Neuro Flashcards
order of sleep stages and waveforms
awake- beta awake (eyes closed)- alpha non-rem: N1- theta N2- sleep spindles, K complexes N3- delta (sleep walking, night terrors, bed wet) REM- beta
decreased mesocortical dopaminergic pathway
negative symptoms
increased mesolimbic dopaminergic pathway
positive symptoms
decreased nigrostriatal dopaminergic pathway
extrapyrimadal symptoms
decreased tuberoinfundibular dopaminergic pathway
increased prolactin–> gynecomastia, galactorrhea, sex dysfunction, decreased libido
deep nuclei of cerebellum
(lateral to medial)
dentate, emboliform, globose fastigial
dont eat greasy food
input to cerebellum
- contralateral cortex via middle cerebellar pedunce
- ipsilateral proprioceptive via inferior cerebellar peduncle
outputs from cerebellum
purkinje cells –> deep nuclei –> superior cerebellar peduncele –> contralateral cortex
stroke of middle cerebral artery
face and upper limb: contralateral paralysis and sensory loss
if dominant: aphasia
if nondominant: hemineglect
stroke of anterior cerebral artery
lower limb: contralateral paralysis and sensory loss
lacunar infarct of lenticulostriate artery
face and body: contralateral paralysis and sensory loss
stroke of anterior spinal artery
Medial medullary syndrome
- contralateral paralysis
- contralateral decreased proprioception
- ipsilateral hypoglossal dys.
stroke of PICA
lateral medullary syndrome (Wallenberg)
- vomit, vertigo, nystagumus
- decreased pain/temp (ipsilateral face, contralateral body)
- dysphagia, hoarse
- decreased gag reflex
- ipsilateral horners
- ataxia, dysmetria
stroke of AICA
lateral pontine syndrome
- vomit, vertigo, nystagmus
- paralysis of face- decreased lacrimation, salivation, taste from anterior
- decreased pain temp (ipsilateral face, contralateral body)
- ataxia, dysmetria
stroke of basilar artery
locked in syndrome- conscious and can blink
stroke of posterior cerebral artery
contralateral hemianopia with macular sparing
charcot-bouchard aneurysm
small vessels
from chronic hypertension
most common spot of berry aneurysm
junction of anterior cerebral artery and anterior communicating artery
effects of anterior communicating artery rupture from aneurysm
SAH
bitemporal hemianopsia, visual acuity deficits
iscemia in ACA–> contralateral hemiparesis and sensory loss in lower limb
effects of posterior communicating artery rupture from aneurysm
SAH
ipsilateral CN III palsy–> mydriasis, ptosis
central post-stroke pain syndrome
initial paresthesias
then- allodynia (pain from painless stimuli), dysesthesia (unpleasant touch)
causes of subdural hematomas
- acute trauma
- chronic cerebral atrophy- elderly, alcoholism
- shaken babies
causes of intraparenchymal hemorrhages
- systemic hypertension
- amyloid angiopathy
- vasculitis
- neoplasm
- reperfusion injury
what enzyme can be defected in ALS?
superoxide dismutase
parinaud syndrome
lesion in superior colliculi (stroke, hydrocephalus, pinealoma)
paralysis of conjugate vertical gaze
afferent and efferent of gag reflex
a- 9
e- 10
afferent and efferent of lacrimation reflex
a- V1
e- 7
uvula deviates which way in CN X lesion
away from lesion
jaw deviates which way in CN V lesion
towards lesion
CN XI lesion
contralateral SCN
ipsilateral trapezius
tongue deviates which way in CN XII lesion
towards lesion (ipsilateral lesion)
cavernous sinus syndrome
opthalmoplegia (CN VI most susceptible to injury)
decreased corneal sensation
Horner syndrome
causes: tumor mass effect, fistula, thrombosis
where in cochlea is low frequency and where is high freq?
low: apex near helicotrema (wide and flexible)
high: base of cochlea (thin and rigid)
DOC for trigeminal neuralgia and its MOA
carbamazepine- reduces ability of Na channels to recover from inactivation
NF-1 what type of inheritance
aut dom
optimal site for femoral nerve blockade
inguinal crease
fracture of orbital floor
parasthesia of upper lip, upper cheek, upper gingiva (damage to infraorbital nerve)
inferior rectus trapped- limits vertical gaze
drugs to treat restless leg syndrome
dopamine agonists (ropinarole, pramipexole)
MS diagnosis
high IgG with myelin basic protein in CSF
oligoclonal bands
MRI- gold standard- periventricular plaques
multiple white matter lesions separated in space and time
acute inflammatory demyelinating polyradiculopathy
Guillain-Barre syndrome- destroy schwann cells
ascending paralysis
autonomic dysregulation
charcot-marie-tooth
hereditary motor and sensory neuropathy
collection of diseases- aut dom- defective protein in peripheral nerves/myelin
foot deformities, lower extremity weakness
metachromatic leukodystrophy
aut rec LSD
arylsulfatase A deficiency
cant degrade myelin –>accumulates in lysosomes –> ataxia dementia
pinealomas can cause…
- parinaud
- obstructive hydrocephalus
- precocious puberty (bHCG)
cingulate (subfalcine) herniation
under falx cerebri
compress anterior cerebral artery
uncal herniation
compress ipsilateral CN III
ipsilateral PCA (contralateral homonymous hemianopsia with macular sparing)
contralateral crus cerebri at Kernohan notch
cerebellar tonsil herniation through foramen magnum
cardiopulm arrest in brain stem–> coma, death
Sturge-Weber syndrome
Sproadic port wine stain of face Tram track calcifications Unilateral Retardation Glaucoma GNAQ mutation Epilepsy
(STURGE)
anomaly of neural crest derivatives
Tuberous sclerosis
Hamartomas in CNS Angiofibromas Mitral regurg Ash leaf spots Rhabdomyoma TUberous sclerosis aut dOm Mental retardation renal Angiomylipoma Seizure Shagreen patches
(HAMARTOMAS)
