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Miriam MD1 > Neuro general > Flashcards

Neuro general Flashcards

1
Q

The most common visual field defect seen in a patient with a large pituitary adenoma is…

A

bitemporal hemianopia

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2
Q

What are the most common causes of bacterial meningitis in adults? What characteristic do they have in common?

A
  • Strep pneumoniae: gram pos diplococci
  • Haemophilus influenza type b (<5 years): gram neg rods

Neisseria meningitidis: gram neg cocci

All have a CAPSULE

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3
Q

What are the most common causes of bacterial meningitis in neonates?

A

• E. coli (from gut) • Group B streptococcus = • Listeria monocytogenes (soft cheeses)

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4
Q

What are the most common causes of viral meningitis?

A

Enteroviruses, including coxsackie and echo

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5
Q

What are the characteristics of CSF in bacterial versus viral meningitis?

A

Bacterial: polymorphs, increased protein (>0.4g/L), low glucose

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6
Q

Phineas Gage had an injury to his brain being impaled on a metal bar. What area of his brain was injured, what psychological symptoms did he have?

A

Prefrontal cortex - dramatic change in personality including executive function (planning, inhibition, etc.). Relatively intact intellectual function. Died from seizures.

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7
Q

Important advances in our understanding of human memory came from intensive study of a patient widely known as HM. How would you best characterises HM’s memory problem and what was the physical cause?

A

Severe and persistent anterograde amnesia (while memories from before the surgery were generally intact, so not retrograde amnesia). HM had a large part of the medial temporal lobe on both sides surgically removed to treat severe epilepsy

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8
Q

What areas make up the basal ganglia?

A

The basal ganglia are a group of nuclei arranged around the thalamus. caudate nucleus + putamen + globus pallidus (posture & movement) + subthalamic nucleus + substantia nigra Note: Striatum = caudate nuclues + putamen Lentiform nucleus = globus pallidus + putamen

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9
Q

Define allodynia

A

a painful response to a normally innocuous stimulus

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10
Q

Define hyperalgesia

A

an increased response to a normally painful stimulus

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11
Q

Hyperasthesia

A

abnormal increase in sensitivity to a stimulus

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12
Q

What structures go through the jugular foramen?

A

Cranial nerves IX, X, and XI and the internal jugular vein pass through the jugular foramen. (the sigmoid sinus become the IJV below the jugular foramen)

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13
Q

Pupillary reflex: which cranial nerves and which part of brainstem is it testing?

A

Sensory/ afferent: CN II Optic Motor/ efferent: CN III (parasymp constricts pupil) Tests midbrain

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14
Q

Corneal blink reflex: which cranial nerves and which part of brainstem is it testing?

A

Sensory/ afferent: CN V trigeminal Motor/ efferent: CN VII facial (temporal & zygomatic) Tests pons - Normal = both eyes blink vigorously

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15
Q

Gag reflex: which cranial nerves and which part of brainstem is it testing?

A

Sensory/ afferent: CN IX glossopharyngeal Motor/ efferent: CN X vagus Tests medulla

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16
Q

Reticular activating system: what is its location and function?

A

Location: RAS projections extend from the reticular formation (dorsal brainstem) throughout the CNS. Function: regulates global CNS arousal and conscious state. “vital centres”: brainstem circuits that control various functions crucial for life-support / homeostasis. include breathing, heart rate, blood pressure, and micturition.

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17
Q

What is the function of the nucleus of the Solitary Tract/ Nucleus Tractus Solitarus (NTS)?

A

Nucleus of the Solitary Tract (NTS) Afferent Inputs from CN VII facial, IX and X. - Rostral: gustatory nucleus = Taste afferents (VII ant 2/3, IX post 1/3) and palate - Caudal: visceral sensory = Afferents from baro/chemoreceptors (IX), heart and abdominal viscera (X)

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18
Q

Which side of the brainstem (dorsal/ ventral) do most cranial nerves exit?

A

Ventral. Exception is CN IV trochlear.

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19
Q

What does the tegmentum contain? Where is it?

A

`The tegmentum contains all the brainstem cranial nerve nuclei, most of the ascending (sensory) tracts, and most of the reticular formation. Runs length of dorsal brainstem, ventral to the 4th ventricle (or the cerebral aqueduct in the midbrain).

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20
Q

Where is the tectum and what does it contain?

A

Dorsal to the midbrain and cerebral aqueduct, forms roof of the 4th ventricle. Contains the four colliculi (superior for eye movements, inferior for hearing)

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21
Q

What does a sympathetic fibre to do the pupil of the eye? And which nerve carries this sympathetic fibre?

A

The radial smooth muscle in the iris (dilator pupillae) causes pupil dilation (mydriasis) with sympathetic activation. Sympathetic efferents to the eye come from T1 spinal cord via the sympathetic trunk (not via cranial nerves).

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22
Q

Which muscle controls constriction of the pupil, and which nerve controls this? Which muscle and nerve controls dilation of pupil?

A

The sphincter pupillae (circular smooth muscle) constricts the pupil (miosis) under parasympathetic control, via CN III occulomotor. The dilator pupillae causes pupil dilation with sympathetic activation coming from T1 spinal nerve.

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23
Q

What are the main symptoms of thyrotoxicosis or hyperthyroidism?

A

intolerance to heat, increased appetite, weight loss, tremor, palpitations, restlessness and feelings of anxiety with no apparent cause Grave’s disease: exopthalmosis/ proptosis (bulging eyes)

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24
Q

What are the symptoms of hypothyroidism or Hashimoto’s?

A

weight gain, decreased energy, fatigue, cold intolerance

25
Q

What do golgi tendon organs measure?

A

the force or tension applied through the tendon

26
Q

What do muscle spindles measure?

A

muscle spindles measure muscle stretch. They run parallel with the muscle fibres.

27
Q

When coordinating movements, which comes first out of postural control or voluntary movements?

A

Postural control pre-emts voluntary movements

28
Q

the external carotid artery divides within the parotid gland into branches called…

A

maxillary and superficial temporal arteries

29
Q

what vein is formed within the parotid gland?

A

maxillary and superficial temporal veins join in the gland to form retromandibular vein. Retromandibular vein drains into the internal jugular vein.

30
Q

which nerve has branches that exit from the parotid gland? Name the branches.

A

Facial nerve CN VII. Temporal, Zygomatic, Buccal, Mandibular, Cervical

31
Q

what bones is the parotid gland located between?

A

mastoid process (of temporal bone) posteriorly and the ramus of the mandible anteriorly

32
Q

Wallerian degeneration

A

Process that occurs in PNS and CNS after neuronal injury. Degeneration of axon distal to site of injury. Debris phagocytosed by macrophages.

33
Q

Which one out of a Schwann cell and oligodendrocyte myelinates many axons?

A

Oligodendrocyte. (Schwann cell myelinates one axon)

34
Q

ganglion

A

collection of nerve cell bodies in the PNS

35
Q

nucleus

A

collection of nerve cell bodies in the CNS

36
Q

fasciculus

A

a bundle of nerve fibres/a bundle of axons + myelin (if myelinated) + endoneurium (connective tissue) with perineurium surrounding

37
Q

nerve fibre

A

an axon (plus myelin sheath)

38
Q

SNS is at what levels of spinal cord?

A

thoracolumbar T1-L3

39
Q

PNS nerves exit where?

A

cranial and sacral

40
Q

where are nicotinic receptors located?

A

autonomic peripheral ganglion (ie junction or pre and postganglionic neurons in SnS and PNS), on the postganglionic neuron somatic

41
Q

where are muscarinic receptors located?

A

In the PNS at the (second) junction of the postganglionic neuron and the tissue In SNS in sweat glands

42
Q

which cranial nerves have parasympathetic innervation? what are their nuclei?

A

III - sphincter pupillae muscle (constricts pupil), Edinger-Wesphal nucleus VII facial - salivary glands - salivatory nucleus IX glossopharyngeal - parotid glands, X - dorsal motor nucleus nucleus ambiguus: CN IX, X, XI

43
Q

What are the two types of sympathetic postganglionic neuron ganglia, and their main functions?

A

Paravertebral ganglia (the sympathetic chain): vasoconstricter neurons Prevertebral ganglia: neurons innervating nonvascular smooth muscle

44
Q

What is the limbic system?

A

involved in emotions. Areas include amygdala, orbitofrontal cortex, hippocampus (check)

45
Q

What is the function of the basal ganglia?

A

The basal ganglia are a group of nuclei arranged around the thalamus Function: higher motor control of voluntary movements: - allows complex patterns of muscle activation - initiates movements - evaluates success of actions also other functions

46
Q

What is the main function of the hippocampus?

A

Formation of declarative memories (includes episodic and semantic). Left is verbal memory, right is nonverbal.

47
Q

Where is the cingulate gyrus and what is it part of?

A

Also called the limbic cortex, is part of the limbic system. Is located medially, immediately above the corpus callosum

48
Q

what are the main branches of the trigeminal nerve?

A

V1 Ophthalmic V2 maxillary V3 mandibular Pharyngeal branch comes off V2 to for sensory innervation of nasopharynx

49
Q

which nerves do sensory and motor innervation of the oropharynx?

A

Sensory CN IX glossopharyngeal Motor CN X (except CN IX does stylopharyngeus muscle)

50
Q

Which nerve does sensory innervation of the laryngopharynx?

A

CN X

51
Q

which cranial nerves are sensory only?

A

I olfactory, II optic, VIII vestibulocochlear

52
Q

What is the corticobulbar tract?

A

Motor tract from cortex to brainstem somatic motor cranial nerve nuclei (non-ocular) ie facial muscles

53
Q

In a cross-section of the brainstem, which area are the cranial nerves in (dorsal or ventral)?

A

dorsal (in the tegmentum with the reticular formation and ascending sensory tracts)

54
Q

Most CN nuclei in the brainstem are related to one cranial nerve. Which nuclei are the exception?

A

Solitarius, Ambiguus, Trigeminal

55
Q

What is the function of the nucleus ambiguus?

A

Motor CN IX, X

56
Q

The majority of early onset familial Alzheimer’s disease is caused by mutations in genes encoding

A

presenelins

57
Q

What is the normal glucose value for CSF? What happens to glucose in meningitis?

A

>2.5 mmol/L normal. Low in bacterial, normal in viral meningitis.

58
Q

Patient has right homonymous hemianopia. Where is the lesion?

A

means loss of half visual field on same side. lesion contralateral / left side, posterior to the optic chiasm. - optic tract, optic radiation or visual cortex If in visual cortex, there may be macular sparing

59
Q

What is frailty?

A

Multisystem dysregulations leading to a loss of homeostasis, decreased physiologic reserve, and increased vulnerability for morbidity and mortality. Linked to chronic inflammation. 3 or more of: - Weight loss - weakness - exhaustion - slow walking speed - low physical activity

Miriam MD1 (6 decks)

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