Neuro Flashcards by elliot sultanik

Contralateral hemiparesis; unmanaged HTN?

Lateral striate artery stroke

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

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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?

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

1) PCA

2) Occipital cortex, visual cortex

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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?

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

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

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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Anterior communicating aneurysms present with?

Visual defects

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Posterior communicating strokes or aneurysms present with?

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

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MCC artery of berry aneurysm?

Anterior communicating

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Epidural hematoma can lead to what kind of herniation?

Transtentorial– CN3 palsy

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crescent shaped hemorrhage that crosses suture liens?

Subdural– bridging veins (atrophy predisposes to this)

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Acute subdural on imaging?

Chronic subdural on imaging?

Acute=hyperdense

Chronic=isodense/hypodense

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Spinal tap of SAH?

Bloody or yellow

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

Risk of vasospasm and treat with CCB (nimodipine)

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Intraprenchymal hemorrhage often seen with ?

Amyoid angiopathy, vasculitis, and neoplasm

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Describe progression of ischemic brain disease? 2 weeks?

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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Glial scar presents how long after brain injury?

> 2 weeks

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Bright areas on noncontrast CT indicate?

hemorrhage–DO NOT GIVE TPA

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Where does reabsorbed CSF drain into?

dural venous sinus

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Communicating hydrocephalus?

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

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Normal pressure hydrocephalus?

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

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Hydrocephalus ex vauo?

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

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CN6 palsy, nausea, vomiting, papilledema?

Possibly noncommunicating hydrocephalus

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Subarachnoid space extends to lower border of?

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Destruction of anterior horns; flaccid paralysis?

Polio– primarily effects legs

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

Multiple Sclerosis

UMN and LMN deficits with no sensory loss?

ALS (deficits in ventral horns and CST)

"Treatment" for ALS and defect?

Defect may be in superoxide dismutase | RiLOUzole-- dec presynaptic glutamate release

Artery of adamkiewicz supplies ASA below?

Tabes dorsalis effects?

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

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

Syringomyelia-- seen with chiari malformations

Impaired position and vibration sense and ataxia?

B12-- affects dorsal columns and Cortical spinal tract

Where does polio virus replicate?

oropharynx and small intestine-- fecal oral-->LMN

Werdnig hoffman?

Same as polio but there is CONGENITAL degeneration

Pes cavus, nystagmus, falls easily, dysarthria?

Friedrichs --die of cardiomyopathy

Brown sequard-- losses AT the level of the lesion?

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

inguinal ligament

umbilicus?

t10

Bicepts reflex?

triceps reflex

achilles reflex

hang on for life reflex of baby?

moro

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

rooting

curling of fingers if palm is stroked?

Palmar

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

Galant reflex

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

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

sensation from anterior 2/3 of tongue

trigeminal

taste from anterior 2/3 of tongue-- eye CLOSING

facial

Stapedius muscle is innervated by? passes through?

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

Midline uvula?

Vagus

Talking CN?

Vagus-- coughing, swallowing, palate elevation

Lateral nuclei (sensory) are derived from ?

aLar plate

Medial nuclei (motor) are derived from?

Basal plate

Nucleus solitarius?

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

Nucleus ambiguus?

Swallowing, palate elevation 9, 10

Dorsal motor nucleus?

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

CN1 passes through?

Cribriform plate-- ethmoid

cranial nerves 2-6 pass through?

sphenoid

Middle meningeal artery passes through?

foramen spinosum

CN7-12 pass throuhg?

Posterior cranial fossa

CN 7, 8?

pass through internal auditory meatus

CN 9,10,11 pass throuhg?

Jugular foramen

CN12 passes through?

hypoglossal canal

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

Foramen magnus

Which cranial nerves pass through the cavernous sinus?

3,4,51,52,6

Opthalmoplegia, decreased corneal and maxillary sensation with normal vision

cavernous sinus syndrome

this muscle prevents jaw from deviating to opposite side?

Pterygoid

CN11 lesion?

Weakness moving head to contralateral side

Alleviates pressure created by oval window?

Round window

DDx for facial nerve palsy?

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

Muscles of mastication? muscle that opens jaw

Temporalis, masster, medial pterygoid all close the jaw lateral pterygoid opens jaw

Hyperopia?

Farsighted-- light focuses behind retina

Myopia?

Near sighted-- light focuses in front of retina

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

Lens becomes more convex Defect is called Presbyopia

Retinitis DDx?

CMV, HSV, HZV-- associated with immunosuppresion

Retina whitening with cherry red spot?

Central retinal artery occlusion

Closed angle glaucoma?

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

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?

Epinephrine-- dt mydriatic efffect

3 metabolic disorders that cause cataracts?

Classic galactosemia; galactokinase deficiency, diabetes (sorbitol)

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

Pseudotumor cerebri

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

Trochlear 4 damage

pathway of miosis?

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

Pathway of mydriasis?

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

Central portion of oculomotor nerve?

motor output to ocular muscles

Peripheral portion of oculomotor nerve?

parasympathetic output-- affected by compression

pathophys of dry macular degeneration?

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

Pathophys of wet macular degeneration?

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

Bilateral MLF?

Multiple sclerosis

Telencephalon

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

Diencephalon?

Thalamus and third ventricle

mesen; meten; myelen

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

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

AChE

Dandy walker

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

Dopamine synthesized in?

Ventral tegmentum

ant. pituitary derived from? | Post pituitary derived from?

``` Ant= ectoderm Post= neuroectoderm ```

Lesion of arcuate fasciculus?

Cannot repeat sentences

Conduction deficit

Conduction can't repeat-- can be caused by damage to arcuate fasciculus

Transcortical lesions

CAN repeat

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

Freebie

Aphasia, ataxia, hemparesis, AIDS patient-- path?

Progressive multifocal leukonencephalopathy see eosinophilic inclusion-- represents accumulation of JC virus

Looks like MS on MRI

Acute disseminated encephalomyelitis-- measles of VZV

Neuro Flashcards

(100 cards)