Neuro! Flashcards
neutral tube defects
increases AFP, AChE
syringomyelia
bilateral loss of pain and temp in upper extremities
cells that originate from neural crest
PNS neurons
Schwann cells
GFAP
astrocyte marker
NE location
locus ceruleus
increased in anxiety, decrease in depression
Dopamine location
ventral tegmentum and SNc
increased in schizpophrenia
decreases in Parkinsons, depression
5HT
raphe nucleus
decreased in anxiety and depression
AcH
basal nucleus of meynert
decreases in alzheimers, huntingtons
increase in REM sleep
GABA
nucleus accumbens
decreases in anxiety, depression
resting tremor
parkinson’s
essential tremer
exacerabted by holding posture/limb position
intention tremor
cerebellar dysfunction
Wernicke-Korsakoff syndrome
thiamine/B1 def
confusion, ataxia, ophthalomoplegia
Broca’s area
inferior frontal gyrus of frontal lobe
Wernicke’s area
superior temporal gyrus of temporal lobe
Broca’s aphasia
comprehends, but can’t understand when they talk
Wernicke’s
fluent aphaisa, impaired comprehension
dorsal column
pressure
vibration
fine touch
proprioception
anterior spinothalmic tract
crude touch, pressure
lateral spinothalamic tract
pain, temp
lateral corticospinal tract
descending voluntary mvmt of CL limbs
biceps reflex
C5
triceps reflex
C7
patella reflex
L4
achilles reflex
S1
Optic Canal
CN II
opthalmic artery
central retinal vein
Superior orbital fissure
CN III, IV, V1, VI
Foramen Rotundum
CN V2
Foramen Ovale
CN V3
Foramen spinosum
middle mengingial artery
internal auditory meatus
CN VII, VIII
jugular foramen
CN IX, X, XI
juglar vein
hypoglossal canal
CN XII
cavernous sinus
CN III, IV
V1, V2
VI
mastication muscles - close jaw
masseter, temporalis, medial pterygoid
V3
mastication muscles - lower jaw
lateral pterygoid
V3
lateral rectus
VI
superior oblique
IV
miosis
constrction
parasympathetic
edinger-westphal nucleus, short ciliary nerves to pupillary sphincter muscles
mydriasis
dilation, sympathetic
superior cervical ganglion
long ciliary nerves
pupillary dilator muscles
pupillary light reflex
bilateral pupillary constriction
Krabbe’s disease
AR
def of galactocerebrosidase
destroys myelin sheath
Craniopharyngioma
calcified cystic mass
cholesterol crystals
common origin of craniopharyngioma
pituitary gland
ectoderm
early onset Alzheimer’s genes
APP (ch21) presenilin 1 (Ch 14) presenilin 2 (Ch 1)
Late onset Alzheimer’s genes
E4 allele of apolipoprotein E
ApoE2
protective for Alzheimer’s disease
Alzheimer’s disease treatments
1) enhance cholinergic neurotransmission
2) antioxidants/neuroprotective
3) NMDA receptor antagonism
Alzheimer’s NT
decreased ACH
neurofibrillary tangles
AD, intracellular
abnormally phosphorylated tau protein
correlate with degree of dementia
alpha tocopheral
vitamin E
neuroprotective for AD
memantine
NMDA receptor antagonist
blood brain barrier
tight junctions (nonfenestrated)
basement membrane
astrocyte foot processes
MCA
contralateral paralysis of upper limb and face
ACA
contralateral paralysis of lower limb
crescent shaped
subdural hematoma
subdural hematoma: vasospasm
due to blood breakdown
treat with CCB (nimodipine)
degernation of posterior columns, spinocerebellar tracts + lateral corticospinal tracts
vit b12 or vit E def
vitamin E def (degeneration of posterior + spinocerebellar tracts) similar to
Friedrich’s ataxia
neuro cytoplasmia eosinophilia
glial hyperplasia
CN V lesion
jaw towards side of lesion
CN X lesion
uvula deviates away
CN XI lesion
weakness turning head to CL side of lesion
shoulder droop on side of lesion
CN XII lesion
tongue deviates towards side of lesion
Schwannoma
spindle cells
S100 positive
Germinoma
pineal gland tumor
- precocious pubery
- obstructive hydrocephalus
- parniaud syndrome
parinaud syndrome
paralysis of upward gaze and convergance
due to germinoma
Cerebral Amyloid Angiopathy
due to advanced age
recurrent hemorrhagic stroke
morphine mofA at spinal cord level
G protein, increase K efflux
hyperpolarize the cell, terminate pain transmission
treatment for trigeminal neuralgia
carbamazepine
treatment for refractory partial seizures
tigabine, vigabatrin, gabapnetin
topiramate
topiramate mofa
blocks Na channels
increase GABA
benzodiazepines
-zepam
increase GABAa
acute opiod withdrawal in neonates
opium solution
Steven Johnson syndromes drugs
carbamazepine
ethosuximide
lamotrigine
phenytoin
lamotrigine AE
steven johnson
carbamazepine AE
SIADH (hyponatremia)
hepatic dysfunction
valproic acid AE
acute hepatic failure
pancreatitis
teratogen
felbamate
aplastic anemia, hepatic failure
phenytoin
ataxia
hepatic dysfunction
gingivial hyperplasia
topiramate
metabolic acidosis
glaucoma
weight loss
kidney stones
levetiracetam
sedation, irriability
zolpidem (ambien)
short acting, binds GABAa receptor
zolpidem reverasal
flumazenil
gardner’s mydriasis
belladonna alkoids – anticholin
treat with physotigimine
atropine overdose
physostigmine
NTD mechanism
failure of neurospores to close
NF-1 Specifics
1) cafe au lait spots
2) neurofibromas
3) lisch nodules (iris)
4) pheochromocytomas
Friedreich Ataxia Symptoms
1) ataxia
2) kyphoscholiosis
3) foot abnormalities
4) DM
5) HCM
intracranial schwanomas location
cerebellopontine angle
Timolol
(beta blocker), use for glaucoma
decrease aqueous humor production
where does aqueous humor production occur
ciliary epithelium
to decrease aqueous humor synthesis
alpha agonist
beta blocker
acetazolamide
benzos increase frequency of
cloride channel openings
contract diaphragm
intrapleural pressure falls
progressively weaker contractions of diaphragm
mysasthenia gravis
suprachiasmatic nucleus
circardian rhythm
CSF flow
lateral –> 3rd –> 4 th –> subarachnoid space
lateral –> 3rd ventricle
interventricular foramen of Monro
3rd ventricle –> 4th ventricle
cerebral aqueduct
4th ventricle –> subarachnoid space
foramen of luschka (lateral)
foramen of magendie (medial)
hydrocephalus exvacu
appearance of increase CSF because atrophy
Alzheimers, HIV, Pick’s
Normal Pressure Hydrocephalus
increased subarachnoid space but no increase in pressure
urinary incontinence
ataxia
cognitive dysfucntion
communicating hydrocephalus
decrease CSF absorption
increase ICP
non communicating hydrocephalus
structural blockage of CSF
Pick’s disease
tau protein aggregates
frontal cortex atrophy
spongiform cortex (transformation of gray matter)
CJD
transtentorial herniation (uncal)
medial temporal lobe thru gap between crus cerebri and tentorium
uncal herniation - symptoms
paralysis of CN III
homonymous hemaniopia with macular sparing
ipsilateral hemiparesis
brainstem hemorrhage = death
subfalcine herniation
cingulate gyrus under falx cerebri
compress ACA
tonsillar herniation
thru foramen magnum
compress medulla
linezolid
weak MAOI
drugs that can cause serotonin syndrome
linezolid
tramadol
ondansteron
triptans
phenelzine
MAOI
washout period after MAOI cessation
allow synthesis of MAO to resume
treatment of drug induced parkinsons
antimuscarinics
benzotropine, trihexyphenidyl
micturition reflex
parasym s2-4
pontine center
cerebral cortex
drugs that can increase lithium levels
hctz
acei
nsaids
tuberoinfundibular pathway
connects hypothalamus and pituitary
prolactin/dopamine
n. meningitis prophylaxis
rifampin
ischemic-hypoxic encephalopathy
wedge shaped areas, esp at watershed regions
primary CNS lymphomas
think EBV, AIDs
side effect of phenytoin
genearlized LAD
what not to take with levodopa therapy
B6, increases metabolism
ischemic neurons release
lysosomal enzymes
narcolepsy treatment
modafinil
nacrolepsy mofa
low levels of orexin/hypocretin
primidone
metabolized to phenobarbital
diphenyldramine SE
anti-cholinergic SE
trazodone AE
pripism
head of radius
radial nerve
lesion to optic nerve
anopia of one eye
lesion to optic chiasma
bitemporal hemianopia
lesion to optic tract
CL homonymous hemianopia
temporal lesion (MCA)
CL upper quandrantic anopia
parietal lesion (MCA)
CL lower quandrantic anopia)
PCA infarct
CL hemianopia with macular sparing
central scotoma
macular degeneration
blood in lateral ventricles
germinal matrix hemorrhage
POMC produces
ACTH
MSH
B-endorphins
Charcot-Bouchard pseudoaneurysms
HTN, hyaline artersclerosis small vessels (basal ganglia, thalamus) sudden onset focal deficits
hemorrhagic stroke
intracerebral bleeding
due to HTN, anticoagulation, cancer
ischemic stroke
atherosclerotic emboli
Conus Medullaris Syndrome
flaccid paralysis of bladder and rectum saddle anesthesia (S3-S5)
Cauda Equina Syndrome
low back pain, radiates to legs
bladder and bowel dysfunction (S3-S5)
Simple Partial Seizure Rx
carbamazepine
Complex Partial Seizure Rx
carbamazepine
Tonic-Clonic Seizure Rx
Phenytoin
Carbamazepine
Valproate
Myoclonic Seizure Rx
Valproic Acid
Absence Seizure Rx
Ethosuximide
2 - valproate
450 INDUCERS
carbamazepine
griseofulvin
phenobarbital, phenytoin
rifampin
450 INHIBTORS
Azoles, Cimetidine, Ciprofloxain
Erythomycin, Grapefruit Juice
Isoniazid
Ritonavir
paraneoplastic cerebellar degeneration
lung, breast, ovary
uterus
lymphoma
cerebellar dgen from lung cancer
anti P/Q
anti Hu
cerebellar degen from breast and ovarian cancer
anti Yo
Alzheimer’s atrophy of
hippocampus
temporopariteal lobes
hemiballism
flinging mvmts of arm
due to CL subthalamic nuclei
lentiform nucleus
Wilson’s dz
globus pallidus + putamen
internal capusle
lacunar infarcts
pure motor or sensory deficits
thalamus insult
bruning or stabbing pain in 1/2 of body
Anterior pituitary origin
surface ectoderm
meningiomas arise from
archnoid villi
meningiomas associated with what histo feature
psassoma bodies
meningiomas often compress
parasagital cortex
CL spastic leg paralysis
ALS - loss of neurons in
anterior horn
lateral corticospinal tracts
hemaglutinin
paramyoxviruses (measles!)
Axonal Rxn
cerebellar edema
cell body rounding
peripheral displacement of nucleus
Nissl substance to peripehry
Cholinergic Agonists - effects
N/V abd cramps
decrease HR, hypotension
Increase NO: sweating, salivating
decrease intraocular pressure
Cholinergic Agonists - examples
Bethanechol
Carbachol, pilocarpine (glaucoma treatment!)
what sensory pathway reaches cortex without using thalamus as relay station?
smell
B2 agonist - use in ob/gyn
uterine relaxation, can prevent preterm labor
ritodrine
terbutaline
double vision when looking down
CN IV
serotonin precursor
tryptophan
GABA precursor
glutamic acid
short acting Benzo’s
addictive
triazolam
oxazepam
midazolam
what binds GABA receptor
benzos
barb
ETOH
Anesthetics - decrease solubility in blood
rapid induction and recovery
Anesthetics - increase potentcy
lower MAC
increase solubility in lipids
DA Agonists - Ergot
bromocriptine
pergolide
DA Agonist - Nonergot
pramipexole
ropinirole
drugs that increase DA
amantadine
L-dopa/cardipoa
prevent DA breakdown
selegiline (MAO type B inhibitor) COMT inhibitors (entacapone)
curb excess cholinergic activity in parkinson’s
bentropine (antimuscarinic)
entacapone
prevents DA breakdown/COMT inhibitor
increase amount of levodopa entering brain
Triptan MofA
5HT 1B/D agonist
post synaptic serotonin receptor blockade
typical antipsychotics
block D2 receptors, increase cAMP
high potency typical antipsychotics
Trifluoperazine
Fluphenazine
Haloperidal
extrapyramidal symptoms
low potency typical antipsychotics
Chlorpromazine
Thioridazine
Venlafazine
SNRI
inhibit SE and NE reuptake
can induce mania
SNRI
venlafazine + duloxetine
Buproprion
increase NE and DA
seizures esp with high doses + EDs
treatment for serotonin syndrome
serotonin receptor antagonist
cyproheptadine
Status eptileptic treatment
1) IV benzo
2) phenytoin
3) phenobarbital
4) intubate and put in come
Phenytoin MofA
decreases Na current
polyhydroaminos
anencephaly
gi obstruction
wernickes - which symptom may persist
memory loss
MS symptom exacerabtor
heat
decreases axonal transmission
left optic nerve lesion
light on left eye: no change
light on right eye: both constrict
mu
euphoria
physical dependence
decrease GI motility
resp and card depression
kappa
miosis
delta
anti-depression
nalaxone
greatest effect on mu receptor
myotonic dystrophy
duchenne
duchenne - physical characteristics
frontal balding
catarcts
gonadal atrophy
carbamazepine mofa
blocks Na channels
methadone for addiction
long half life
synaptophysin stain
neuronal origin
fainting mediated by
vagus nerve
Neurloptic Malignant syndrome
fever, muscle rigidity
haloperidol
edrophonium test
symptom improve – up meds
no change - too much medication
blotchy red fibers on gomori trichrome stain
mitochondrial myopathy
NF tumors oirigins
neural crest
blood/gas partition coeff
decreased – poor solubility, also fast rise in partial pressure
clozapine
acts on D4
agraulocytosis
syringomyelia destroys
ventral white commisure and ventral horns
psych drug that causes hypothyroidism
lithium
organophophate poisoning – excess
cholinergic stmulation
treatment of organophosphate poisoning
atropine
still risk for muscle paralysis
symptoms of organophosphoate posionin
diarrhea, diaphoresis, urination, miosis, bradycardia, bronchospasm, emesis, lacrimation, salviation
tb - type of hydrocephalus
communication
fexofenadine
2nd generation antihistamine
12-28 hrs after T/E
red neurons
24-72 hrs after T/E
neutrophilic infiltrate
necrosis
3-5 days after T/E
macrophage
1-2 weeks after T/E
reactive gliosis
vascular proliferation
liquefactive necrosis
1 month after T/E
gial scar
ethoxasumide mofa
decreases calcium current
Botulinium toxin binds to
Ach containing synaptic vesicles
pentazocine
can precipitate withdrawal of opiates
partial agonist/antagonist at mu receptor
inhaled anesthetics
increases cerebral blood flow
cocaine
inhibits presynaptic reuptake of NE, DA, serotonin
fragile x syndrome mutation
causes hypermethylation of FMR1gene and deactivates it
vomitting control center
CTZ, medulla
thalamic syndrome
CL sensory loss
liquefactive necrosis
brain ischemic injury
amitriptyline se
anticholinergic SE
urinary retention
akathsia
restlessness
antipsychotics AE
cardopa/levadopa AE
anxiety, agitation
satiety center
VM nucleus of thalamus
barbituate metabolism
redistrubution to skeletal muscle and adipose tissue
MAOI therapy for
mood reactivity
leaden fatigue
rejection sensitivity
increased sleep and appetite
UMN
hyperflexia, babinski, muscle paralysis
LMN
muscle atrophy, fasciulations, hyporeflexia
TCA related death
due to Na channel inhibit
hypotension, arrhythmia, conduction defects
HSV-1 encephalitis
temporal lobe
pliocystic astrocytoma
hair-like glial processes
spindle cells
microcysts
halothane
causes neuroleptic malignatn syndrome
due to intracellular ca release in skeletal muscle
insulin and sympathetics
alpha adrenergic – decrease/inhibit insulin
beta adrenergics - increase insulin
phenoxybenzamine
alpha blocker
retinitis pigmentosa
thioridazine
hiccups
phrenic nerve
hypertensive arteriolar sclerosis
lacunas
Type II Arnold Chiari Malformations
macrocepahly/hydrocephalus/enlargement of vnetricles
muscle hypertonicity
chlorpromazine SE
corneal deposits
ziprasidone SE
prolong QT
olanzapone SE
weight gain
carbemazepine SE
bone marrow suppression
halothane SE
hepatitis
CN III palsy in DM, HTN
ischemic neuropathy, sympathetic fibers only
first area to be damaged with cerebral ischemia
hippocampus
length constant
how far along an axon an electrical impulse can propagate
decrease in MS