Neuro First Aid Flashcards
NE location of synthesis
locus ceruleus (pons)
NE changes in anxiety and depression
dec in depression
inc in anxiety
DA location of synthesis
ventral tegmentum and Substantia nigra pars compacta (midbrain)
DA changes in schizophrenia, PD, depression
inc schizophrenia
dec PD
dec depression
5-HT synthesis
raphe nucleus (pons)
5-HT disease changes in anxiety and depression
dec in both
ACh synthesis
Basal nucleus of Meynert
ACh changes in Alzheimer’s, Huntington’s, REM
dec in Alzheimer’s
dec in Huntington’s
inc in REM
GABA synthesis
nucleus accumbens
GABA changes in anxiety and Huntington’s
dec in both
primary driver of cerebral perfusion
PCO2
cerebral perfusion pressure is directly proportional to PCO2 until PCO2 > 90 mmHg
hypoxemia inc cerebral perfusion pressure only when PO2
Therapeutic hyperventilation
dec PCO2 –> dec ICP in cases of acute cerebral edema (stroke, trauma)
Medial medullary syndrome
ASA stroke, often b/l
contralateral hemiparesis of lower limbs, ipsi hypoglossal dysfunction
Lateral medullary (Wallenberg’s) syndrome
nucleus ambiguus effects
“Don’t pick a (PICA) horse (hoarseness) who can’t eat (dysphagia)”.
also dec gag reflex, ipsi Horner’s, vomiting, vertigo, nystagmus
AICA stroke
“Facial droop means AICA’s pooped”
paralysis of face, dec taste from anterior 2/3 of tongue (bc trigeminal nucleus affected, V3)
PCA stroke
CL hemianopia with macular sparing
PComm berry aneurysm
CN III palsy - eye is “down and out” with ptosis and pupil dilation
AComm berry aneurysm
visual field defects
Charcot-Bouchard Microaneurysm
a/w chronic HTN; affects small vessels (eg in basal ganglia, thalamus)
Poliomyelitis and Werdnig-Hoffman disease
destruction of anterior horns of spinal cord
- polio = ssRNA, +sense
- Werdnig-Hoffman disease = congenital, “floppy baby”, AR
Amyotrophic lateral sclerosis (ALS)
no sensory, cognitive, or oculomotor deficits
mx in superoxide dismutase 1
tx Riluzole - dec presynaptic glutamate release; modest survival inc
Artery of Adamkiewicz
supplies ASA below T8 hence above it is susceptible to occlusion and infarction
Tabes dorsalis
demyelination of dorsal columns
- charcot joints
- argyll robertson pupils
- absent DTRs
- positive Romberg
Friedrich’s ataxia mutation
GAA in gene that encodes frataxin –> impaired mitochondrial functioning