Neuro 5 Flashcards
Neurologic consequences of B12 deficiency due to abnormal __ synthesis
degenerates __ of spinal cord- losing proprioception/vibration
look for __ abnorms
__ CS tract w UMN signs
axonal degen of __ leads to numbness/paresthesias
tabes dorsalis has damage to dorsal __/__ w lost position/vibration + pain
myelin
dorsal column
gait
lateral
peripheral nerves
column/horn
Anterior spinal syndrome presents w loss of __ below injury w loss of _/__
H, C, intracranial calcifications seen in congenital __
mother infected in first __ of pregnancy
strength
temp/pain
hydrocephalus, chorioretinitis
toxo
6m
__ nerve arises from L1
motor to __ ab wall muscles
sensory to skin above __ region or __ region
can be damaged during __
__ nerve comes from L1/L2, provides motor for cremasteric reflex in men
__ nerve arises from L1/L2 to supply sensation to upper/medial thigh and exertnal genitalia
iliohypogastric, anterolateral
pubic, gastric
ab surgery
genitofemoral
ilioinguinal
__ is imprinting disorder w deletion of parental chromosome __
leads to hypotonia and hyper__, motor delay, __ disability and __ problems
Prader Willi
15
phagia, intellectual, behavior
MG has dec compound muscle AP __ w repeated excitation
rapid restoration of strength w __
autoantibodies destroy receptor on __ plate
dec number of Ach __, thus reducing end plate __
threshold potential not reached, so muscle cells do not __
tx w ___ like P
to avoid side effects, use selective muscarinic antagnoist like G/H/P
these preferentially inhibit __ receptors
amplitude
rest
motor end
receptors, potential
depolarize
cholinesterase inhib, pyridostigmine
glycopyrrolate, hyoscamine, propantheline
nicotinic
__ is nonselective muscarinc agonist
arginase deficiency sx
__ diplegia, abnormal __, and __ delay
elevated __ levels, cannot produce urea/ornithine
tx w low __ diet
unlike others, has no __
hyper__ is assc w atherosclerosis/thrombotic events
citrullinemia/OTC def leads to excess __
accompanied by __
__ is formed from ___ via tryptophan hydroxylase
pilocarpine
spastic, movement, growth
arginine
protein
hyperammonemia
homocysteiemia
carbamoyl phosphate
hyperammonemia
Serotonin, tryptophan
Acoustic schwannoma affects cochlear CN8 leading to __ hearing loss and T
vestibular portion leads to V/N
compression of CN v leads to loss of facial __/muscles of __/affarent __
compressed CN 7 can lead to __ paralysis, loss of __ in tongue, and __ due to paralzed stapedius
bilateral involvement seen in
sensorineural, tinnitus
vertigo/nystagmus
sensation, mastication, corneal reflex
facial muscle, taste, hyperacusis
NF2
C botulinum has preformed \_\_ descending paralysis w 3Ds occur after eating \_\_ toxin affects \_\_ nerves via endocytosis prevents binding/fusion of \_\_ w/in plasma membrane
no release of __ into synapse
toxin is __ and is destroyed w cooking
neurotoxin Dysphagia, dysphonia, diplopia canned food cholinergic vesicles
Ach
heat labile
Poisoning due to muscarinic __ prevents __ action of Ach
organophosphates prevent Ach __ w/in synaptic cleft
sx include weakness, P, L, seizures, __ toxicities
antags, postsynaptic
degredation
paralysis, lethargy, muscarinic
Diazepam can be used as \_\_ for GAD/PA sedative _ effect for insomnia \_\_ for status epilepticus also for alcohol withdrawal seizures w C muscle relaxant w \_\_ disorders/tetanus
SE is __ w M/C problems
avoid w A/B/1st gen __
Clorpheniramine/D/P/H are 1st gen antihistamines
major SE is __ by crossing BBB
anxiolytic
hypnotic
anticonvulsant, Chlordiazepoxide
UMN
sedation, memory/conc
alcohol, barbs, antihistamine
diphenhydramine, promethazine, hydroxyzine
__ is used in tx of ACS
inhibit NT from interacting at __ synapse
__ blocker dec HR
__ blocker causes bronchoconstriction/wheezing
SE is ___ in pt w asthma/COPD
B blocker, adrengergic
B1
B2
SOB
NTD due to failure of fusion of ___
begins in __ region and proceeds __
w failure to close, __ and __ can leak into amniotic fluid, and are seen at high levels
neural plate
cranial
caudally
AFP, AChE
__ is vasc malformation of liver/brain
abnormal, __ bv w thin __
leading to recurrent __
can present w __ deficits/s if brain is involved
__ is seen around bv forming perivascular pseudorosettes
__ is a tuor w psuedopalisading necrosis
cavernous hemangioma
dilated, adventitia
bleeds
neuro/seizures
ependymoma
glioblastoma
__ is do w underdevelopment of posterior fossa
results in __/__ herniating through the foramen magnum
Type 1 assc w low lying cerebellar ___ below the FM
presents w paroxysmal occipital HA an _ dysfxn
Type 2 evident as __
see downward displacement of cerebellum and ___ due to aqueductal stenosis
compression of __ can lead to apnea/stridor/dysphagia
assc w __ causing lower limb paralysis
Chiari malformations
cerebellum/medulla
vermis
cerebellar
neonate
NCH
medulla
myelomeningocele
Metabolic derangements like ___ can result in seizure
Seizure is __ if originates in 1 hemisphere
or __ in both hemispheres
Simple if __ preserved
Complex is loss of ___
DKA
partial
generalized
conciousness
conciousness
Absence seizure is a __ seizure lasting less than __ sec w staring spells (lack of __) in child
__ seizure leads to loss of postural tone and conciousness
___ is focal seizure w lost conciousness and behavioral abnorms
followed by __ confusion
may have preceding __
tongue biting/bowel incontinence/myoclonus seen in __ seizure
generalized, 10, conciousness
atonic
complex partial
post ictal
aura
generalized tonic clonic
Hepatic hydroxylation of phenytoin is __
lower doses are eliminated __ thus non __
phenytoin induces __
interacts w other p450 meds
P450 induces B/R/C/G/A
P450 inhibitors I/C/M/A/G juice
dose dependent
quickly, toxic
p450
barbs, rifampin, carbamezipine, griseofulvin, alcohol
isoniazid, cimetidine, macrolids, azole, grapefruit
absence seizure provoked by __
ECG shows 3Hz __ pattern
tx w __ to inhibit T type Ca channels
or V
Carbamezipine/Gabapentin/Phenobarbitol/Pheynoin preferred for __ seizures
hyperventilation
spike and wave
ethosuximide
valproate
focal
motor innervation of tongue by __
exception is palatoglossus muscle innervted by __
genera sensory of tongue
Anterior 2/3 by __
Posterior 1/3 by __
Posterior of tongue root __
taste sensation
Anterior 2/3 by __ branch of Facial nerve
Posterior 1/3 by ___
Posterior of tongue root __
anterior to terminal sulcus/foramen cecum is located in __ of tongue
CN 9
vagus
CN V3
glossopharyngeal
vagus
chorda tympani
glossopharyngeal
vagus
anterior 2/3
excessive daytime sleepiness, episodic loss of motor tone (cataplexy), sleep paralysis dx is __
caused by lack of hypocretin 1 aka __
or __ orexin B
produced in ___
these promote W and inhibit __
Hypocretin 1 is only detectable in __ and should be __
narcolepsy
orexin a
hypocretin 2
lateral hypothalamus
wake, REM
CSF, low
positive romberg seen in __ ataxia
seen in _ column/__ nerve defets
CT images show ischemic area to be __ and poorly __
also see E__ and loss of Grey/white __
__ present 1w after infarct
see abundance of __ in microglia due to breaking down __ products
sensory
posterior, peripheral
hypodense, delineated
edema, jxn
Microglia
lipids
myelin
__ is motile, gram neg, facultative anaeobic rod
ferments L/G
can grow on __ agar, which prevents growth of __ orgs
orgs that ferment __ have pink/red appearance
E coli/K/E
__ is major virulence factor
e coil
lactose/glucose
maconkey gram positive lactose klebsiella, enterobacter K1 capsular antigen
erythrocyte glutathione reductase def can be seen in pt w vitamin __ deficiency
see __ anemia
__ deficiency is congenital hemolytic anemi due to impaired glycolytic ATP generation
B2
normocytic
pyruvate kinase
__ nerve lies bw FCU and FDP
also seen bw Olecranon and __ of humerus
__ courses bw humeral/ulnar heads of pronator teres
also found bw FDP and ___ in the carpal tunnel
__ nerve located bw Biceps/coracobrachialis muscles
ulnar
medial epicondyle
median nerve
FDS
musculocutaneous
__ supplies medial portion of 2 hemispheres
occulsions leads to abnorms in __ and __ changes
maybe __ incontinence
ACA
legs, behavioral
urinary
UMN lesions affect the __ motor system
__ tracts, M/p/M, IC, and __ gyrus
look for __ spasticity
damage to __ GP leads to excesive movement
damage to __ GP leads to diminished movement
pyramidal
CS, midbrain, pons, medulla, internal capsule, precentral
clasp knife
internal
external
anticholinergic agents like A/S competitively inhibit Ach at Muscrinic receptor
reverse w __ inhibitors like P
SAH, blood accumulates bw A/P
LP shows B/X
atropine, scopolamine
cholinesterase, physostigmine
arachnoid, pia
blood/xanthochromia
months to years after ischemic infarct, __ predominate and form __ cavity
reactive gliosis helps to protect __ areas from inflamm response
paresthesias, weakness, dizziness, nausea w food consumption think __ producing tetrodotoxin
binds voltage gated __ channels, in neural/cardiac tissue
preventing __
can lead to severe __ and P
astrocytes, cystic
surrounding
pufferfish
Na, depolarization
hypoTN, paralysis
Tetrodotoxin/saxitoxin bind __ channels and block Na __, stopping AP
ciguatoxin/batrachotoxn bind __ channel and keep it open, causing recurrent ___
Na, influx
Na, depolarization
blood solubility of anesthetic determined by __ partition coefficient
high solubility leads to __ BGPC
thus, drug is more soluble in __ w slower equilibrium in __
time to onset is __
N2O has rapid onset, much __ BGPC
blood gas
higher
blood, brain
longer
lower
__ is neuroprotective agent to tx AD
__ is NMDA receptor antag to tx AD
__ is cholinesterase inhib for AD
NPH presents w __ opening pressure bc ventricles enlarge slowly
acute causes of CH will have __ opening pressure
__ is absence of gyri
Vitamin E
Memantine
Donezepil
normal
high
lissencephaly
__ tentorial herniaton presents w CN 3 palsy and affected PCA
Neurodegenerative dz can lead to hydrocephalus __ w cortical atrophy
atrophy in AD is most pronounced in the T lobe and H
transtentorial
ex vacuo
temporoparietal lobe and hippocampus
__ runs in the posterior triangle of the neck
injury results in weakness of __/__ muscles
see __ of shoulder, impaired __ of arm above horizontal, and winging of __
__ innervates deltoid
see impaired abdcion __ horizontal plane
most powereful adductor of arm is __
innervated by __ nerve
__ innervates the serratus anterior
injury leads to impaired __ and __ of scapula, no __
Spinal accessory nerve
trapezius/SCM
drooping, abduction, scapula
axillary nerve, below
lat dorsi, thoracodorsal
serratus anterior
abduction, winging, droop
infarct of anterior medial pons can lead to D and contralateral hemiparesis w __ facial palsy
due to disruption of ipsilateral __/__ tracts
may have D/D
__ nerve is found here
__ nerve is located on dorsalateral pons
not present if there is __ of the forehead muscles
dysarthria, lower
CS/corticobulbar
dysmetria/dysdiadokinesia
trigeminal
facial
sparing
Sacral micturation center located at __/__ level, responsible for bladder __
stimulated by __ fibers to __ receptors on bladder wall
pontine micturation center located in the __ formation
leads to relaxation of __ w bladder contraction
Cerebral cortex inhibits __
S2-S4, contraction
PNS, cholinergic
reticular, EUS
SMC
In NPH, dec absorption of __ leads to ventricular enlargement
compresses the C__, blocking descending cortical fiber impulse from cortex to ___
thus, there is no __ from cerebral cortex
pt gets __ as bladder fills, emptying when full
CSF
corona radiata
SMC
inhibition
urge incontinence
