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IPAP JUNIOR SEM. > NEURO BLOCK 1 > Flashcards

NEURO BLOCK 1 Flashcards

1
Q

What does the word lancinating mean

A

Knife like radicular pain

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2
Q

What is diplopia

A

Double vision

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3
Q

What is dysphagia

A

Difficulty swallowing

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4
Q

What is parasthesia

A

Burning, tingling, pricking

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5
Q

What is dyskenesia

A

Involuntary movements

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6
Q

What is the cerebellar portion of your brain responsible for

A

Coordinated movements

```
When lesions are here it causes
Altered coordination
Abnormal equilibrium
Dizzyness, vertigo
Tremors
~~~

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7
Q

Thunderclap head ache, or “worst head ache of my life… think

A

Subarachnoid Hemorrhage

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8
Q

Sudden blindness think..

A

Amaurosis fugax/ hypoperfusion to the retinal circulation

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9
Q

Back pain worse at night, think..

A

Cancer

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10
Q

Loss of bowel or urinary control think..

A

Cauda equina

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11
Q

What are the criteria for a focused physical neuro exam

A 
General impression 
Mental Status 
Cranial nerves 
Motor System 
Reflexes
Sensory 
Coordination 
Gait
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12
Q

A score of less than 24 on a mini mental status exam indicates..

A

Cognitive D/o

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13
Q

List the Cranial nerves

A 
Olfactory 
Optic 
Oculomotor 
Trochlear 
Trigeminal 
Abducens
Facial 
Vestibulocochlear (auditory) 
Glossopharyngeal 
Vagus 
Spinal 
Hypoglossal
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14
Q

Decreased muscle tone is most commonly a sign of what..

A

Decreased tone is most commonly due to lower motor neuron or peripheral nerve disorders.

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15
Q

How are DTRs graded

A 
4/4: hyperactive +/- clonus
3/4: exaggerated response
2/4: “normal”
1/4: diminished response
0/4: absent reflexes
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16
Q

How is strength graded

A 
0 = no movement
1 = flicker or trace of contraction but no associated movement at a joint
2 = movement with gravity eliminated
3 = movement against gravity but not against resistance
4– = movement against a mild degree of resistance
4 = movement against moderate resistance
4+ = movement against strong resistance
5 = full power
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17
Q

What is the motor, reflex, and sensation for C5

A

Motor: deltoid
Reflex: biceps reflex
Sensation: Lateral upper arm

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18
Q

What is the Motor, Reflex, sensation for C6

A

Motor: Wrist extension
Reflex: Forarm reflex
Sensation: radial side of forearm and hand (first two digits)

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19
Q

What is the motor, reflex, and sensation for C7

A

Motor: wrist flexion
Reflex: tricep tendon
Sensation: middle of palm and middle finger

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20
Q

What is the motor, reflex, and sensation for C8

A

Motor: finger flexion
Reflex: none
Sensation: Ulnar side of forearm and had ( last two digits)

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21
Q

What is the motor, reflex, and sensation for L4

A

Motor: tibialis anterior
( foot inversion)
Reflect: patellar tendon
Sensation: medial side of the foot

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22
Q

What is the motor, reflex, and sensation of L5

A

Motor: extensor digitorum longus
Reflex: none
Sensation: middle of the food
(Majority of toes)

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23
Q

What is the motor, reflex, and sensation for S1

A 
Motor: peroneus longus and brevis 
(Foot eversion) 
Reflex: Achilles’ tendon 
Sensation: Lateral portion of foot
(Pinky toe)
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24
Q

What is babinski sign

A

with upper motor neuron lesions above the S1 level of the spinal cord, a paradoxical extension of the toe is observed, associated with fanning and extension of the other toes

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25
Q

What is the palmomental response

A

A primitive reflex

Contraction of mentalis muscle ipsilateral to a scratch stimulus diagonally applied to the palm

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26
Q

T4-5 dermatomes is where

A

Across the nipple line

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27
Q

T 10 dermatomes is where

A

Umbilicus

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28
Q

What nerve root moves the trapezius

A

C3-4

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29
Q

What is the most important part of a neuro exam

A

Observation of gait

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30
Q

What platelet count is a C/I for lumbar puncture

A

A count less than 20,000

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31
Q

When should warfarin be stopped prior to lumbar puncture

A

4-5 days prior

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32
Q

When should ticlopidine or Clopidogrel be stopped prior to Lumbar puncture

A

D/c 14 and 7 days respectively

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33
Q

What is the landmark for a Lumbar o puncture

A

L3-4

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34
Q

What is the principle complication of lumbar puncture

A

Headache

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35
Q

Tx approach to headache caused by lumbar puncture

A

Analgesics, caffeine or epidural blood patch

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36
Q

Are there any C/I to EEG

A

No

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37
Q

What are the 4 Indications for CT in neuro

A

Stroke or Sub Arac Hem

Tumor ( -/+ contrast)

Trauma

dementia
(Detect atrophy, hydrocephalus)

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38
Q

What is the definition of contrast nephropathy

A

A rise in serum creatinine of at least 0.5 mg/dL within 48 h of contrast administration is often used as a definition of contrast nephropathy

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39
Q

When should Creatinine testing be done for CT

A

Age >60

History of “kidney disease” as an adult, including tumor and transplant

Family history of kidney failure

Diabetes mellitus treated with insulin or other prescribed medications

Hypertension

Paraproteinemia syndromes or diseases (e.g., myeloma)

Collagen vascular disease (e.g., SLE, scleroderma, rheumatoid arthritis)

Solid organ transplant recipient

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40
Q

The American college of Radiology recommends GFR assessment with MRI on what criteria

A

Must be obtained within 6 weeks before MRI if:

A history of renal disease (including solitary kidney, renal transplant, renal tumor)
Age >60 years

History of hypertension

History of diabetes

History of severe hepatic disease, liver transplant, or pending liver transplant; for these patients, it is recommended that the patient’s GFR assessment be nearly contemporaneous with the MR examination.

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41
Q

What is a pet scan

A

Positron emission tomography

Functional imaging study

Demonstrates perfusion and metabolic activity

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42
Q

What is the use of Myeolgrpahy

A

Inject contrast through LP needle to visualize subarachnoid space

Evaluate degree of cord compression, AVMs, epidural abscesses, and tumors

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43
Q

Are sensory neurons afferent or efferent

A

Afferent

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44
Q

Are motor nuerons afferent or efferent

A

Efferent

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45
Q

Where is the development of the CNS and PNS

A

CNS is from the neural tube (Brian and spinal cord)

PNS is from the neural crest

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46
Q

At what week of fetal development does the Nervous system begin

A

Week 3

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47
Q

What is the first step in neural plate development

A

Thickening of the ectoderm

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48
Q

What happens after the ectoderm thickens in NS plate development

A

The neural plate folds inward forming a longitudinal groove or neural groove.

49
Q

What are the 3 layers of the neural tube

A

The outer layer (marginal layer) cells develop into white matter.

The middle layer (mantle layer) cells develop into gray matter.

The inner layer (ependymal layer) cells eventually form the:

  • Lining of the central canal of the spinal cord
  • Ventricles of the brain.
50
Q

White matter develops from…

A

The marginal layer of the neural tube

51
Q

Gray matter develops from

A

The mantle layer of the neural tube

52
Q

The lining of the central canal of the spinal sword and the ventricles of the brain develop from ..

A

The ependymal layer of the nueral tube

53
Q

What does the nueral crest give rise to

A

Dorsal/posterior root ganglia of spinal nerves

Spinal nerves

Ganglia of cranial nerves.

Cranial nerves

Ganglia of the ANS

Adrenal medulla

Meninges

54
Q

When does nueral tube closure happen ( at what week/ days )

A

26-28 days post conception

55
Q

What are the 3 major neural tube defects

A

Anencephaly, Encephalocele, Menigomyelocele

56
Q

What is anencephaly

A

Failure of the anterior neuropore to close.

Cranial bones fail to develop and brain degenerates

1:1000

2 to 4x more common in females than males

57
Q

What is myleomenigiocele

A

AKA Spina bifida

Failure of the posterior neuropore to form.

Most commonly in the sacrolumbar region (80%)

58
Q

What supplements can be added to reduce the RSK of neural tube deficits

A

Folic acid ( 0.4 mg q day) (one month prior to conception)

High risk? (4mg q day) (3 months prior to conception)

59
Q

What are the 4 major parts of the Brain

A

Brain stem
Cerebellum
Diencephalon
Cerebrum

60
Q

What are the 3 parts of the brain stem

A

Medulla
Pons
Midbrain

61
Q

What are the two major parts of the diencephalon

A

Thalmus and the Hypothalmus

62
Q

What is the connection between R and L hemispheres of the brain

A

The corpus Callosum

63
Q

Destruction of the motor and pre motor cortex of the frontal lobe leads to..

A

Spastic paresis

64
Q

Destruction of the frontal eye field of the frontal lobe leads to..

A

Ipsilateral deviation of the eyes

65
Q

Where is brochas speech area located

A

In the posterior frontal gyrus of the dominant hemisphere

66
Q

What are the results of damage to the prefrontal cortex

A

Destruction of the anterior 2/3 results in deficits in concentration, orientation, abstracting ability, judgment, and problem solving.

Destruction in other areas may cause loss of initiative, inappropriate behavior, gait apraxia, sphincteric incontinence.

Destruction of the orbital portion results in inappropriate social behavior such as use of obscene language or urinating in public

67
Q

What is the result of damage to the primary auditory cortex in the temporal lobe

A

Loss of hearing (cortical deafness)

68
Q

Where is wernickes speech area located

A

Posterior part of the superior gyrus of the temporal lobe

69
Q

Where is meyers loop located and what happens if it is damaged

A

In the temporal lobe, and Interruption results in contralateral homonymous superior quadrantanopia (pie in the sky)

70
Q

Where are the olfactory bulb, tract, and primary cortex located

A

In the temporal lobe, responsible for smell

71
Q

Where is the hippocampal cortex located

A

In the temporal lobe

Bilateral lesions result in inability to consolidate short-term memory into long term memory.

72
Q

What is prosopagnosia

A

Inability to recognize faces

A function of the inferiomedial occipitotemporal complex

73
Q

What is asterognosis

A

The ability to ID objects by feel only

Close eyes and ID an object by touch

74
Q

Where is the sensory cortex located

A

In the parietal lobe

75
Q

What is the result of damage to the superior parietal lobe

A

Destruction results in contralateral astereognosis and sensory neglect

76
Q

What is the result of damage to to the inferior parietal lobe

A

Leads to topographic memory loss, anosognosia, construction apraxia, dressing apraxia, contralateral sensory neglect, and contralateral hemianopia or lower quadrantanopia

77
Q

What is the most common transmitter at postganglionic sympathetic neurons

A

NE

78
Q

What is the major inhibitory NT of the brain

A

GABA

79
Q

What is the major inhibitory NT of the spinal cord

A

Glycine

80
Q

What is the major excitatory NT of the brain

A

Glutamate

81
Q

What is the single most common finding in aphasia pts

A

Anomia ( a deficit of naming)

82
Q

What is non fluent aphasia

A

Brocas

83
Q

What is fluent aphasia

A

Wernickes

84
Q

Neglect is a sign of..

A

Cortical D/o of the right frontal or parietal lobes

85
Q

What are the components of the basal ganglia

A

the globus pallidus
The Putamen make up the lentiform nucleus and combined with the

The caudate nucleus

make up the corpus straitum

86
Q

What is the function of the basal ganglia

A

Coordianate muscle aditivo y

87
Q

Damage to the basal ganglia results in..

A

Damage to the basal ganglia results in uncontrollable shaking (tremor), muscular rigidity (stiffness), and involuntary muscle movements.
(All Parkinson’s criteria eg: Cogwheel stiffness)

Parkinson’s:
dopamine-producing neurons of the basal ganglia degenerate

Huntington’s disease:
damage to the corpus striatum

88
Q

What is the “master control for the ANS”

A

Hypothalmus

Also controls the pituitary gland

89
Q

What is the epithalmus

A

The pineal gland

90
Q

What are the 5 structures that make up the limbic system

A 
Amygdala
Cingulate Gyrus
Midbrain Raphae
Locus Ceruleus
Hippocampus
91
Q

What is the function of the limbic cortex

A

Emotion, eating, and reproduction

92
Q

What is the function of the amygdala

A

Chief role in the memory of emotional experiences

Central role in behavioral responses to fear

93
Q

What is the role of the hippocampus

A

Integrator of incoming novel and unpleasant stimuli.

Connects w/ temp. lobe closely

May predict the next event based on what has already happened.

94
Q

What are the 3 functions of the cerebellum

A

Sensory perception
Coordination
Motor control

95
Q

Do lesions in the cerebellum lead to paralysis

A

No

Instead they cause feedback D./o

Posture
Equilibrium
Motor Learning

Like ataxias

96
Q

What is the difference between the pyramidal and extra pyramidal functions of the midbrain

A

Tracts responsible for movement pass through here

Pyramidal:
Voluntary movements

Extrapyramidal:
Involuntary movements
Posture/adjustments/coordination

97
Q

Where is the RAS located and what is its function

A

The pons Contains the RAS and controls respirations

Is the Consciousness center

98
Q

Where does the spinal cord extend to (what vertebra)

A

L1-2

99
Q

Gray matter in the spinal cord is what

A

Nerve cell bodies

100
Q

White matter in the spinal cord is what

A

Mylienated nerves

101
Q

Where do Upper motor nuerons originate

A

In the cortex and Brain stem

102
Q

Where do Lower motor nuerons originate

A

Begin in the anterior horn of the spinal column

103
Q

In the spinal cord:

The anterior root has what kind of fibers

The posterior root has what kind of fibers

A

Anterior: motor (efferent)

Posterior: sensory (afferent)

104
Q

What is the function of the coticospinal tract

A

Voluntary motor activity

105
Q

What is the function of the spinothalamic tract

A

Pain, temp, light/crude touch, pressure

106
Q

What is the function of the dorsal columns of the spinal tract

A

Fine touch, 2 point discrimination, and proprioception

107
Q

How do the spinthalamic tract and dorsal column ascend up the spinal cord

A

Spinothalamic: enter and cross midline immediately

Ascend to the thalamus in the spinothalamic tract, on opposite side

Dorsal columns: Sensory impulses ascend up the same side as fibers enter the cord

Fibers cross the midline at medulla

108
Q

Cord lesions of the corticospinal tract produce

A

Ipsilateral S/s

109
Q

Cord lesions of the dorsal columns produce

A

Ipsilateral S/s

110
Q

Cord lesions of the spinothalamic tract produce

A

Contralat s/s

111
Q

What is the blood flow through the circle of Willis

A
  1. Internal carotid artery
  2. Vertebral artery
  3. Cavernous sinus
  4. Carotid canal
  5. Anterior cerebral artery
  6. Posterior cerebral artery
112
Q

Poor circulation in the anterior cerebral artery affects what area

A

The lower limb area of the motor cortex

113
Q

Poor perfusion to the middle cerebral artery has effects where

A

Affects the face and upper limb
are of the motor cortex

Also affects the dominant language hemisphere

Occlusion of either the ACA or MCA may lead a devastating stroke

114
Q

Poor profusion to the basilar artery has effects where r

A

Leads to both Left and Right PCA

Occlusion of the vertebrobasilar system leads to “drop attacks”

Complete occlusion results in blindness

115
Q

What are the 4 vessels that make up “posterior circulation:” of the brain

A

The superior cerebellar artery
The posterior inferior cerebellar artery
The anterior inferior cerebellar artery
And the basilar artery

116
Q

What are the 3 layers of the meninges

A

Dura mater: outermost layer
Arachnoid mater: lies above the subarachnoid space
Pia mater: the delicate inner layer that directly covers the brain

117
Q

Where is CSF secreted from

A

Secreted by choroid plexus, absorbed in subarachnoid space

118
Q

What is an encephaloele

A

Nueral tube defect

Anterior pore defect
Least common of the 3 NTD

Classification is based on location

Occipital is the most common encephalocele

119
Q

What is the function of the ANS

A

Regulates glands, smooth muscle, cardiac muscle

Sympathetic: fight or flight
Fibers exit spinal cord at T1-L2

Parasympathetic: Restorative, conserve energy
Fibers exit through CN III, VII, IX, X, and S2-S4 to gut and bladder

Hypothalamus provides the master control for ANS

IPAP JUNIOR SEM. (43 decks)

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