NEURO: first aid 2015 pg 455-459 Flashcards
what is athetosis? lesion in? seen in what?
writhing, snake-like movement
- BG
- Huntington
bilateral atrophy of caudate and putamen seen in which?
Huntington
what is dystonia?
substained, involuntary muscle contractions
treatment of essential tremor
BB, primidone
intentional tremor, lesion in what?
cerebellum
lists the tremor(s) alleviated by intentional movement
resting tremor and intentional tremor
essential is worsened with movement
myoclonus is common in which metabolic abnormalities
renal and liver failure
Patient with Hemiballismus. Lesion in which? ipsi or contralateral?
contralateral subthalamic nucleus
Hemiballismus caused by what kind of stroke?
lacunar
Lists symptoms of parkinson disease (5 of them)
TRAPS Parkinson TRAPS your body: Tremor (pill-rolling tremor at rest) Rigidity (cogwheel) Akinesia (or bradykinesia) Postural instability Shuffling gait
(contralateral or ipsilateral) proprioceptive information from spinal cord travel to cerebellum through ____ ?
inferior cerebellar peduncle
Input from (contralateral or ipsilateral) cortex to cerebellum through ____ ?
middle cerebellar peduncle
output: Cerebellum to cortex through ____ ?
Superior cerebellar peduncle
patient has damage to lateral lobes of cerebellum. what are the symptoms?
fall towards injured sides
xxx voluntary movement extremities xxx
Patient with truncal ataxia. which part of cerebellum
vermis, fastigial nuclei, or flocculonodular lobe
- bilateral motor deficits of axial and proximal limb mucles
- extremities
- midline structures
2. lateral lesions
List the deep nuclei in cerebellum
Don’t Eat Greasy Food
Dentate, Emboliform, Globose, Fastigal
circardian rhythm which nucleus
suprachiasmatic nucleus
describe the pathway of melatonin release
SCN–> NE –> pineal gland –> Melatonin
Extraocular movements during REM sleep is due to activity of what?
PPRF
paramedian pontine reticular formation/conjugate gaze center
List the causes that decrease REM
alcohol, benzo, barbituates, norepi
why does depression has total REM increased?
decreased NE
when stage of sleep does bedwetting occur? and what other 2 patho occurs in that stage too?
Stage N3 (Delta) others: sleep walking, night terrors
what are the difference between nightmares and night terrors?
nightmare in delta non REM
night terrors in REM (Thats why you remember)
Treatment of night terrors
BDZ
treatment of sleepwalking
BDZ
treatment of sleep enuresis
oral desmopressin ADH analog
Bruxism, which stage
“You grind your teeth like spindles and complexes in most amount of time”
- Sleep spindles and K complexes.
- which is stage N2 (45% = most amount of time)
What happen in REM
- eyes
- motor
- brain O2
- pulse and BP
-eyes: REM
-motor: loss
-brain O2: increased
-pulse and BP: increased and variable
- sex arousal
-dream
“BRAIN ON BODY OFF”
List the stages of sleep
at night, BATS Drink Blood Beta Alpha Theta Sleep spindles and K complexes Delta Beta
where do you see Beta
eyes open and REM
highest f, lowest A
B
lowest f, highest A
Delta
slow and big
T or F
Thalamus relay for all ascending sensory information
F
NOT olfaction
VPL
input?
Spinothalamic and DC
to 1o ss cortex
where does trigeminal and gustatory pathway go?
VPM
LGN is for?
light
MGN is for
Music
hearing
Superior olive + inferior colliculus of tectum –> MGN –> auditory cortex of temporal lobe
Motor info to which part of thalamus
VL
What part of thalamus is affected in W-Korsakoff?
Ant + Dorsomedial thalamus
what’s the famous 5 F’s of limbic system
Feeding, fighting, fleeing, feeling, Sex
T or F
olfaction is closely linked to limbic system
T
You correct hyponatremia too quickly…what patho?
Central pontine myelinolysis
what about correct high to low too quickly?
cerebral edema/ herniation
what is pseduobulbar palsy and give one example of syndrome associated with it
Pseudobulbar palsy is CN 9,10,11 affected but not their actual nuclei. Just their axons are demyelinated.
symptoms: head and neck muscle weakness, dysphagia, dysarthria
DDx: Bulbar palsy: nuclei of 9,10,11
describe the NTs change in Huntington
Increased DA
Decreased GABA and Ach
Huntington Genetics
AD Trinucleotide repeat on chr 4
Huntington patients are usually misdiagnosed for what?
substance abuse
Atrophy of which nucleus seen in Huntington
caudate and putamen
Ex vacuo hydrocephalus is seen in Huntington why?
frontal horns of lateral ventricles. atrophy of striatum
What is anticipation
Increased severity of disease in successive generation
CAG repeats = Caudate Ach GABA = all loss :(
