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Elliot Step 1 > Neuro > Flashcards

Neuro Flashcards

1
Q

Contralateral hemiparesis; unmanaged HTN?

A

Lateral striate artery stroke

Lesion is in striatum (caudate+ putamen=striatum) or internal capsule

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2
Q

Pt presents with vomiting, vertigo, nystagmus, dec pain and temp sensation to limbs and face; can’t swallow and having trouble speaking– WHERE IS LESION? WHAT ARTERY? WHAT IS THIS CALLED?

A

1) Lesion is in lateral medulla (vestibular nuclei, later STT, spinal trigeminal nucleus, NUCLEUS AMBIGUUS, inferior cerebellar peduncle
2) PICA
3) Lateral medullary syndrome– nucleus ambiguus are specific to pica lesions

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3
Q

Pt. presents with contralateral heminaopia with macular sparing– Artery? Lesion?

A

1) PCA

2) Occipital cortex, visual cortex

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4
Q

Pt. presents with vomiting, nystagmus and vertigo. Pt.’s cannot lift up cheeks to smile. Pt. has decreased lacrimation, and dec corneal reflex– artery? Lesion? Name of disease?

A

1) AICA
2) Lateral pons– facial nucleus are specific to AICA (Facial droop means AICAs pooped
3) Lateral Pontine syndrome

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5
Q

Pt. presents with hemiparesis of right leg. Tongue deviates to left. Proprioceptive problems with right leg as well?

A

1) ASA– think about where artery is
2) Lateral corticospinal tract, medial lemniscus; caudal medulla is where hypoglossal nerve is
3) Medial medullary syndrome caused by paramedian branches of ASA and vertebral arteries

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6
Q

Anterior communicating aneurysms present with?

A

Visual defects

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7
Q

Posterior communicating strokes or aneurysms present with?

A

CN3 palsy– eye is down and out with ptosis and pupil dilation

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8
Q

MCC artery of berry aneurysm?

A

Anterior communicating

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9
Q

Epidural hematoma can lead to what kind of herniation?

A

Transtentorial– CN3 palsy

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10
Q

crescent shaped hemorrhage that crosses suture liens?

A

Subdural– bridging veins (atrophy predisposes to this)

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11
Q

Acute subdural on imaging?

Chronic subdural on imaging?

A

Acute=hyperdense

Chronic=isodense/hypodense

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12
Q

Spinal tap of SAH?

A

Bloody or yellow

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13
Q

2-3 days after SAH, there is a risk of ? What should this be treated with?

A

Risk of vasospasm and treat with CCB (nimodipine)

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14
Q

Intraprenchymal hemorrhage often seen with ?

A

Amyoid angiopathy, vasculitis, and neoplasm

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15
Q

Describe progression of ischemic brain disease? 2 weeks?

A

Red neurons appear from 12-48 hours

Necrosis plus neutrophils appear from 1-3 days after

Macrophages appear from 3-5 days after

Reactive gliosis and vascular proliferation occurs from 1-2 weeks after

Glial scarring happens>2 weeks after

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16
Q

Glial scar presents how long after brain injury?

A

> 2 weeks

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17
Q

Bright areas on noncontrast CT indicate?

A

hemorrhage–DO NOT GIVE TPA

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18
Q

Where does reabsorbed CSF drain into?

A

dural venous sinus

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19
Q

Communicating hydrocephalus?

A

Dec CSF absorption by arachnoid granulations–>papilledema, and herniation

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20
Q

Normal pressure hydrocephalus?

A

Increase in subarachnoid space volume but no increase in pressure–? Wet, wobbly, whacky

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21
Q

Hydrocephalus ex vauo?

A

Appearance of increased CSF due to atrophy (alzheimers, picks, HIV)

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22
Q

CN6 palsy, nausea, vomiting, papilledema?

A

Possibly noncommunicating hydrocephalus

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23
Q

Subarachnoid space extends to lower border of?

A

S2

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24
Q

Destruction of anterior horns; flaccid paralysis?

A

Polio– primarily effects legs

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25
Q

Random asymmetric lesions dt demyelination, scanning speech, intention tremor, nystagmus?

A

Multiple Sclerosis

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26
Q

UMN and LMN deficits with no sensory loss?

A

ALS (deficits in ventral horns and CST)

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27
Q

“Treatment” for ALS and defect?

A

Defect may be in superoxide dismutase

RiLOUzole– dec presynaptic glutamate release

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28
Q

Artery of adamkiewicz supplies ASA below?

A

T8

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29
Q

Tabes dorsalis effects?

A

Dorsal columns– assoc with charcot joints, shooting pain, argyll pupuils, also postivie Rombergs

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30
Q

Bilateral loss of pain and temp from c8-t1? assoc?

A

Syringomyelia– seen with chiari malformations

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31
Q

Impaired position and vibration sense and ataxia?

A

B12– affects dorsal columns and Cortical spinal tract

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32
Q

Where does polio virus replicate?

A

oropharynx and small intestine– fecal oral–>LMN

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33
Q

Werdnig hoffman?

A

Same as polio but there is CONGENITAL degeneration

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34
Q

Pes cavus, nystagmus, falls easily, dysarthria?

A

Friedrichs –die of cardiomyopathy

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35
Q

Brown sequard– losses AT the level of the lesion?

A

All sensory loss and ipsilateral LMN signs AT the level of the lesion

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36
Q

L1

A

inguinal ligament

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37
Q

umbilicus?

A

t10

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38
Q

Bicepts reflex?

A

c5

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39
Q

triceps reflex

A

c7

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40
Q

achilles reflex

A

s1

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41
Q

hang on for life reflex of baby?

42
Q

Movement of head to one side if cheek or mouth is stroked?

43
Q

curling of fingers if palm is stroked?

44
Q

stroking along one side of spine while newborn is in ventral suspension causes lateral flexion of lower body toward stimulated side?

A

Galant reflex

45
Q

Paralysis of conjugate vertical gaze due to lesion of superior colliculi?

A

Parinaud syndrome– dorsal midbrain is compressed; large irregular pupils, ptosis; impairment of upward gaze

46
Q

sensation from anterior 2/3 of tongue

A

trigeminal

47
Q

taste from anterior 2/3 of tongue– eye CLOSING

48
Q

Stapedius muscle is innervated by? passes through?

A

Stapedius is innervated by the facial nerve and passes through the parotid gland

49
Q

Midline uvula?

50
Q

Talking CN?

A

Vagus– coughing, swallowing, palate elevation

51
Q

Lateral nuclei (sensory) are derived from ?

A

aLar plate

52
Q

Medial nuclei (motor) are derived from?

A

Basal plate

53
Q

Nucleus solitarius?

A

Visceral sensory information (taste, barorectpros, gut distention)– 7, 9, 10

54
Q

Nucleus ambiguus?

A

Swallowing, palate elevation 9, 10

55
Q

Dorsal motor nucleus?

A

Sends parasympathetic fibers to heart, lungs, and upper GI— CN10

56
Q

CN1 passes through?

A

Cribriform plate– ethmoid

57
Q

cranial nerves 2-6 pass through?

58
Q

Middle meningeal artery passes through?

A

foramen spinosum

59
Q

CN7-12 pass throuhg?

A

Posterior cranial fossa

60
Q

CN 7, 8?

A

pass through internal auditory meatus

61
Q

CN 9,10,11 pass throuhg?

A

Jugular foramen

62
Q

CN12 passes through?

A

hypoglossal canal

63
Q

Brain stem, vertebral arteries, and spinal roots of CN 11 pass through?

A

Foramen magnus

64
Q

Which cranial nerves pass through the cavernous sinus?

A

3,4,51,52,6

65
Q

Opthalmoplegia, decreased corneal and maxillary sensation with normal vision

A

cavernous sinus syndrome

66
Q

this muscle prevents jaw from deviating to opposite side?

67
Q

CN11 lesion?

A

Weakness moving head to contralateral side

68
Q

Alleviates pressure created by oval window?

A

Round window

69
Q

DDx for facial nerve palsy?

A

AIDS, lyme idsease, herpes, sarcoid, tumors, diabetes

70
Q

Muscles of mastication? muscle that opens jaw

A

Temporalis, masster, medial pterygoid all close the jaw

lateral pterygoid opens jaw

71
Q

Hyperopia?

A

Farsighted– light focuses behind retina

72
Q

Myopia?

A

Near sighted– light focuses in front of retina

73
Q

During accomodation lens becomes more….? Defect in accomodation is called?

A

Lens becomes more convex

Defect is called Presbyopia

74
Q

Retinitis DDx?

A

CMV, HSV, HZV– associated with immunosuppresion

75
Q

Retina whitening with cherry red spot?

A

Central retinal artery occlusion

76
Q

Closed angle glaucoma?

A

Enlargement of lens pushing it against the central iris leading to obstruction of normal AH flow

77
Q

Patient presents with sudden onset of excruciating pain in her eye. She has been corticosteroids for along time. She also has a frontal headache. What should NOT be given to this patient?

A

Epinephrine– dt mydriatic efffect

78
Q

3 metabolic disorders that cause cataracts?

A

Classic galactosemia; galactokinase deficiency, diabetes (sorbitol)

79
Q

26yo obese woman with H/N/V, visual changes?

A

Pseudotumor cerebri

80
Q

Eye moves upward, problems going down stairs, contralateral gaze with ipsilateral head tilt?

A

Trochlear 4 damage

81
Q

pathway of miosis?

A

Edinger westphal nucleus to ciliary ganglion via cnIII–>short ciliary nerves to pupillary sphincter muscles

82
Q

Pathway of mydriasis?

A

hypothalamus to ciliospinal center of budge (c8-t2)–>exit at T1 to superior cervical ganglion– travels along sympathetic chain–>plexus along internal carotid– enters orbit at long ciliary nerve to pupillary dilator muscle

83
Q

Central portion of oculomotor nerve?

A

motor output to ocular muscles

84
Q

Peripheral portion of oculomotor nerve?

A

parasympathetic output– affected by compression

85
Q

pathophys of dry macular degeneration?

A

Deposition of yellowish extracellular material beneath retinal pigment epithelium– PREVENT WITH MULTIVITAMIN AND ANTIOXIDANT

86
Q

Pathophys of wet macular degeneration?

A

Rapid loss of vision due to bleeding secondary to choroidal neovascularization –TREAT WITH ANTI VEGF or laser

87
Q

Bilateral MLF?

A

Multiple sclerosis

88
Q

Telencephalon

A

Lateral Ventricles— Think of the top part of the T as the ventricles

89
Q

Diencephalon?

A

Thalamus and third ventricle

90
Q

mesen; meten; myelen

A

midbrain (aqueduct); pons/cerebellum (upper part of fourth ventricle); medulla (lower part of fourth ventricle

91
Q

Helpful confirmatory test for neural tube defect in addition to high alpha fetoprotein

92
Q

Dandy walker

A

agenesis of cerebeller vermis with cystic enlargement of fourth ventricle (fills the enlarged posterior fossa)– associated with hydrocephalus and spina bifida

93
Q

Dopamine synthesized in?

A

Ventral tegmentum

94
Q

ant. pituitary derived from?

Post pituitary derived from?

A 
Ant= ectoderm
Post= neuroectoderm
95
Q

Lesion of arcuate fasciculus?

A

Cannot repeat sentences

96
Q

Conduction deficit

A

Conduction can’t repeat– can be caused by damage to arcuate fasciculus

97
Q

Transcortical lesions

A

CAN repeat

98
Q

Hypoxemia increases cerebral perfusion only when PO2 is below 50mmHg or 70%

99
Q

Aphasia, ataxia, hemparesis, AIDS patient– path?

A

Progressive multifocal leukonencephalopathy

see eosinophilic inclusion– represents accumulation of JC virus

100
Q

Looks like MS on MRI

A

Acute disseminated encephalomyelitis– measles of VZV

Elliot Step 1 (32 decks)

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