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Neuro Flashcards

1
Q

CN arising from spinal cord

A

CNXI (accessory nucleus found at C1-C4 spinal cord levels)

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2
Q

CN arising from the medulla oblongata

A

CN IX, X, XII

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3
Q

CN arising from pontomedullary junction

A

CN VI, VII, VIII

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4
Q

CN arising from pontocerebellar angle

A

CN VII and VIII

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5
Q

CN arising from the pons

A

CN V, VII

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6
Q

CN arising from midbrain

A

CN II, IV

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7
Q

CN arising from the posterior aspect of the midbrain

A

CN IV

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8
Q

CN arising from diencephalon

A

CN II

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9
Q

CN arising from telencephalon

A

CN I

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10
Q

Signs of Foster Kennedy Syndrome

A

olfactory groove meningioma, IL anosmia, IL optic atrophy, CL papilledema

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11
Q

CN sensory ganglia

A

TGIS9+10

Trigeminal (CNV), Geniculate (CNVII), inferior and cuperior ganglia (CN IX, X)

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12
Q

CN motor ganglia

A 
COPS
ciliary (CN III)
Otic (CN IX)
Pterygopalatine (CN VII)
Submandibular (CN VII)
Intramural (CN X)
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13
Q

Nerves traversing the jugular foramen

A

CN IX, X, XI

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14
Q

Nerves traversing the supraorbital fissure

A

CN III, IV, V1 (ophthalmic)

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15
Q

Nerves traversing cavernous sinus

A

CN III, IV, VI, V1 (opthalmic) and V2 (maxillary) + internal carotid plexus (sympathetic)

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16
Q

Nerve through foramen rotundum

A

CN V2 (maxillary)

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17
Q

Nerve through foramen ovale

A

CN V3, (mandibular)

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18
Q

Nerve through foramen magnum

A

CN XI + sympathetic plexus on vertebral artery

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19
Q

Nerves through internal auditory meatus

A

CN VII, VIII

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20
Q

nerves through stylomastoid foramen

A

CN VII

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21
Q

Brainstem Nuclei for CN III

A

oculomotor, Edinger-Westphal

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22
Q

Brainstem Nucleus for CN IV

A

Trochlear Nerve

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23
Q

What CN decussates before exiting the brainstem?

A

CN IV

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24
Q

Brainstem nuclei for CN V

A

chief sensory nucleus, mesencephalic, spinal trigeminal, trigeminal motor nucleus

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25
Q

Brainstem Nucleus for CN VI

A

Abducens

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26
Q

Brainstem Nucleus for CN VII

A

Facial, Superior Salivatory, Spinal Trigeminal, Solitary

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27
Q

Brainstem Nuclei for CN IX?

A

nucleus ambiguous, inferior salivatory, spinal trigeminal, solitary

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28
Q

Brainstem nuclei for CN X

A

Nucleus Ambiguis, dorsal vagal, spinal trigeminal, solitary

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29
Q

Nucleus for CN XI

A

acessory nucleus (cervical spinal cord)

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30
Q

Brainstem Nucleus for CN XII

A

Hypoglossal

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31
Q

two smooth muscles innervated by CN III

A

sphincter/constrictor pupillae + ciliary body

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32
Q

5 skeletal muscles innervated by CN III

A

levator palpebrae, superior rectus, medial rectus, inferior oblique, inferior rectus

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33
Q

Three components of the near triad

A

3 by III, convergence of eyes, pupilary constriction, contraction of ciliary muscle

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34
Q

muscle innervated by CN IV

A

superior oblique

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35
Q

action of muscle innervated by CN IV

A

intorsion, abduction and depression (turns pupil down and out)

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36
Q

Action to test muscle innervated by CN IV

A

Adduct and depress [in and then down]

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37
Q

Muscle innervated by CN VI

A

Lateral rectus

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38
Q

Signs of compressive injury to CN III

A

dilated pupil with normal eye movements

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39
Q

Aneurysm of what artery compresses CN III

A

Posterior Communicating Artery

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40
Q

Signs fo Diabetic Infarct in CN III

A

Oculomotor Palsy with normal pupil

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41
Q

Signs of Injury to CN IV

A

Diplopia worse walking down stairs; improves with head tilt to opposite side

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42
Q

Sign of injury to CN VI

A

diplopia with head tilt towards paralyzed muscle

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43
Q

Location of horizontal gaze center

A

pons

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44
Q

Location of vertical gaze center

A

midbrain

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45
Q

Signs of Argyll-Robertson pupil

A

pupil accomadate but doesn’t react (to light); tertiary syphilis; “prostitutes pupil”

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46
Q

Signs of internuclear ophthalmoplegia

A

injury to MLF (demyelination in MS): on leftward gaze, right eye does not adduct (convergence is still intact)

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47
Q

Structures injured in “one-and-a-half” syndrome

A

abducens nucleus and both MLF

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48
Q

Injury to right abducens nerve

A

IL CN VI palsy; cannot abduct eye

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49
Q

Injury to right abducens nucleus

A

ib rightward gaze, Right Eye does not ABduct, Left eye does not ADduct

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50
Q

Eye movement deficits in Right Medial Pontine Syndrome

A

On Rightwadr Gaze: Right eye does not ABduct, Left eye does not ADduct + on Leftward gaze Right eye does not ADduct

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51
Q

3 Causes of ptosis

A

CN III Palsy, Horner Syndrome, Myasthenia Gravis

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52
Q

Muscles innervated by CN V

A

temporalis, masseter, medial and lateral pterygoi, anterior digastric, tensor tympani, tensor veli palatinin, myelohyoid

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53
Q

Motor Signs with CN V injury

A

jaw closes to good side, atrophy of temporalis and masseter

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54
Q

Muscles innervated by CN VII

A

muscles of facial expression, poster digastric, stylohyoid, stapedius

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55
Q

Motor Signs with CN VII injury

A

Bell’s Palsy: complete facial paralysis, can’t smile or wrinkle forehead

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56
Q

Muscle Innervated by CN IX

A

Stylopharyngeus

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57
Q

Motor signs with CN IX injury

A

Dysphagia

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58
Q

Skeletal Muscles innervated by CN X

A

Levator veli palantini, palatoglossus, pharyngeal, laryngeal and esophageal

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59
Q

motor signs with CN X injury

A

dysphagia, hoarsenss, sagging palate, uvula deviated to opposite side

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60
Q

Muscles innervated by CN XI

A

Trapezius and SCM

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61
Q

Motor signs with CN XI injury

A

weakness shrugging shoulder, cannot abduct humerous beyond 90, weakness turning head to opposite side

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62
Q

Muscles innervated by CN XII

A

genioglossus, hyoglossus, styloglossus, intrinsic tongue muscles

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63
Q

Motor signs with CN XII injury

A

tongue deviates to side of lesion on protrusion, atrophy of tongue muscles

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64
Q

Skin innervated by CN V

A

V1 - forehead, upper eyelid and nose
V2 - cheek, lower eyelid, upper lip
V3 - jaw, lower lip

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65
Q

Skin innervated by CN VII, IX and X

A

small area around ear

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66
Q

What is Ramsay Hunt syndrome

A

Herpes infection in the geniculate ganglion = blisters in pinna

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67
Q

Signs of Ramsay Hunt Syndrome

A

IL facial paralysis, hyperacusis, loss of taste, herpes vesicles on external ear, canal

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68
Q

Viscera innervated by CN III

A

sphincter pupillae and ciliary muscle

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69
Q

Viscera innervated by CN VII

A

mucosa of nasal cavity, oral cavity, lacrimal, submandibular, sublingual glands

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70
Q

Viscera innervated by CN IX

A

parotid gland, mucosa of middle ear, mucosa of oropharynx

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71
Q

Viscera innervated by CN X

A

mucosa of larynx, pharynx, all viscera of foregut and midgut

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72
Q

CN/ganglia/nucleus for taste at the anterior 2/3 tongue

A

CN VII/ geniculate / solitary

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73
Q

General sensory innervation to anterior 2/3 tongue

A

CN V

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74
Q

CN/ganglia/nucleus for taste at posterior 1/3 tongue

A

CN IX/inferior ganglion of IX/ solitary

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75
Q

Signs of CN VII injury at the internal auditory meatus

A

IL complete facial paralysis, dry eye, dry mouth, hyperacusis, decreased taste on ant 2/3 of tongue (tinnitus/hearing loss if CN VIII affected)

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76
Q

Signs of CN VII injury in facial canal

A

IL complete facial paralysis, decreased taste on anterior 2/3 tongue

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77
Q

Signs of CN VII injury at the stylomastoid foramen

A

IL complete facial paralysis

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78
Q

Nerves for corneal reflex

A

In by CN V out by VII

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79
Q

Nerves for Pupillary Light Reflex

A

In by CN II, out by CN III

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80
Q

Nerves for Jaw Jerk

A

In by CN V, out by CN V

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81
Q

Nerves for Cough Reflex

A

In by CN X, out by CN X (also C3-T12 for diaphragm and intercostals)

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82
Q

Nerves for Gag Reflex

A

In by CN IX and out by CN X

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83
Q

Nerve most likely affected with aneurysm of Anterior Communicating/ACA

A

CN II

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84
Q

Nerve most likely affected with aneurysm of Posterior Communicating Artery

A

CN III

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85
Q

Nerve most likely affected with aneurysm at basilar bifurcation

A

CN III

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86
Q

Nerve most likely affected with aneurysm of ICA in cavernous sinus

A

CN VI

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87
Q

Nerves most likely affected with aneurysm of PICA

A

CN IX, X, XI, XII

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88
Q

What neurons (4 locations) are involved in discriminitive touch/proprioception/vibration pathway

A

posterior root ganglion, nucleus gracilis/cuneatus, VPL thalamus, postcentral gyrus

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89
Q

Where does the posterior column/medial lemniscus decussate?

A

rostral medulla (decussation of medial lemniscus as internal arcuate fibers)

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90
Q

Signs of injury to posterior columns in spinal cord

A

IL loss of discriminitive touch, proprioception and vibratory sense

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91
Q

Signs of injury to medial lemniscus

A

CL loss of discriminitive touch, proprioception and vibratory sense

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92
Q

What is Rombery test?

A

Test of Proprioceptive function, have patient stand upright with arms abducted eyes open and closed

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93
Q

3 sensory modalities that maintain stability of the trunk

A

vision, proprioception and vestibular

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94
Q

What is a positive Romberg test

A

a marked difference in the ability to maintain erect posture with eyes open and closed

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95
Q

What does a Romberg test look like in someone with cerebellar injury?

A

Patient cannot stand up even with eyes open

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96
Q

Neurons (4 locations) in pain/temperature pathway?

A

posterior root ganglia, posterior horn, VPL thalamus, postcentral gyrus

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97
Q

Where does the spinothalamic tract decussate?

A

Anteriori White Commissure, Spinal cord, at all levels

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98
Q

Deficits in Syringomyelia

A

BL dermatomal loss of pain and temperature (usually upper limbs)

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99
Q

Cause and signs of Dejerine-Roussy Syndrome

A

Extreme hypersensitivity to painful stimuli following posterior thalamic infarct

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100
Q

What is the function of lower motor neurons

A

innervate skeletal muscle

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101
Q

locatino of lower motor neurons

A

spinal cord + motor cranial nerve nuclei (III, IV, V, VI, VII, IX, X, XI, XII)

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102
Q

Location of upper motor neurons

A

cerebral cortex, red nuclear, reticular formation

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103
Q

Signs of injury to upper motor neuron

A

hemiparesis, increase muscle stretch reflexes (hyper-reflexia), spasiticty, clonus, +Babinski sign and Hoffman sign

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104
Q

Lower Motor Neuron (LMN) signs

A

paralysis, decreased muscular stretch reflexes (hyporeflexia), flaccid tone, atrophy

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105
Q

Motor tracts in the Posterior Limb of the internal capsule

A

Corticospinal (upper imb, lower limb)

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106
Q

What is spasticity?

A

a velocity-dependent increase in muscle tone (injury to UMNs)

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107
Q

What is rigidity?

A

A velocity-independent increase in muscle tone (damage to Basal Nuclei structures)

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108
Q

The corticospinal tract decussates at what level?

A

pyramidal decussation, caudal medulla

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109
Q

Motor tracts in the genu of the internal capsule

A

corticobulbar (to cranial nerve nuclei)

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110
Q

Signs of injury to the corticospinal tract in the right internal capsule

A

left UMN signs

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111
Q

Signs of injury to the corticospinal tract in the cervical spinal cord on the right

A

right, UMN signs

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112
Q

Signs of injury to the corticobulbar tract in the right internal capsule

A

Left, lower facial paralysis; tongue points away from lesion

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113
Q

Features of decorticate posture

A

UL flexed; LL extended

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114
Q

Location of lesion in decorticate posturing

A

rostral midbrain or thalamus (red nucleus intact)

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115
Q

Features of Decerebrate posturing

A

UL and LL extended

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116
Q

Location of lesion causing Decerebrate posturing

A

Midbrain - damage involving red nucleus or rubrospinal tract

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117
Q

Signs of Myopathy

A

Proximal Symmetric weakness, no sensory loss

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118
Q

What are the 2 most common causes of peripheral neuropathies?

A

Diabetes and Alcoholism

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119
Q

Signs of polyneuropathy

A

Stocking/Glove sensory loss

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120
Q

neurons in auditory pathway (at least 6)

A

Spiral ganglion, Cochlear Nucleus, Superior Olive, Inferior Colliculus, Medial Geniculate, Primary Auditory Cortex

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121
Q

Normal human frequency hearing range

A

20Hz to 20kHz –> decreases with age

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122
Q

Result of Rinne test in normal ear

A

air conduction > bone conduction

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123
Q

Result of Rinne test in Conductive Hearing Loss

A

Air Conduction < Bone Conduction

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124
Q

Result of Rinne test in Sensorineural Hearing Loss

A

Air Conduction > Bone Conduction

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125
Q

Weber in Normal Hearing

A

Localize to Midline

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126
Q

Weber test with Sensorineural hearing loss in Right Ear

A

Localize to the Left

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127
Q

Weber test with Conductive Hearing Loss in Right Ear

A

Localize to the RIght

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128
Q

Deficits with injury to CN VIII

A

IL deafness, dizziness, CL nystagmus

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129
Q

Deficits with injury to brainstem auditory pathways

A

BL hearing loss (greater on CL side)

130
Q

What is presbycusis?

A

age-related hearing loss, high frequencies lost first

131
Q

Neurons in visual pathway (3 Neurons)

A

Retinal Ganglion Cells, Lateral Geniculate, Primary Visual Cortex

132
Q

Signs of injury to optic nerve/retina

A

IL visual loss, can affect both temporal and nasal hemifield

133
Q

Signs of injury to optic chiasm

A

bitemporal hemianopsia

134
Q

signs of injury to optic tract

A

CL homonymous hemianopsia

135
Q

signs of injury to Meyer’s loop

A

Upper quadrant homonymous hemianopsia

136
Q

Visual deficits in PCA stroke affecting calcarine sulcus

A

CL homonymous hemianopsia, with macular sparring

137
Q

What is Marcus Gunn pupil?

A

Optic Nerve Lesion, when light is shown into bad eye, pupil dilates

138
Q

What Structures comprise the basal nuclei (ganglia)?

A

Caudate, Putamen, Globus Pallidus, Subthalamic nucleus, Basal Nucleus of Meynert

139
Q

Brain region affected in Parkinson disease

A

substantia nigra, pars compacta (dopamine)

140
Q

Signs of Parkinson Disease

A

Bradykinesia, Pill-rolling tremor, masked facies, postural instability

141
Q

Pathological Sign of Parkinson Disease

A

Loss of Dopaminergic neurons in substantia nigra + Lewy bodies in SN

142
Q

Brain region affected in Huntington disease

A

Caudate Nucleus

143
Q

Signs of Huntington Disease

A

Choreioform movements, dementia

144
Q

Brain region injured in right hemiballismus

A

Left subthalamic nucleus

145
Q

Signs of Essential Tremor

A

Chronic, Progressive tremor in arms, neck, larynx, chin; reduced with alcohol consumption

146
Q

What is Wilson Disease?

A

Inborn error of Copper metabolism; Kayser-Fleischer rings; wing-beating tremor, rigidity

147
Q

Structures most susceptible to cerebral hypoxia (CO poisoning, drowning, strangulation)

A

Globus pallidus and putamen

148
Q

What are the signs of Cerebellar Injury?

A

Ataxia, Dysmetria, Dysdiadokinesia, Nystagmus, Dysarthria

149
Q

Signs of injury to vestibulocerebellum (flocculonodular lobe)?

A

truncal atazia, nystagmus

150
Q

Signs of injury to lateral hemisphere of cerebellum/dentate nucleus

A

IL limb ataxia, intention tremor, dysarthria

151
Q

Signs of injury to middle cerebellar peduncle

A

IL limb ataxia

152
Q

Results of caloric testing in normal individual

A

COWS
Cold - nystagmus to opposite side
Warm - nystagmus to same side

153
Q

Signs of Arnold Chiari I malformation

A

extension of cerebellar tonsil below foramen magnum

154
Q

Signs of Arnold Chiari II malformation

A

displaced vermis - myelomeningiocele

155
Q

Signs of Dandy-Walker

A

Enlarged posterior Fossa, small cerebellum, absent vermis, cystic dilation of 4th ventricle, hydrocephalus

156
Q

Signs of injury to corticospinal tract in spinal cord

A

UMN signs below lesion

157
Q

Signs of injury to anterior horn of spinal cord

A

LMN signs AT level

158
Q

Signs of injury to posterior columns

A

IL loss of discriminitive touch, proprioception and vibrator sense

159
Q

Signs of injury to spinothalamic tract

A

CL loss of pain and temperature sensation

160
Q

Signs of Intramedullary Tumor/Central Cord Syndrome

A

Sensory Loss, Sacral sparing of motor function, maybe bowel/bladder disturbances

161
Q

Deficits in Anterior Spinal Syndrome

A

UMN signs below lesion, LMN signs at level, loss of pain and temperature below lesion, discriminitive touch, proprioception and vibration are intact

162
Q

Deficits in Tabes Dorsalis

A

loss of disc touch, proprioception and vibration below lesion, Romberg sign

163
Q

Deficits in Brown-Sequard Injury

A

IL loss of discriminitive touch, CL loss of pain/temp, UMN signs below lesion, LMN signs at level

164
Q

Deficits in Friedreich’s Ataxia

A

loss of disc touch, proprioception and vibration below lesion, Romberg sign, ataxia and UMN signs below lesion

165
Q

Deficits in Subacute Combined Degeneration

A

B12 deficiency; loss of disc touch, proprioception and vibration below lesion, UMN signs below lesion

166
Q

Signs of Conus Medullaris Syndrome

A

sudden, bilateral onset; decrease calcaneal reflex, perianal sensory loss, impotence, urinary and fecal incontinence

167
Q

Signs of Cauda Equina Syndrome

A

gradual, unilateral onset, calcaneal and patellar reflexes decreased, saddle sensory loss

168
Q

Signs of tethered cord syndrome

A

commonly associated with spina bifida, pain, weakness, sexual dysfunction

169
Q

Signs of Spinal Cord Transection at C6

A

LMN signs at C6 (brachioradialis), UMN signs below; complete sensory loss below C6

170
Q

Signs of Spinal Cord transection at L4

A

LMN signs at L4 (quads), UMN signs below; complete sensory loss below L4

171
Q

Deficits in medial medullary syndrome

A

CL loss of discriminitive rouch, CL UMN signs, tongue deviates to lesion on protrusion (w/ fasciculations)

172
Q

Artery involved in medial medullary syndrome

A

Alternating branches of anterior spinal artery

173
Q

Deficits in lateral medullary syndrome

A

IL loss of pain and temp on face, CL loss of pain and temp on body, dysphagia, hoarseness

174
Q

Artery involved in lateral medullary syndrome

175
Q

Deficits in medial pontine syndrome

A

CL loss of discriminitive rouch, CL UMN signs, IL CN VI palsy + INO…maybe 1 1/2 syndrome

176
Q

Artery involved in medial pontine syndrome

A

basilar, paramedian branches

177
Q

Deficits in lateral pontine syndrome

A

IL loss of pain and temp on face, CL loss of pain and temp on body, CN VII or V palsy

178
Q

Artery involved in lateral pontine syndrome

A

basilar and circumferential branches

179
Q

Deficits in Weber Syndrome

A

IL CN III palsy, CL UMN sign, CL lower facial paralysis

180
Q

Deficits in Benedikt Syndrome

A

IL CN III palsy, CL ataxia [superior cerebellar peduncle]

181
Q

Deficits in Claude Syndrome

A

IL CN III palsy, CL UMN sign, CL lower facial paralysis, CL ataxia

182
Q

Arteries involved in midbrain syndromes

A

Paramedian branches from PCA

183
Q

Strokes that can lead to Horner Syndrome

A

Lateral Medullary, Cervical Spinal

184
Q

Signs/ Symptoms of basilar artery thrombosis

A

hemi or tetraparesis (corticospinal tract), dysarthria (nuc. Amg/corticonuclear tract), lower facial paralysis (corticonuclear tract), altered consciousness (reticular formation), visual disturbances (med geniculate/optic tract)

185
Q

What signs/symptoms are characteristic of cortical injury?

A

aphasia, agnosia, anosognosia, primitive reflexes: grasp, snout, suck, root, magnetic gate, astereognosia, apraxia, contralateral neglect

186
Q

Deficits in left inferior division MCA stroke

A

receptive aphasia, CL homonymous hemianopsia

187
Q

Deficits in left superior division MCA stroke

A

expressive aphasia, CL UMN signs [face + UL], CL sensory loss [face + UL]

188
Q

Deficits in right MCA main stem stroke

A

CL UMN signs [face, UL + LL], CL sensory loss [face, UL + LL]

189
Q

Deficits in left PCA stroke

A

CL homonymous hemianopsia with macular sparring

190
Q

Deficits in left ACA stroke

A

CL UMN signs [LL], frontal lobe signs

191
Q

Deficits in Parinaud Syndrome

A

vertical gaze palsy, obstructuve hydrocephalus

192
Q

Deficits in Anterior Choroidal Artery Stroke

A

CL UMN signs, CL homonymous hemianopsia

193
Q

Deficits in lenticulostriate artery hemorrhage

A

CL UMN signs, CL lower facial paralysis, tongue deviates away from lesion

194
Q

Blood supply to thalamus

A

posterior cerebral [thalamogeniculate + thalamoperforating]

195
Q

Signs of thalamic hemorrhage

A

CL sensory loss, CL homonymous hemianopsia

196
Q

Signs of tonsillar herniation

A

respiratory and cardiovascular arrest

197
Q

Signs of uncal herniation

A

CN III palsy, UMN signs, papilledema

198
Q

Structure injured in CL neglect

A

Right parietal lobe

199
Q

Signs of Gerstman’s syndrome

A

acalulia, left-right confusion, finger agnosia; left parietal lobe

200
Q

Structure damaged in alexia without agraphia

A

left splenium of corpus callosum

201
Q

Where is Broca’s area? Function?

A

left inferior frontal gyrus; expressive speech

202
Q

Where is Wernicke’s area? Function?

A

left supramarginal, angular, superior temporal gyri; receptive speech

203
Q

Signs of Conduction Aphasia

A

normal comprehension and fluent speech; impaired repetition

204
Q

Aphasia type in a patient who is fluent, cannot comprehend or repeat?

A

Wernicke’s

205
Q

Aphasia type in a patient who is not fluent, can comprehend but cannot repeat?

206
Q

Aphasia type in a patient who is fluent, can comprehend but cannot repeat?

A

Conduction

207
Q

Aphasia type in a patient who is not fluent, cannot comprehend or repeat?

208
Q

Structures implicated in obsessive compulsive disorder?

A

Basal nuclei, cingulate gyrus, orbitofrontal cortex, raphe nuclei

209
Q

Structures implicated in Schizophrenia

A

Limbic System, Frontal Lobe, Basal Nuclei

210
Q

Cause of Cushing’s Disease

A

ACTH-secreting pituitary adenoma

211
Q

Signs of LH or FSH secreting adenoma

A

hypogonadism and infertility

212
Q

Signs of prolactin-secreting adenoma

A

amenorrhea in females, hypogonadism in men, galactorrhea, infertility, hair loss, decreased libido, weight gain

213
Q

Signs of Diabetes Insipidus

A

Polyuria, Polydipsia

214
Q

Signs of SIADH

A

concentrated urine with osmolality >300mOsm/L

215
Q

SIADH treated with rapid infusion of hyperotnic saline will cause

A

central pontine myelolysis

216
Q

Signs of craniopharyngioma

A

visual deficits, diabetes insipidus, adiposity, developmental delay, HA, papilledema

217
Q

Craniopharyngioma derived from

A

remnant of Rathke’s pouch

218
Q

Bladder problems in cortical lesions (paracentral lobule)

A

uninhibited, spastic bladder

219
Q

Bladder problems in brainstem/high spinal cord injury

A

flaccid paralysis that becomes spastic (urge incontinence, hyperactive, empties too frequently)

220
Q

Bladder Problems in Sacral spinal cord injury

A

overflow incontinence

221
Q

Disturbances of erection/ejaculation with spinal cord injury above T12

A

loss of psychogenic erections, reflex erections intact, only reflex ejaculation

222
Q

Disturbances of erection/ejaculation with sacral spinal cord injury

A

loss of reflex erection, psychogenic may be preserved, ejaculation is abolished

223
Q

Signs of Horner Syndrome

A

Constricted pupil, ptosis, red face, anhydrosis

224
Q

Site of injury in patient with miosis, ptosis and CN VI palsy

A

cavernous sinus - ICA aneurysm (sympathetics follow ICA and CN VI is riding on ICA)

225
Q

Why no red face/anhydrosis in previous patient?

A

External Carotid Nerve is intact

226
Q

Components of the Limbic System

A

parahippocampal gyrus, uncus, hippocampus, amygdala

227
Q

Structures in the Papez circuit

A

hippocampus, mamillary body (via fornix), anterior nucleus of thalamus, cingulate cortex

228
Q

Function of hippocampus

A

consolidation of short term memory

229
Q

Part of hippocampus most vulnerable to seizure activity

230
Q

Part of hippocampus most susceptible to anoxia

231
Q

Structure affected in Korsakoff Syndrome

A

mammillary bodies, dorsomedial thalamus

232
Q

Metabolic deficiency in Korsakoff Syndrome

233
Q

Signs of Korsakoff Syndrome

A

amnesia, confabulation with short term memory intact

234
Q

Signs of Wernicke-Korsakoff syndrome

A

ophthalmoplegia, ataxia and disturbances of mentation and consciousness

235
Q

Signs of injury in akinetic mutism

A

immobile, mute and unresponsive but awake; BL lesion of cingulate gyrus

236
Q

Signs of Kluvy-Bucy syndrome

A

Placid, visual agnosia, hyperorality

237
Q

Brain region injured in Kluver-Bucy syndrome

A

BL temporal lobe

238
Q

Signs of normal pressure hydrocephalus

A

wet, wacky, wobbly

239
Q

structure damaged in epidural hematoma

A

middle meningeal artery

240
Q

Structure damaged in subdural hematoma

A

“bridging” beins (cerebral beins emptying into superior sagittal sinus)

241
Q

How do you age subdural hematomas?

A

acute bleed is white (hyperdense) on CT; isodense in 1-2weeks and hypodense after that

242
Q

Structure damaged in subarachnoid hemorrhage

A

vessels in or around the circle of willis

243
Q

contents of cisterna magna

A

vertebral artery, CN IX, X, XI and XII, choroid plexus

244
Q

Contents of prepontine cistern

A

basilar artery, CN VI

245
Q

Contents of cerebellopontine cistern

A

CN V, VII, VIII

246
Q

Contents of Interpeduncular cistern

247
Q

Contents of the ambient cistern

248
Q

Structure comprising the lateral wall of the lateral ventricle?

A

caudate nucleus

249
Q

Structure(s) comprising the lateral wall of the 3rd ventricle?

A

thalamus, hypothalamus

250
Q

Structure at floor of 4th ventricle?

A

pons [facial colliculus], medulla [hypoglossal trigone]

251
Q

Signs of injury to facial colliculus?

A

facial colliculus (genu of facial nerve and abducens nucleus) = IL facial paralysis + IL CN

252
Q

Signs of injury to the reticular formation?

253
Q

Components of the diencephalon?

A

thalamus, hypothalamus, epithalamus (pineal), subthalamus

254
Q

Deficits in ALS?

A

UMN and LMN signs, sensation intact

255
Q

Deficits in MS?

A

multiple (motor, sensory, special sensory, cognitive) deficits in time and lesions in space

256
Q

Deficits in Guillan-Barre?

A

typically follows viral illness or vaccination, ascending paralysis (LE then UE), some

257
Q

Signs of radiculopathy?

A

pain/sensory loss in a dermatomal pattern

258
Q

What is tabes dorsalis?

A

demyelination of posterior columns from syphillis

259
Q

Signs/symptoms of tabes dorsalis?

A

decreased muscle stretch reflexes, loss of discriminitve touch, proprioception and vibratory sense, + Romberg, ataxia (not from cerebellum)

260
Q

Structures innervated by posterior rami?

A

deep back muscles and overlying skin

261
Q

Dermatome for C2?

A

back of the scalp; greater occipital nerve [posterior ramus of C2]

262
Q

Signs of injury to musculocutaneous nerve in axilla?

A

decreased biceps reflex, weakness in flexion at elbow, supination, sonsory loss along

263
Q

Signs of injury to median nerve at elbow?

A

severe weakness in forearm flexion, paralysis of thenar muscles, sensory loss over

264
Q

Signs of injury to median nerve at carpal tunnel?

A

paralysis of thenar muscles, sensory loss over palmar aspect and tips of digits 1 - 3, lateral half of digit 4

265
Q

Signs of injury to ulnar nerve at cubital tunnel?

A

weakness in flexion of digits 4 and 5, sensory loss in 5th digit (palmar and dorsal), weakness in ab/adduction of fingers, hypothenar muscles, adductor pollicis , Froments sign, slight ulnar claw

266
Q

Signs of ulnar nerve injury at Guyon’s tunnel?

A

sensory loss in 5th digit (palmar only), weakness in ab/adduction of fingers, hypothenar muscles, adductor pollicis , Froments sign, ulnar claw

267
Q

Signs of injury to radial nerve with midshaft humeral fracture?

A

wrist drop, weak supination, sensory loss on dorsum of hand, triceps normal

268
Q

Signs of injury to radial nerve in axilla?

A

paralyzed triceps, decreased triceps reflex, decreased brachioradialis reflex, wrist drop, weak supination, sensory loss on dorsum of hand

269
Q

Signs of lesion to upper roots of brachial plexus?

A

Erb-Duchenne palsy, decreased biceps + brachioradialis reflexes; arm is medial rotated and extended [cant abduct, laterally rotate of flex at elbow], sensory loss over lateral arm

270
Q

Signs of lesion to lower roots of brachial plexus?

A

Klumpke palsy, complete claw, sensory loss over 5th digit and medial arm, forearm

271
Q

Signs of thoracic outlet syndrome?

A

weakness in intrinsic hand muscles, sensory loss over 5th digit and medial arm, forearm

272
Q

Signs of injury to C5 nerve root?

A

weakness in abduction, lateral rotation and flexion at elbow, decreased bicep reflex, sensory loss over lateral arm

273
Q

Signs of injury to C6 nerve root?

A

weakness in wrist extension, flexion at elbow, decreased brachioradialis reflex, sensory loss over lateral forearm

274
Q

Signs of injury to C7 nerve root?

A

weakness in finger extension, elbow extension, wrist flexion, decreased tricep reflex, sensory loss over middle finger

275
Q

Signs of injury to C8 nerve root?

A

weakness in finger flexion, sensory loss over 4th + 5th digit, medial forearm

276
Q

Signs of injury to T1 nerve root?

A

weakness in finger ab/adduction, sensory loss over medial forearm/arm

277
Q

Signs of injury to lateral femoral cutaneous nerve?

A

sensory loss over anterior and lateral thigh; aka meralgia paresthetica

278
Q

Signs of entrapment/injury to saphenous nerve?

A

sensory loss along anterior and medial leg, medial malleolus and foot

279
Q

Signs of injury to femoral nerve?

A

paralysis of quadriceps, decreased patellar reflex, sensory loss along anterior and medial thigh, leg, medial malleolus and foot

280
Q

Signs of piriformis syndrome?

A

decreased achilles reflex, weakness in knee flexors, dorsiflexors, plantar flexors, sensory loss over lateral leg, lateral malleolus, dorsum of foot

281
Q

Signs of injury to common fibular nerve?

A

foot drop, weakness in dorsiflexion, eversion, sensory loss over lateral leg and dorsum of the foot

282
Q

Signs of injury to superficial fibular nerve?

A

weakness in eversion, sensory loss over dorsum of foot

283
Q

Signs of injury to deep fibular nerve?

A

foot drop, weakness in dorsiflexion, eversion, sensory loss in the web between 1st and 2nd toes

284
Q

Signs of injury to tibial nerve in popliteal fossa?

A

weakness in plantar flexion, toe flexion, weakness in intrinsic foot muscle, sensory loss on plantar surface of foot

285
Q

Signs of injury to the tibial nerve in tarsal tunnel?

A

weakness in intrinsic foot muscles, sensory loss on plantar surface of foot

286
Q

Signs of injury to superior gluteal nerve?

A

Trendelenburg sign: pelvis drops to good side during gait, paralysis of gluteus medius, minimus and tensor fascia lata

287
Q

Signs of injury to inferior gluteal nerve?

A

Paralysis of gluteus maximus, weakness in extension and lateral rotation of thigh

288
Q

Signs of injury to L2 nerve root?

A

weakness in leg flexion, knee extension, adduction, sensory loss over anterior thigh

289
Q

Signs of injury to L4 nerve root?

A

weakness in knee extension, decreased patellar reflex, sensory loss over anterior medial leg, medial malleolus

290
Q

Signs of injury to L5 nerve root?

A

weakness in dorsiflexion, toe extension, abduction of thigh, sensory loss over anterior leg, dorsum of foot, digits 1 and 2

291
Q

Signs of injury to S1 nerve root?

A

weakness in plantar flexion, eversion, hip extension, decreased achilles reflex, sensory loss over posterior leg, digits 3-5

292
Q

Signs of injury to S2 nerve root?

A

weakness in toe flexion, decreased anal wink, sensory loss over posterior thigh, perineum

293
Q

Structure infected in herpes zoster?

A

posterior root ganglion

294
Q

Reflex for C5?

A

biceps [via musculocutaenous n]

295
Q

Reflex for C6?

A

brachioradialis [via radial n]

296
Q

Reflex for C7?

A

triceps [via radial n]

297
Q

Reflex for L1?

A

cremaster [ilioinguinal and genitofemoral ns.]

298
Q

Reflex for L4?

A

patellar tendon [quadriceps, via femoral n]

299
Q

Reflex for S1?

A

Achilles/calcaneal tendon [gastroc, via tibial n]

300
Q

Levels of sympathetic innervation of the eye?

301
Q

Levels of sympathetic innervation of the heart?

302
Q

Levels of sympathetic innervation of the lungs?

303
Q

Levels of sympathetic innervation of the foregut?

304
Q

Levels of sympathetic innervation of the small intestine?

305
Q

Levels of sympathetic innervation of the large instestine to splenic flexure?

306
Q

Levels of sympathetic innervation of the descending colon to rectum?

307
Q

Levels of sympathetic innervation of the kidney?

308
Q

Levels of sympathetic innervation of the testes/ovary?

309
Q

Levels of sympathetic innervation of the pelvic organs?

310
Q

Levels of sympathetic innervation of the upper limb?

311
Q

Levels of sympathetic innervation of the lower limb?

312
Q

Parasympathetic innervation of the eye?

A

CN III, Edinger-Westphal

313
Q

Signs of Adie’s pupil?

A

tonically dilated pupil that constricts with low dose pilocarpine

314
Q

Structure injured in Adie’s pupil?

A

ciliary ganglion

315
Q

Parasympathetic innervation of the lacrimal, submandibular and sublingual glands?

A

CN VII, superior salivatory

316
Q

Parasympathetic innervation of the parotid gland?

A

CN IX, inferior salivatory

317
Q

Parasympathetic innervation of the thoracic organs?

A

CN X, dorsal vagal

318
Q

Parasympathetic innervation of midgut?

A

CN X, dorsal vagal

319
Q

Parasympathetic innervation of the kidney?

A

CN X, dorsal vagal

320
Q

Parasympathetic innervation of the testes/ovaries?

A

S2 - 4 + dorsal vagal

321
Q

Parasympathetic innervation of the hindgut?

322
Q

Parasympathetic innervation of pelvic organs?

Neuro One-Liners (3 decks)

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