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BT_anatomySTEP > neuro > Flashcards

neuro Flashcards

1
Q

what does Nissl staining stain?

A

RER

** neuronal cell bodies and dendrites stain, axons DO NOT

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2
Q

Wallerian degeneration?

A

degeration distal to injury

axonal retraction proximal to injury

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3
Q

physical support, repair, K+ metabolism, glycogen fuel reserve buffer, GFAP+?

A

astroctyes

    • reactive gliosis in response to neural injury
    • derived from neuroectoderm
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4
Q

phagocytic cells of CNS, activated in response to injury?

A

microglia

    • mesodermal - mononuclear origin
    • HIV infected microglia –< multinucleated giant cells
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5
Q

myelinate PNS axons, promote axonal regeneration?

A

Schwann cells
(1 Schwann cell: 1 axon)

** promote axonal regeneration

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6
Q

myelinate CNS axons, look like fried eggs?

A

oligodendrocytes
(1 oligo: 30 axons)

    • derived from neuroectoderm
    • injured in MS, PML, leukodystrophies
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7
Q

sense pain and T, located in skin/epidermis and some viscera?

A

free nerve endings

1) C = slow, unmyelinated
2) Adelta = fast, myelinated

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8
Q

sense dynamic fine/light touch and position, located in glabrous skin?

A

Meissner corpuscles

large, myelinated, fast adaptation

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9
Q

sense vibration/pressure, located in deep skin/ligaments/joints?

A

Pacinian corpuscles

large, myelinated, fast adaptation

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10
Q

located in fingertips/superficial skin, sense pressure/deep static touch/position?

A

Merkel disks

large, myelinated, slow adaptation

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11
Q

located in finger tips/joints, sense pressure/slippage/joint angle change?

A

Ruffini corpuscles
dendritic endings with capsule
slow adaptation

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12
Q

layers of peripheral nerve covering?

A

endoneurium –> single nerve fiber
perineurium –> fascicle
epineurium –> entire n (fascicles and blood vessels)

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13
Q

made in locus ceruleus?

A

NE
increased in anxiety
decreased in depression

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14
Q

made in VTA and SNc?

A

dopa
increased in HD
decreased in PD, depression

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15
Q

made in raphe nuclei?

A

serotonin

decreased in anxiety, depression

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16
Q

made in nucleus basalis of meynert?

A

ACh
increased in PD
decreased in AD, HD

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17
Q

made in nucleus accumbens?

A

GABA

decreased in anxiety, HD

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18
Q

structures that make up BBB (blood brain barrier)?

A

tight jcts bw capillary endothelial cells
basement membrane
astrocyte foot processes

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19
Q

how do glucose and AAs cross BBB?

A

slowly - carrier-mediated

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20
Q

how do lipid-soluble/non-polar substances cross BBB?

A

fast - diffusion

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21
Q

what causes vomiting after chemo?

A

area postrema

** no BBB - can sample blood

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22
Q

what does osmotic sensing in the CNS?

A

OVLT = organum vasculosum of lam terminalis

** no BBB

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23
Q

what does the supraoptic nucleus do?

A

makes ADH

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24
Q

what does the paraventricular nucleus do?

A

makes oxytocin

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25
Q

regulates hunger, inhibited by leptin?

A

lateral area of hypothalamus

** destruction –> anorexia, FTT

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26
Q

regulates satiety, stimulated by leptin?

A

ventromedial area of hypothalamus

** destruction (e.g. craniopharyngioma) –> hyperphagia

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27
Q

regulates cooling?

A

anterior hypothalamus

** parasympathetic

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28
Q

regulates heating?

A

posterior hypothalamus

** sympathetic

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29
Q

regulates circadian rhythm?

A

suprachiasmatic nucleus (SCN)

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30
Q

SCN releases what NT?

A

NE

–> pineal gland releases melatonin

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31
Q

what causes EOM movement during REM?

A

PPRF activity

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32
Q

what substances are associated with decreased REM?

A

alcohol, barbiturates, benzos (all also decrease delta wave)

NE decreases REM

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33
Q

night terrors, sleepwalking - give what?

A

BZOs

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34
Q

order of EEG waveforms in sleep?

A 
BATS Drink Blood
Beta (awake, active)
Alpha (awake, eyes closed)
Theta (stage N1)
Spindle/K complex (stage N2)
Delta (stage N3)
Beta (REM)
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35
Q

in what stage of sleep do you get bruxism?

A

Stage N2 - sleep spindles

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36
Q

in what stage of sleep do you get sleepwalking, night terrors, bedwetting?

A

stage N3 - delta waves

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37
Q

gets input from spinothalamic and dorsal columns?

A

VPL

output to 1ary somatosensory cortex

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38
Q

gets input from trigeminal and gustatory pathways?

A

VPM
(face sensation and taste)
output to 1ary somatosensory cortex

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39
Q

which thalamic nucleus gets input from CN 2?

A

LGN

output to calcarine sulcus

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40
Q

which thalamic nucleus gets input from superior olive and inferior colliculus?

A

MGN

output to auditory cortex - temporal lobe

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41
Q

which thalamic nucleus gets input from BG and cerebellum?

A

VL

output to motor cortex

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42
Q

made up of hippocampus, amygdala, fornix, mammillary bodies, cingulate gyrus?

A

limbic system

** feeding, fleeing, fighting, feeling, f***ing

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43
Q

acute paralysis, dysarthria, dysphagia, diplopia, LOC?

A

central pontine myelinolyis

overrapid correction of hyponatremia

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44
Q

inputs to cerebellum?

A 
contralateral cortex (via middle peduncle)
ipsilateral proprioception (via inferior peduncle)
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45
Q

outputs from cerebellum?

A

contralateral cortex (via purkinje cells –> deep nuclei –> sup cerebellar peduncle)

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46
Q

deep nuclei of cerebellum?

A 
lateral --> medial = Don't Eat Greasy Foods
dentate
emboliform
globose
fastigial
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47
Q

truncal ataxia, nystagmus, head tilt?

A

medial cerebellar lesion

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48
Q

propensity to fall to injured side, issues with voluntary movement of extremities?

A

lateral cerebellar lesion

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49
Q

what is the striatum comprised of?

A

putamen (motor)

caudate (cognitive)

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50
Q

what is the lentiform comprised of?

A

putamen

globus pallidus

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51
Q

BG excitatory pathway?

A

cortex –> striatum –> GABA –> inhibits GPi/SNr –> release of thalamic inhibition –> motion

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52
Q

BG inhibitory pathway?

A

cortex –> striatum –> inhibits GPe –> release of STN inhibition –> GPi activation –> thalamic inhibition –> decreased mtion

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53
Q

dopa and BG pathways?

A

binds D1 –> stimulates excitatory pathway

binds D2 –> inhibits inhibitory pathway

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54
Q

tx of essential tremor?

A

BBs

primidone

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55
Q

hemiballismus caused by what lesion?

A

contralateral STN - e.g. lacunar stroke

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56
Q

NT changes in HD?

A

increased dopa
decreased GABA, ACh

** neuronal death: NMDA-R binding and glu toxicity

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57
Q

nonfluent aphasia, intact comprehension, impaired repetition?

A

Broca’s

- inferior frontal gyrus of frontal lobe

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58
Q

fluent aphasia, impaired comprehension, impaired repetition?

A

Wernicke’s

- superior temporal gyrus

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59
Q

poor repetition, fluent speech, intact comprehension?

A

conduction aphasia

- arcuate fasciculus

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60
Q

nonfluent aphasia, impaired comprehension?

A

global aphasia

- Broca, Wernicke, AND arcuate fasciculus

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61
Q

nonfluent aphasia with good comprehension and intact repetition?

A

transcortical motor aphasia

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62
Q

poor comprehension with fluent speech and intact repetition?

A

transcortical sensory aphasia

63
Q

nonfluent speech, poor comprehension, intact repetition?

A

mixed transcortical aphasia

  • Broca and Wernicke
  • NO arcuate fasciculus involvement
64
Q

disinhibited behavior: hyperphagia, hypersexuality, hyperorality?

A

Kluver-Bucy:
bilateral amygdala lesion

** assoc with HSV1

65
Q

hemispatial neglect?

A

lesion in nondominant parietal-temporal cortex

66
Q

agraphia, acalculia, finger agnosia, L-R disorientation?

A

Gerstmann

lesion in dominant parietal-temporal cortex

67
Q

reduced levels of arousal and wakefulness?

A

lesion in reticular activating system (midbrain)

68
Q

confusion, ophthalmoplegia, ataxia; memory loss, confabulation, personality changes?

A

Wernicke Korsakoff

lesion in mamillary bodies

69
Q

anterograde amnesia?

A

lesion to b/l hippocampus

70
Q

PPRF vs FEF lesion?

A

PPRF: eyes look AWAY from lesion
FEF: eyes look TOWARD lesion

71
Q

cerebral arteries - watershed areas?

A

ACA/MCA and PCA/MCA

** hypoT –> upper leg/upper arm weakness, defects in higher-order visual processing

72
Q

what drives cerebral perfusion?

A

primarily PCO2 - until PCO2 > 90mmHg

PO2 contributes when PO2 < 50 mmHg

73
Q

equation for cerebral perfusion pressure?

A

CPP = MAP - ICP

74
Q

contralateral paralysis and sensation loss (upper limb and face), aphasia/neglect?

A

MCA stroke

L –> aphasia, R –> neglect

75
Q

contralateral paralysis and sensation loss - lower limb?

A

ACA stroke

76
Q

contralateral hemiparesis/hemiplegia?

A

lenticulostriate stroke (–> striatum, internal capsule)

** common location of lacunar infarcts 2/2 unmanaged HTN

77
Q

contralateral hemiparesis (upper and lower), decreased contralateral proprioception, ipsilateral hypoglossal dysfunction?

A

ASA stroke - commonly bilateral
affects lateral corticospinal tract and medial lemniscus

** medial medullary syndrome: infarct of paramedian ASA brr and vertebral aa

78
Q

vomiting, vertigo, nystagmus; loss of pain/T from ipsilateral face and contralateral body, dysphagia, hoarseness, ipsilateral Horners?

A

PICA stroke
Lateral medullary/Wallenberg syndrome

** nucleus ambiguus (CN X motor) effects specific to PICA lesions (hoarseness, dysphagia)

79
Q

vomiting, vertigo, nystagmus; facial paralysis, decreased lacrimation/salivation/anterior tongue taste; loss of pain/T from ipsilateral face and contralateral body?

A

AICA stroke
lateral pontine syndrome

** facial nucleus effects specific to AICA lesions (facial droop, taste, etc)

80
Q

contralateral hemianopia with amcular sparing?

A

PCA stroke

81
Q

preserved consciousness and blinking, quadriplegai, loss of voluntary facial/mouth/tongue movements?

A

basilar artery stroke
–> pons, medulla, lower midbrain etc
locked in

82
Q

PCOm aneurysm effects?

A

CN III –> down and out with ptosis and midriasis

** aneurysm&raquo_space; stroke

83
Q

ACom aneurysm effects?

A

visual field defects

** aneurysm&raquo_space; stroke

84
Q

risk factors for Berry aneurysm?

A 
ADPKD
Ehlers-Danlos
smoking
advanced age
HTN
race
85
Q

allodynia and dysesthesia weeks to months after stroke?

A

central post-stroke pain syndrome

10% of stroke pts

86
Q

tx of post-SAH vasospasm?

A

nimodipine

87
Q

causes of intraparenchymal hemorrhage?

A

MCC systemic HTN

also: amyloid, vasculitis, neoplasm

88
Q

locations of intraparenchymal hemorrhage?

A

basal ganglia

internal capsule

89
Q

most vulnerable locations to hypoxic brain injury?

A

hippocampus
neocortex
cerebellum
watershed areas

90
Q

histology changes after ischemic brain injury?

A 
12-48 hrs: red neurons
24-72 hrs: necrosis + neutrophils
3-5 d: macrophages
1-2 weeks: reactive gliosis and vascular proliferation
>2 weeks: glial scar
91
Q

MC site of intracerebral hemorrhage?

A

basal ganglia

92
Q

foramen of luschka vs magendie?

A

both drain 4th ventricle to sub arachnoid space
luschka = lateral
magendie = medial

93
Q

tx of pseudotumor?

A

weight loss
acetazolamide
topamax
invasive: repeat LPs, shunt, optic n fenestration

94
Q

communicating vs non communicating hydrocephalus?

A

communicating: decreased CSF absorption by granulations

non-communicating: structural blockage of CSF system

95
Q

which spinal nn exit above vs below their corresponding vertebrae?

A

C1-C7: above

C8 –> : below

96
Q

where does the spinal cord end in adults? what about the subarachnoid space?

A

spinal cord: L1-L2

subarachnoid space: lower border of S2

97
Q

where do dorsal column fibers decussate?

A

medulla –> ascends in medial lemniscus

98
Q

where do spinothalamic tract fibers decussate?

A

spinal cord - anterior white commissure –> ascend contralaterally

99
Q

where do lateral corticospinal tract fibers decussate?

A

caudal medulla - pyramid –> descend contralaterally

100
Q

flaccid paralysis only?

A

anterior horn cell dz - polio, SMA

101
Q

UMN and LMN signs?

A

ALS

can be defect in superoxide dismutase

102
Q

tx of ALS?

A

riluzole (riLOUzole)

decreases presynaptic glutamate release

103
Q

impaired sensation and proprioception, progressive sensory ataxia?

A

tabes dorsalis

** assoc with Charcot jt, shooting pain, Argyll-Robertson pupil

104
Q

bilateral loss of pain and T?

A

syringomyelia

    • often at C8-T1
    • assoc with chiari I
105
Q

ataxic gait, paresthesias, impaired position and vibratory sense?

A

B12 deficiency

106
Q

polio lifecycle?

A

fecal-oral transmission

replicates in oropharynx and SI –> bloodstream –> CNS

107
Q

polio CSF findings?

A

increased WBCs and slight increase of protein

108
Q

staggering gait, frequent falls, pes cavus, hammer toes, diabetes, HOCM, kyphoscoliosis?

A

friedrich ataxia - AR
trinuc repeat on ch 9 - frataxin gene
impairment in mitochondrial functioning

109
Q

dermatome - posterior skull cap?

110
Q

dermatome - high turtleneck shirt?

111
Q

dermatome - low collar shirt?

112
Q

nipple dermatome?

113
Q

xiphoid process dermatome?

114
Q

umbilicus dermatome?

115
Q

inguinal ligament dermatome?

116
Q

kneecap dermatome?

117
Q

nerve root for reflexes?

A 
biceps = C5
triceps = C7
patella = L4
achilles = S1
cremaster = L1, L2
anal wink = S3, S4
118
Q

which CN nuclei lie medially at brain stem?

A

III, IV, VI, XII

119
Q

superior vs inferior colliculi?

A

in midbrain

superior: conjugate vertical gaze (affected in Parinaud syndrome)
inferior: auditory

120
Q

CN nuclei in midbrain?

A

CN III

CN IV

121
Q

CN nuclei in pons?

A

CN V, VI, VII, VIII

122
Q

CN nuclei in medulla?

A

CN IX, X, XII

123
Q

CN nuclei in spinal cord?

124
Q

lateral vs medial CN nuclei?

A 
lateral = sensory
medial = motor
125
Q

what exits through optic canal?

A

CN II
ophthalmic artery
central retinal v

126
Q

what exits through sup orbital fissure?

A

CN III, IV, V1, VI
ophthalmic v
sympathetics

127
Q

what exits through foramen rotundum?

128
Q

what exits through foramen ovale?

129
Q

what exits through foramen spinosum?

A

middle meningeal artery

130
Q

what exits through internal auditory meatus?

A

CN VII, VIII

131
Q

what exits through jugular foramen?

A

CN IX, X, XI, jugular vein

132
Q

what exits through hypoglossal canal?

133
Q

what exits through foramen magnum?

A

spinal roots of CN XI
brain stem
vertebral aa

134
Q

which cranial n controls the orbicularis oculi?

135
Q

which cranial n controls the stapedius?

136
Q

which cranial n monitors carotid body and sinus?

137
Q

which cranial n monitors aortic arch chemo and baroreceptors?

138
Q

which CN nucleus does visceral sensory information?

A

nucleus solitarius

CN VII, IX, X

139
Q

which CN nucleus does motor to pharynx, larynx, upper esoph?

A

nucleus ambiguus

CN IX, X, XI (cranial portion)

140
Q

which CN nucleus sends parasympathetic fibers to heart/lungs/upper GI?

A

dorsal motor nucleus

141
Q

afferent and efferent nn of corneal reflex?

A

V1 ophthalmic –> VII (temporal – orbicularis oculi)

142
Q

afferent and efferent nn of lacrimation reflex?

A

V1 –> VII

143
Q

afferent and efferent nn of jaw jerk reflex?

A

V3 (sensory spindle from masseter) –> V3 (motor masseter)

144
Q

afferent and efferent nn of pupillary reflex?

A

II –> III

145
Q

afferent and efferent nn of gag reflex?

146
Q

what runs in cavernous sinus?

A

blood vessels from eye and superficial cortex
CN III, IV, V1 (V2)
postgang sympathetic pupillary fibers
cavernous portion of ICA

147
Q

variable ophthalmoplegia, decreased corneal sensation, Horner, decreased maxillary sensation?

A

cavernous sinus syndrome
2/2 pituitary tumor mass effect, carotid-cavernous fistula, cavernous sinus thrombosis

** CN VI most susceptible to injury

148
Q

low frequency sounds heard best where?

A

at apex of basilar membrane in cochlea
near helicotrema
wide and flexible

149
Q

high frequency sounds heard best where?

A

at base of basilar membrane in cochlea

thin and rigid

150
Q

overgrowth of desquamated keratin debris w/in middle ear space?

A

cholesteatoma

** may erode ossicles, mastoid air cells –> conductive hearing loss

151
Q

facial UMN vs LMN lesion?

A

UMN –> forehead sparing (dual innervation)

LMN –> forehead involved

152
Q

which mm of mastication close the jaw?

A

masseter
temporalis
medial pterygoid

153
Q

which mm of mastication open the jaw?

A

lateral pterygoid

BT_anatomySTEP (10 decks)

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