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"Neuro Gold" Flashcards

1
Q

3 components of blood-brain barrier

A

Endothelial cells, basement membrane, astrocytic end feet

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2
Q

Conditions associated with proximal symmetric weakness but no sensory loss

A

Myopathies

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3
Q

Symptoms associated with peripheral neuropathies

A

Distal asymmetric weakness with atrophy, fasciculations, sensory loss and pain

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4
Q

Two most common conditions that result in peripheral neuropathies

A

Diabetes and alcoholism

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5
Q

Distribution of sensory loss in polyneuropathies

A

Stocking/glove pattern

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6
Q

Symptoms of Guillan-Barre syndrome

A

Ascending symmetric muscle weakness, areflexia and paresthesias in hands and feet 1-3 weeks following a viral respiratory or GI infection

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7
Q

CSF findings in Guillan-Barre syndrome

A

CSF has elevated protein without elevated WBC

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8
Q

Motor neuron disease characterized by UMN and LMN lesions

A

Amyotrophic lateral sclerosis

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9
Q

MRI and CSF findings of MS

A

MRI: white matter lesions

CSF: oligoclonal bands on electrophoresis

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10
Q

Conditions that cause pain/loss in a dermatomal pattern

A

Radiculopathies

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11
Q

Signs of UMN lesions

A

Spastic paralysis, hyper-reflexia, positive Babinksi, Hoffman sign, and clonus

With an acute UMN lesion, there may be hyporeactive reflexes and flaccid paralysis

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12
Q

Cause of lower facial paralysis (can wrinkle their forehead but cannot smile)

A

Sign of damage to the corticobulbar tract in the pons or higher (internal capsule or crus cerebri)

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13
Q

Signs of LMN lesions

A

Flaccid paralysis, hyporeflexia, fasciculations, atrophy

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14
Q

Symptoms of spinal shock

A

Temporary flaccid paralysis, hyporeflexia, sensory loss and loss of bladder tone

Hyper-reflexia develops over a period of days to weeks

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15
Q

Cause and symptoms of anterior spinal artery syndrome

A

Cause: occlusion of the artery of Adamkiewicz

Symptoms: bilateral weakness, loss of pain and temperature and hyper-reflexia below the lesion

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16
Q

Symptoms of cauda equina syndrome

A

Weakness and sensory loss in the lower extremities, radicular pain, saddle anesthesia, and urinary incontinence

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17
Q

Cause and symptoms of syringomyleia/hyromelia

A

Cause: cavitation of the central spinal cord

Symptoms: impinges the anterior white commissure producing bilateral loss of pain and temperature in a dermatomal pattern

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18
Q

Cause and symptoms of Brown-Sequard syndrome

A

Cause: hemisection of the spinal cord

Symptoms: ipsilateral UMN paralysis and loss of discriminative touch and contralateral loss of pain and temperature

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19
Q

Cause and symptoms of anterior cord syndrome

A

Cause: compression of anterior spinal artery

Symptoms: affects the neurons of the anterior horn, spinothalamic tract and lateral corticospinal tract

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20
Q

Symptoms of tabes dorsalis

A

Loss of posterior columns (discriminative touch, proprioception, and vibration)

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21
Q

Cause and symptoms of subacute combined degeneration

A

Cause: B12 deficiency

Symptoms: peripheral neuropathy that can progress to cord (posterior columns and lateral corticospinal tracts)

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22
Q

Cause and symptoms of medial medullary syndrome

A

Cause: infarct within anterior spinal artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), ipsilateral deviation of the tongue on protrusion (hypoglossal nucleus or nerve) and contralateral loss of discriminative touch, proprioception and vibration (medial lemniscus)

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23
Q

Cause and symptoms of lateral medullary syndrome

A

Cause: infarct within posterior inferior cerebellar artery

Symptoms: ipsilateral loss of pain and temperature on face (spinal trigeminal tract), contralateral loss of pain and temperature on body (spinothalamic tract), nystagmus, dizziness, nausea (vestibular nuclei), hoarseness, ipsilateral sagging palate, dysphagia (nucleus ambiguous), loss of taste (solitary nucleus), ataxia (restiform body, inferior cerebellar peduncle), Horner syndrome (hypothalamospinal fibers)

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24
Q

Cause and symptoms of Foville syndrome

A

Cause: infarct within paramedian branches of basilar artery

Symptoms: contralateral spastic hemiparesis (corticospinal tract), diplopia, paralysis of abduction (CN VI; maybe also intranuclear ophthalmoplegia), ataxia (middle cerebellar peduncle), contralateral loss of discriminative touch, proprioception, and vibration (medial lemniscus)

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25
Cause and symptoms of Gubler syndrome
Cause: infarct within paramedian branches of basilar artery Symptoms: contralateral spastic hemiparesis (corticospinal tract), ipsilateral facial paralysis (facial nerve or nucleus), ipsilateral loss of pain and temperature on face (CN V), contralateral loss of pain and temperature on body (spinothalamic tract)
26
Cause and syndrome of midpontine base syndrome
Cause: infarct within paramedian or short circumferential branches of basilar artery Symptoms: contralateral spastic hemiparesis (corticospinal tract), paralysis of jaw muscles (CN V), loss of sensation on face (CN V), ataxia (middle cerebral peduncle)
27
Symptoms of tonsillar herniation
Central apnea, hypertension, hyperventilation, loss of consciousness
28
Injury to the facial nerve (or nucleus) results in complete or lower facial paralysis
COMPLETE facial paralysis
29
Corticonuclear lesions (at pons or above) results in complete or lower facial paralysis
Lower facial paralysis
30
Cause and symptoms of Parinaud syndrome
Cause: lesion of the midbrain Symptoms: paralysis of vertical gaze (vertical gaze center), obstructive hydrocephalus (pinealoma)
31
Cause and symptoms of Weber syndrome
Cause: infarct within branches of the posterior cerebral artery within the midbrain Symptoms: contralateral spastic hemiparesis (corticospinal tract), diplopia, dilated pupil (CN III), paralysis of lower face, deviation of tongue to contralateral side, weakness of ipsilateral SCM and trapezius (corticonuclear tract), tremor (substantia nigra)
32
Cause and symptoms of Claude syndrome
Cause: infarct within branches of the posterior cerebral artery within the midbrain Symptoms: diplopia, dilated pupil (CN III), tremor, hyperkinesia (red nucleus), ataxia (cerebellothalamic fibers)
33
Symptoms of an uncal herniation
Diplopia, dilated pupil (CN III), contralateral hemiparesis (corticospinal tract), paralysis of lower face, deviation of tongue to contralateral side, weakness of SCM and trapezius (corticonuclear tract)
34
Findings for Weber test
Tests bone conduction Normally localizes to midline Sensorineuronal loss - localizes to good ear Conductive loss - localizes to bad ear
35
Findings for Rinne test
Compares air and bone conduction; air conduction is normally better than bone conduction Sensorineuronal loss - air > bone Conductive loss - bone > air
36
Cause of anisocornia (unequal pupils)
Lesion to CN III or sympathetics A dilated pupil indicates injury to CN III
37
Cause of ipsilateral blindess
Lesion to retina or optic nerve
38
Cause of bitemporal hemianopsia
Lesion to optic chiasm
39
Cause of contralateral homonymous hemianospia
Lesion to optic tract
40
Cause of contralateral homonymous hemianopsia, maybe quantrantopia
Lesion to optic radiations
41
Marcus-Gunn pupil
Pupil that appears to dilate with direct stimulation of light on a swinging light test Indicates lesion to optic nerve
42
Cause and symptoms of intranuclear ophthalmoplegia
Cause: lesion of the medial longitudinal fasciculus (in the pons or caudal midbrain) Symptoms: eye that fails to adduct on lateral gaze (but convergence is intact)
43
Cause and symptoms of one-and-a-half syndrome
Cause: lesion involving both the medial longitudinal fasciculus and abducens nucleus Symptoms: on testing horizontal gaze, one eye can only abduct and other eye cannot abduct or adduct
44
Cause of Argyll-Robertson pupil
Tabes dorsalis
45
Decorticate posturing
UL flexed, LL extended (rubrospinal tract intact)
46
Decerebrate posturing
All limbs in extension (rubrospinal tract damaged)
47
Damage to what structure results in coma
Reticular formation
48
Cause and symptoms of Meniere's syndrome
Cause: excess endolymph in the scala media Symptoms: episodic vertigo, tinnitus and hearing loss
49
Cause and symptoms of benign positional vertigo
Cause: free otoliths in the semicircular canals Symptoms: outbursts of vertigo and nystagmus with particular positions of the head
50
Caloric testing
Cold=nystagmus to Opposite side Warm=nystagmus to Same side COWS
51
Cause of ballismus
Lesion to subthalamuc nucleus
52
Cause of hemiballismus
Lesion to subthalamic nucleus on opposite side
53
Differentiate between sensory vs cerebellar ataxia with the Romberg test
In sensory ataxia, the patient sways considerably when eyes are closed In cerebellar ataxia, the patient sways with eyes open
54
Cause and symptoms of Friedreich's ataxia
Cause: autosomal recessive disorder, degeneration of posterior columns and spinocerebellar tracts Symptoms: progressive limb and gait ataxia, dysarthria, loss of joint position and vibration senses, absent tendon reflexes in the lower extremity and Babinski sign
55
Symptoms resulting from blockage of anterior choroidal artery
Contralateral hemiparesis (corticospinal tract) and contralateral homonymous hemianopsia (optic tract)
56
Symptoms resulting from blockage of lenticulostriate arteries
Contralateral hemiparesis and hemianesthsia (posterior limb of internal capsule)
57
Symptoms resulting from blockage of MCA: superior division
Motor and sensory symptoms involving the contralateral face (lower facial paralysis), upper limb and trunk (lower extremity is spared); on the left will produce expressive (Broca's) aphasia
58
Symptoms resulting from blockage of MCA: inferior division
Contralateral homonymous hemianopsia; on left receptive (Wernicke's ) aphasia
59
Symptoms resulting from blockage of ACA
Motor and sensory symptoms involving the contralateral trunk and lower limb (upper limb and face are spared) with frontal lobe signs (magnetic gate, personality changes, release of primitive reflexes [grasp, root, suck])
60
Symptoms resulting from blockage of PCA
Produces visual symptoms - contralateral homonymous hemianopsia, macular sparring is possible; may infarct thalamus (thalmogeniculate and thalamoperforating) = contralateral homonymous hemianopsia/somoatosensory loss
61
Symptoms of Broca's aphasia
Impaired comprehension, repetition, naming and speech output
62
Symptoms of Wernicke's aphasia
Fluent speech full of nonsense words and phrases
63
Cause and symptoms of conductive aphasia
Cause: damage to the arcuate fasciculus Symptoms: poor repetition
64
Symptoms of anterior watershed strokes
Expressive aphasia and lower limb affects
65
Symptoms of posterior watershed strokes
Receptive aphasia and visual loss
66
Definition of apraxia
Loss of the ability to perform a learned and familiar motor task
67
Definition of agnosia
Inability to recognize a familiar object regardless of intact sense
68
Cause and symptoms of Gerstmann syndrome
Cause: damage to the angular gyrus in the dominant hemisphere Symptoms: acalculia, agraphia, finger agnosia, and left-right confusion
69
Cause and symptoms of Kluver-Bucy syndrome
Cause: bilateral lesions of the amygdala Symptoms: docility, placidity, hypersexuality, hyperorality, and hypermetamorphosis

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