas of the acoustic nerve
protein product of mutant allele is merlin

A

NF2

114
Q

○ Develops at 6 months age
○ Affected children become blind and regress mentally and physically
○ Fatal in early childhood (2-4 years)
○ Motor development plateaus and regresses at 8 months; loss of voluntary movement by age 2
-Causes a deficiency of hexosaminidase A, an enzyme required for catabolism of GM2 ganglioside
AR

A

Tay-Sachs

Ashkenazi Jewish population

115
Q 
degeneration of dorsal columns and roots
impaired sensation & proprioception
progressive sensory ataxia
Charcot joints, shooting pains
Argyll Robertson pupils
Absence of DTRs
\+ Romberg
A

Tabes dorsalis

Tertiary syphilis

116
Q 
weakness
atrophy
fasciculations
flaccid paralysis
diminished reflexes and muscle tone
A

LMN lesion

117
Q 
weakness
Babinski
spastic paralysis
clasp knife spasticity
increased reflexes and muscle tone
A

UMN lesion

118
Q

ascending: pressure, vibration, fine touch, proprioception

A

Dorsal column
ipsilateral dorsal column -> nucleus cuneatus or gracilis in medulla -> decussates and ascends in the medial lemniscus -> VPL in thalamus to sensory cortex

119
Q

portion of the dorsal column for lower body/legs

A

Fasciculus gracilis

120
Q

portion of the dorsal column for upper body and arms

A

Fasciculus cuneatus

121
Q

Lateral: Pain, temperature
Anterior: Crude touch, pressure

A

Spinothalamic tract
sensory nerve -> ipsilateral gray matter of spinal cord -> decussates anterior white commissure -> contralateral ascends -> VPL thalamus

122
Q

descending: voluntary movement of contralateral limb

A

lateral corticospinal tract

123
Q
  • combined UMN & LMN defects with no sensory, cognitive or oculomotor defects
  • defect in SOD1
  • fasciculations with atrophy and weakness of hands
  • fatal
A

amyotrophic lateral sclerosis

tx: riluzole

124
Q

level where the spinal cord ends

A

L1-L2 in the adult

Lumbar puncture is performed between L3-L4 or L4-L5

125
Q 
AR
kyphoscoliosis in childhood
GAA repeat -> frataxin -> iron metabolism
muscle weakness & loss of DTRs, vibratory sense, proprioception
Staggering gait
Frequent falls
nystagmus
hammer toes
hypertrophic cardiomyopathy
A

Friedreich ataxia

	○ Onset: typically before adolescence and characterized by incoordination of limb movements, difficulty with speech, diminished or absent tendon reflexes, impairment of position and vibratory senses, cardiomyopathy, scoliosis, foot deformities , type 2 diabetes
126
Q

Ptosis
Anhidrosis
Miosis
associated with lesion of spinal cord above T1: Pancoast tumor, Brown-Sequard, late-stage syringomyelia

A

Horner syndrome

sympathetic loss of the face

127
Q

levels of nipple and umbilicus

level of the penis

A

nipple T4 teat pore at T4
umbilicus T10 is at belly butTEN”
penis: S2-S4 “S2, 3, 4 keep the penis off the floor”

128
Q

colliculus corresponding functions
superior?
inferior?

A

superior colliculus: conjugate vertical gaze
inferior colliculus: auditory
“your eyes are above your ears”

129
Q

corneal reflex

afferent CN? efferent CN?

A

afferent: V1 (ophthalmic)
efferent: VII (temporal branch)

130
Q

lacrimation
Afferent CN?
Efferent CN?

A

A: V1
E: VII

131
Q

jaw jerk reflex
Afferent CN?
Efferent CN?

A

A: V3 sensory
E: V3 motor

132
Q

Pupillary reflex
Afferent CN?
Efferent CN?

A

A: II
E: III

133
Q

Gag reflex
Afferent?
Efferent?

A

A: IX
E: X

134
Q

produces aqueous humor

A

ciliary processes of the posterior chamber

135
Q

gelatinous substance between the back of the lens and retina

Maintains the shape of the eye

A

vitreous humor

136
Q

Why does increased ICP make the optic disk swell (papilledema)?

A

the subarachnoid space surrounding the optic nerve is continuous with the subarachnoid space of the brain. Increased ICP will make the optic disk swell.

137
Q

Changes the shape of the lens for focusing

A

ciliary muscles

138
Q

produced by the ciliary body and flows through the pupil to the anterior chamber to provide nutrients to the cornea & lens

A

aqueous humor

this drains into the venous blood via the canal of Schlemm. Blockage of the canal of Schlemm leads to glaucoma.

139
Q

crystallin proteins become oxidized and aggregate, usually due to older age

A

cataract

140
Q

Complication of measles.

Lethal changes in personality, behavior, memory, myoclonic jerks, blindness and spasticity

A

Subacute sclerosing panencephalitis

141
Q

Location where CN III, CN IV and CN VI enter the orbit of the eye

A

Superior orbital fissure

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