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Board Review > Neuro > Flashcards

Neuro Flashcards

1
Q

mesocortical pathway

A

ventral tegmental of midbrain–>cortex

result of blocking: increased negative symptoms of schizophrenia (social w/drawl, depression)

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2
Q

mesolimbic pathway

A

ventral tegmental of midbrain–>limbic system

result of blocking: relieves (+) symptoms of schizophrenia (target of antipyschotics)

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3
Q

nigrostriatal pathway

A

Basal ganglia
substantial nigra pars compacta–>neostratium

result of blocking: Parkinson disease

stimulation: extrapyramidal SE

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4
Q

tuberoinfundibular pathway

A

arcuate nucleus of hypothalamus–>pituitary

result of blocking: increase release of prolactin from anterior pituitary–>hypogonadism

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5
Q

structures running through cavernous sinus

A 
internal carotid
occulomotor nerve
trochlear nerve
abducens nerve
trigeminal nerve (opthalmic, maxillary)
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6
Q

Erb palsy

A
  • traction or tear of upper trunk (C5-C6 roots)
  • lateral traction on neck during delivery
  • deltoid, supraspinatus: abduction (arm hangs by side)
  • infraspinatus: lateral rotation (arm medially rotated)
  • biceps brachii: flexion, supination (arm extended and pronated)
  • “water’s tip”
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7
Q

Klumpke palsy

A
  • traction or tear of lower trunk C8-T1 root
  • upward force on arm during delivery, grabbing tree branch to break fall
  • intrinsic muscles affected (lumbricals, interossei, thenar, hypothenar
  • total claw hand: lumbricals normally flex MCP joints and extend DIP and PIP joints
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8
Q

thoracic outlet syndrome

A
  • compression of lower trunk and subclavian vessels
  • cervical rib injury, pancoast tumor
  • intrinsic muscles affected (lumbricals, interossei, thenar, hypothenar
  • atrophy of intrinsic hand muscles; ischemia, pain, and edema due to vascular compression
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9
Q

winged scapula

A
  • lesion of long thoracic nerve
  • axillary node dissection after mastectomy stab wound
  • serratus anterior: inability to anchor scapula to thoracic cage–>can’t abduct arm above horizontal position
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10
Q

axillary (C5-C6)

A
  • fractured surgical neck of humerus, anterior dislocation of humerus
  • flattened deltoid
  • loss of arm abduction at shoulder
  • loss of sensation over deltoid muscle and lateral arm
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11
Q

musculocutaneous (C5-C7)

A
  • upper trunk compression
  • loss of forearm flexion and supination
  • loss of sensation over lateral forearm
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12
Q

radial (C5-T1)

A
  • midshaft fracture of humerus, compression of axilla (crutches or “Saturday night palsy”)
  • wrist drop
  • decrease grip strength
  • loss of sensation over posterior arm/forearm and dorsal hand
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13
Q

median (C5-T1)

A
  • supracondylar fracture of humerus, carpal tunnel syndrome and wrist laceration
  • “ape hand” and “Pope’s blessing”
  • loss of wrist and lateral finger flexion, thumb opposition, lumbricals of 2nd and 3rd digits
  • loss of sensation over thenar eminence and dorsal and palmar aspects of lateral 3.5 fingers w/ proximal lesion
  • Tinel sign
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14
Q

ulnar (C8-T1)

A
  • fracture of medial epicondyle of humerus, fractured hook of hamate
  • “ulnar claw” on digit extension
  • radial deviation of wrist upon flexion (proximal lesion)
  • loss of flexion of wrist and medial fingers, abduction and adduction of fingers, actions of medial 2 lumbrical muscles
  • loss of sensation over medial 1.5 fingers including hypothenar eminence
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15
Q

recurrent branch of median nerve (C5-T1)

A
  • superficial laceration of palm
  • “ape hand”
  • loss of thenar muscle group: opposition abduction, flexion of thumb
  • NO loss of sensation
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16
Q

extending index and middle fingers at rest

A
  • “ulnar claw”

- distal ulnar nerve lesion

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17
Q

extending index and middle fingers when making fist

A
  • “Pope’s blessing”

- proximal median nerve

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18
Q

extending pinkie and ring fingers at rest

A
  • “median claw”

- distal median nerve

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19
Q

extending pinkie and ring fingers when making fist

A
  • “OK gesture”

- proximal ulnar nerve

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20
Q

atrophy of thenar eminence

A

“ape hand”–> unopposable thumb

-median nerve lesion

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21
Q

atrophy of hypothenar eminence

A

-ulnar nerve lesion

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22
Q

thenar muscles

A

Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

“OAF”

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23
Q

hypothenar muscles

A

Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minim brevis

“OAF”

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24
Q

Dorsal interosseous muscles

A

abduct fingers

DAB- dorsal abducts

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25
Q

palmar interosseous muslces

A

adduct fingers

PAD-palmars adduct

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26
Q

lumbrical muscles

A

flex at the MCP joint, extend PIP and DIP joints

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27
Q

obturator (L2-L4)

A
  • pelvic surgery
  • decreased thigh sensation (medial)
  • decreased adduction
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28
Q

femoral (L2-L4)

A
  • pelvic fracture

- decreased thigh flexion and leg extension

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29
Q

common peroneal (L4-S2)

A
  • trauma or compression of lateral aspect of leg; fibular neck fracture
  • foot drop: inverted and plantar flexed at rest, loss of eversion and dorsiflexion
  • “steppage gait”
  • loss of sensation of dorsum of foot

“PED”-peroneal everts and dorsiflexes; if injured, foot dropPED

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30
Q

tibial (L4-S3)

A
  • knee trauma, baker cyst, tarsal tunnel syndrome
  • inability to curl toes
  • loss of sensation on sole of foot
  • proximal lesions: foot everted at rest w/ loss of inversion and plantar flexion

“TIP”-tibial inverts and plantarflexes; if injured, can’t stand on TIPtoes

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31
Q

superior gluteal (L4-S1)

A
  • posterior hip dislocates, polio
  • Trendelenburg sign/gait- pelvis tilts b/c weight-bearing leg can’t maintain alignment of pelvis
  • innervates gluteus medius and minimus
32
Q

inferior gluteal (L5-S2)

A
  • posterior hip dislocation
  • difficulty climbing stairs, rising from seated position
  • loss of hip extension
  • innervates gluteus maximus
33
Q

lateral area (hypothalamus)

A
  • hunger
  • inhibited by leptin
  • “if you zap your lateral nucleus, you shrink lateral”
34
Q

ventromedial area (hypothalamus)

A
  • satiety
  • stimulated by leptin
  • “if you zap your ventromedial nucleus, you grow vertrally and medially”
35
Q

anterior hypothalamus

A
  • cooling, parasymathetic

- “A/C=anterior cooling”

36
Q

posterior hypothalamus

A

-heating, sympathetic

37
Q

suprachiasmatic nucleus

A

-circadian rhythm

38
Q

supraoptic nucleus

A

-makes ADH

39
Q

paraventricular nucleus

A

-makes oxytocin

40
Q

VLP (thalamus nucleus)

A
  • input: spinothalamic and dorsal columns/medial lemniscus
  • pain, temperature, pressure, touch, vibration, proprioception
  • destination: primary somatosensory cortex
41
Q

VMP (thalamus nucleus)

A

-input: trigeminal and gustatory pathway
-face sensation and taste
-destination: primary somatosensory cortex
“Makeup goes on the face”

42
Q

LGN (thalamus nucleus)

A

-input: CN II
-vision
-destination: calcarine sulcus
“Lateral=Light”

43
Q

MGN

A

-input: superior olive and inferior colliculus of tectum
-hearing
-destination: cortex of temporal lobe
“Medial=Music”

44
Q

VL

A
  • input: basal ganglia, cerebellum
  • motor
  • destination: motor cortex
45
Q

MCA: area of lesion

A

motor cortex: upper limb and face
sensory cortex: upper limb and face
temporal lobe: Wernicke area
frontal lobe: Broca area

46
Q

MCA stroke symptoms

A
  • contralateral paralysis of upper limb and face
  • contralateral loss of sensation of upper/lower limbs and face
  • aphasia if in dominant hemisphere
  • hemineglect if nondominant side
47
Q

ACA area of lesion

A
  • motor cortex: lower limb

- sensory cortex: lower limb

48
Q

ACA stroke symptoms

A
  • contralateral paralysis lower limbs

- contralateral loss of sensation of lower limbs

49
Q

lenticulo-striate artery stroke

A
  • striatum, internal capsule
  • contralateral hemiparesis/hemiplegia
  • common in unmanaged hypertension
50
Q

ASA area of lesion

A
  • lateral corticospinal tract
  • medial lemniscus
  • caudal medulla-hypoglossal nerve
51
Q

ASA stroke symptoms

A
  • contralateral hemiparesis-upper and lower limbs
  • decreased contralateral proprioception
  • ipsilateral hypoglossal dysfunction
  • Medial medullary syndrome: infarct of paramedian branches of ASA and vertebral arteries
52
Q

PICA area of lesion

A

-lateral medulla: CN IX, X, XII; lateral spinothalamic tract

53
Q

PICA stroke symptoms

A
  • vomiting, vertigo, nystagmus
  • decreased pain/temp. sensation of ipsilateral face and contralateral body
  • dysphagia, hoarseness, decreased gag reflex
  • ipsilateral Horner syndrome; ataxia, dysmetria
  • Lateral medullary (Wallenberg) syndrome
54
Q

AICA area of lesion

A
  • lateral pons: CN V, VI, VII, VIII

- middle and inferior cerebellar peduncles

55
Q

AICA stroke symptoms

A
  • vomiting, vertigo, nystagmus
  • paralysis of face, decreased lacrimation/salvation, decreased taste of anterior 2/3 of tongue, decreased corneal reflex
  • decreased face pain and temp sensation
  • ipsilateral decrease in hearing
  • ipsilateral Horner syndrome
  • ataxia, dysmetria
  • Lateral pontine syndrome
56
Q

PCA stroke

A
  • occipital cortex, visual cortex

- contralateral hemianopia w/ macular sparing

57
Q

Basilar artery stroke

A
  • pons, medulla, lower midbrain: corticospinal and corticobulbar tracts, ocular nerve nuclei, PPRF
  • preserved consciousness and blinking, quadriplegia, loss of voluntary facial, mouth, and tongue movement
  • “locked-in syndrome”
58
Q

ACom lesion

A
  • aneurysm impinge cranial nerves
  • visual field defects
  • typically aneurysms, not strokes
59
Q

PCom lesion

A
  • saccular aneurysm
  • CN III palsy: eyes down and out w/ ptosis and pupil dilation
  • lesions typically aneurysms, not strokes
60
Q

dorsal column

A
  • ascending: pressure, vibration, fine touch, proprioception
  • decussates in medulla–>ascend contralaterally in medial lemniscus
  • synapse VPL–> sensory cortex
61
Q

spinothalamic tract

A
  • ascending: later-pain, temperature; anterior-crude touch, pressure
  • decussates at anterior white commissure–>ascends contralaterally
  • synapse VPL–> sensory cortex
62
Q

lateral corticospinal tract

A
  • descending: voluntary movement of contralateral limbs

- decussates at caudal medulla (pyrimidal decussation)–> descends contralaterally

63
Q

nucleus solitarius

A
  • visceral Sensory info
  • taste, baroreceptors, gut distention
  • CN VII, IX, X
64
Q

nucleus ambiguus

A
  • Motor innervation of pharynx, larynx, and upper esophagus
  • swallowing, palate elevation
  • CN IX, X, XI
65
Q

dorsal motor nucleus

A
  • autonomic (parasympathetic) fibers to heart, lungs, and upper GI
  • CN X
66
Q

cribiform plate

A

CN I

67
Q

middle cranial fossa: through sphenoid bone

A

CN II-VI

68
Q

optic canal

A
  • CN II
  • ophthalmic artery
  • central retinal vein
69
Q

superior orbital fissure

A
  • CN III, IV, V1, VI
  • ophthalmic vein
  • sympathetic fibers
70
Q

foramen rotundum

A

CN V2

71
Q

foramen ovale

A

CN V3

72
Q

foramen spinosum

A

middle meningeal artery (ruptured in epidural hematoma)

73
Q

posterior cranial fossa: through temporal or occipital bone

A

CN VII-XII

74
Q

internal auditory meatus

A

CN VII, VIII

75
Q

jugular foramen

A

CN IX, X, XI

jugular vein

76
Q

hypoglossal canal

A

CN XII

77
Q

foramen magnum

A

spinal roots of XI
brain stem
vertebral arteries

Board Review (11 decks)

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