NEURO-BEHMED Flashcards by TRINA KRIZELDA OANDASAN

Sleep Stage

Eyelids begin to drop, Muscles start to Relax
Loss of ALPHA WAVES
Presence of VERTEX SHARP WAVES
but no sleep spindles
Lasts for 5 to 10 minutes

Stage 1 NREM

How well did you know this?

Not at all

Perfectly

Sleep Stage

Presence of HIGH VOLTAGE VERTEX WAVES WITH SLEEP SPINDLES (7 to 14 Hz lasting for 0.5 secs)
Lasts for 15 to 30 minutes

Stage 2 NREM

How well did you know this?

Not at all

Perfectly

Sleep stage aka DEEP SLEEP
>50% occupied by high voltage delta waves
Lasts 30 to 45 minutes

Stage 3 NREM

How well did you know this?

Not at all

Perfectly

Sleep stage
Low voltage intermixed cerebral activity with absent muscle tone
(+) Saw tooth waves
Appears 90-100 minutes in young adults
State of paradoxical sleep which means your metabolic activity brain function is similar to the in wakefulness

REM

Low voltage intermixed cerebral activity with absent muscle tone but rapid eye movement

How well did you know this?

Not at all

Perfectly

HORNERY’S SYNDROME

3 characteristics

Ptosis
Myosis
Anhidrosis

How well did you know this?

Not at all

Perfectly

Imaging Studies of Alzheimer’s

CSF Studies of Alzheimer’s

Imaging:
Diffuse Cortical Atrophy
Hippocampal Atrophy

CSF:
BETA AMYLOID
PHOSPHORYLATED TAU

How well did you know this?

Not at all

Perfectly

Pathology of Alzheimer’s

Neuritic Plaques (amyloid beta peptides accumulating extracellularly)
Neurofibrillary tangles (abnormally phosphorylated tau protein which accumulates intracellularly)

How well did you know this?

Not at all

Perfectly

Which motor cortex is involved in sensory guidance of movement, controls the more proximal muscles and trunk muslces

Premotor Cortex

How well did you know this?

Not at all

Perfectly

Which motor cortex generates neural impulses that control the execution of movement

Primary motor cortex

How well did you know this?

Not at all

Perfectly

Which motor cortex is involved in transforming visual information into motor commands

Posterior Parietal Cortex

How well did you know this?

Not at all

Perfectly

Which motor cortex is involved in the planning of complex movements and coordinating two-handed movements like typing

Supplementary Motor Area

How well did you know this?

Not at all

Perfectly

Charcot’s Triad

Multiple Sclerosis - Charcot’s Triad

Nystagmus
scanning speech
intention tremor

How well did you know this?

Not at all

Perfectly

Disease that results in demyelination and axonal degeneration of the brain and spinal cord

Multiple Sclerosis

How well did you know this?

Not at all

Perfectly

1st or earliest manifestation of MS

Optic Neuritis

How well did you know this?

Not at all

Perfectly

Define the UHTHOFF PHENOMENON

a reversible exacerbation of neurological symptoms following an increase in body temperature ex. exercise, warm bath, fever

How well did you know this?

Not at all

Perfectly

Presence of Multiple Oligoclonal Bands in CSF and their absence in the blood is highly suggestive of ________

Multiple Sclerosis

How well did you know this?

Not at all

Perfectly

Parasympathetic vs Sympathetic
In terms of:
Nerves - Alin ang T5-L2?
innervation - alin ang direct/indirect?
Where does sympathetic start?
neurotransmitter?
alin ang stimulatory? aling ang inhibitory?

T5-L2 - Sympathetic
direct - para
distal 1/2 of large intestine to anus and para
Para - Ach
Sympa - NE
para - stimulatory (IKR baliktad) hahaha
^cos it stimulates Secretory and Motor Activity
Slide 366 of Jasshin ppt

How well did you know this?

Not at all

Perfectly

Dorsal column vs Anterolateral

Touch pressure, Position Sense, Vibration, Kinesthesia

Dorsal

How well did you know this?

Not at all

Perfectly

Dorsal column vs Anterolateral

Pain, temp, crude-touch

Anterolateral

How well did you know this?

Not at all

Perfectly

Dorsal column vs Anterolateral
Somatotrophic organiztion
alin ang strictly maintained?

Dorsal column

How well did you know this?

Not at all

Perfectly

Dorsal column vs Anterolateral
alin ang large myelinated?
alin ang small myelinated and unmyelinated?

large - dorsal

small - anterolateral

How well did you know this?

Not at all

Perfectly

Dorsal column vs Anterolateral

alin ang nagbbrainstem termination sa VPL, posteiror nuclear group of thalamus, Brainstem reticular formation

Anterolateral

How well did you know this?

Not at all

Perfectly

Dorsal column vs Anterolateral

Cerebral termination of both

Primary and Secondary somatic sensory cortices &

Somatic sensory association area

How well did you know this?

Not at all

Perfectly

FAST/INITIAL PAIN
Description
Pathway
Effect

Discrete, well-localized, pinprick sensation
A Delta fibers - > Spinothalamic Tract
topographically represented in cortex

Withdrawal Reflex and Sympathetic Response

How well did you know this?

Not at all

Perfectly

SLOW/DELAYED PAIN Description Pathway Effect

Poorly-localized, Dull, Burning sensation C Fibers -> Spinoreticulothalamic collaterals pass through reticular formation produces emotional peretion, nausea, profuse sweating, lowering of BP generalized reduction in skeletal muscle tone

NEUROPATHIC PAIN - caused by Facilitated by which neurotransmitters opening which channels? Examples?

NEUROPATHIC PAIN - caused by damage to neural structures faci: glutamate & aspartate --> opening of K channels** inh: GABA & glycine --> Cl conductance across cell membranes Diabetic Neuropathy, Herpes Zoster

``` DERMATOMAL LANDMARKS T4 spinal nerve T10 spinal nerve L1 L5 S1 ```

``` DERMATOMAL LANDMARKS T4 spinal nerve - nipple T10 spinal nerve - umbsilicu L1 - groin L5 - big toe S1 - small toe ```

``` DERMATOMAL LANDMARKS nipple umbsilicus groin big toe small toe ```

``` T4 T10 L1 L5 S1 ```

Matching type: Neurotransmitter and corresponding cell Norepinephrine Glutamate, Aspartate Dopamine Raphe nuclei

NE - locus ceruleus of pons Glumate, Aspartate - pyramidal cells Dopamine - Substantia nigra pars compacta Serotonin - Raphe Nuclei

Americal Spinal Injury Association (ASIA) impairment scale

Basta ASIA E yung intact all sensory and motor function :) ASIA B, C, D (+) Sensation on S4-S5 Nagkakaiba lang sa if majority are graded 3/5 sa MMT ASIA A - absence of motor or sensory function in the sacral segments S4-S5

Pain-senstive vs. Pain Insensitive!!!!! HI YIELD

``` JUST REMEMBER PAIN INSENSITIVE PECPADS Parenchyma of the brain Ependyma Choroid Pia Arachnoid Dura over convexity Skull ```

PAIN INSENSITIVE STRUCTURES PEPCPADS

``` PECPADS Parenchyma of the brain Ependyma Choroid Pia Arachnoid Dura over convexity Skull ```

Homunculus shows the somatotrophic organization of different body parts on the cerebral cortex lateral 1/3 middle 1/3 medial 1/3

lateral 1/3 - face middle 1/3 - upper ex medial 1/3 - lower ex, perianal areas basta face yung pinakadulo mga nasa side

CIRCLE OF WILLIS Anterior circulation supplies Posterior circulation supplies

``` Ant Circ (80%) from ICA Post Circ (20%) from Vertebral Artery ```

``` CIRCLE OF WILLIS Ano sinusupply nila? MCA ACA PCA BAsilar ```

MCA - lateral part of the cerebrum (UE, face) ACA - supplies the medial part of the cerebrum (LE) PCA - supplies occipital lobe, thalamus BAsilar

Lesion of the ACA will present as

contra lower extremity weakness, incontinence, impaired judgment

Lesion of the MCA will present as

face and upper extremity motor deficit language deficit acalculia apraxia

Lesion of the PCA will present as

3rd nerve palsy contra ataxia hemiballismus

Lesion of the Basilar Artery will present as

crossed motor/sensory syndrome | intranuclear opthalmoplegia

UMNL vs LMNL Alin ang may spastic paresis? flaccid paresis? Alin ang may atrophy? Alin ang increased DEEP TENDON REFLEXES? Alin ang may pathologic reflex? (+) babinski Alin ang may superficial reflexes? Fasiculation and fibrillation?

``` spastic paresis - Upper flaccid - lower atrophy - lower DTR - upper pathologic reflex - upper superficial reflex and fasciculations - lower ```

Broca's vs Wernicke's Aphasia? Alin and motor/expressive aphasia? Alin ang sensory/receptive aphasia? Alin yung bobo, nakakapagsalita pero walang sense? Alin yun hindi salita ng salita/non-fluent pero comprehension is spared?

Expressive aphasia - cannot express = broca’s pero nakakaunderstand

broca's area is at which gyrus? | wernicke's area is at which gyrus?

inferior frontal gyrus | superior temporal gyrus

Matching type Cerebral cortex vs Brainstem Contralateral face and body - alin to sa dalawa? Ipsilateral face, contralateral body - alin to sa dalawa? internal capsul stroke question thingyyy***

contra both - cortex | ipsi face contra body - brainstem

Flow of CSF

Lateral ventricles --> interventricular foramen of marilyn --> 3rd ventricle --> aqueduct of sylvius --> 4th ventricle --> medial and lateral apertures --> subarachnoid space

Parts of the brainstem plus corresponding CNs

Midbrain - 3,4 Pons - 5,6,7,8 Medulla - 9,10,11,12

Lesion of the optic nerve

ipsilateral monocluar blindness

Lesion of the oculomotor nerve***

Diplopia, Exotropia (Esotropia sa abducens nevrve prob) Ptosis Midriasis

Lesion of the trochlear nerve

Vertical Diplopia

Lesion of the abducens nerve

Esotropia (Internal Strabismus) | Horizontal diplopia

Lesion of the facial nerve

bell's palsy (whole ipsi side of the face)

Lesion of the vestibulocochlear nerve

BPPV, sensorineural hearing loss

Lesion of the vagus nerve

contralateral deviation of the uvula (deviation toward the strong side cos hinihila ng strong side) hila motion

Lesion of the accessory nerve

SCM, trapezius paralysis

Lesion of the hypoglossal nerve

ipsi deviation of the tongue on protrusion (deviation toward the weak side) tulak motion

CN Reflexes Afferent & Efferent Limb Pupillary Light Reflex Corneal Reflex Gag Reflex

Pupillary Light Reflex - CN 2 --> 3 Corneal Reflex - CN 5 --> 7 Gag Reflex - CN 9 --> 10

``` LMNL Anterior horn cells Peripheral Nerve NMJ Muscles ```

Anterior horn cells - poliomyelitis, motor neuron disease Peripheral Nerve - peripheral neuropathy NMJ - myasthenia gravis Muscles - muscular dystrophies

Cushing's Triad

1. systemic hypertension 2. dec. PULSE 3. dec. RESPI (basically vital signs)

Cardinal Symptoms of Parkinson's

``` TRAP Tremor Rigidity Akinesia/Bradykinesia Postural Instability ```

``` Most common intracranial tumor Most common tumor of childhood most common primary brain tumor in adults most common benign cns tumor most common malignant tumor in children ```

Most common intracranial tumor - Metastasis Most common tumor of childhood - Pilocytic Astrocytoma (Glioma) clue** mahilig mga bata sa astro most common primary brain tumor in adults - Glioblastoma multiforme most common benign cns tumor - meningioma most common malignant tumor in children - medulloblastoma

Subdural Hematoma vs Epidural Hematoma ``` Alin ang concave/crescent shaped? Alin ang convex or lense shaped? alin ang middle meningeal artery? alin ang may lucid interval? alin ang bridging veins? alin ang elderly, alcoholics? ```

Subdural Hematoma vs Epidural Hematoma Alin ang concave/crescent shaped? - subdural Alin ang convex or lense shaped? - Epidural alin ang middle meningeal artery? - Epidural alin ang may lucid interval? - Epidural alin ang bridging veins? - Subdural alin ang elderly, alcoholics? - Subdural

nuchal translucency thickness

<2.2-2.8