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STEP > Neuro IV > Flashcards

Neuro IV Flashcards

1
Q

Location of Broca’s area

A

Inferior frontal gyrus of frontal lobe.

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2
Q

Broca’s

1) speech fluidity
2) comprehension
3) repetition

A

1) confluent
2) intact
3) Impaired

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3
Q

Wernicke’s

1) speech fluidity
2) comprehension
3) repetition

A

1) fluent
2) Impaired
3) impaired

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4
Q

Wernicke area

A

Superior temporal gyrus of temporal lobe

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5
Q

Conduction aphasia

1) speech fluidity
2) comprehension
3) repetition

A

1) Fluent
2) intact
3) impaired

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6
Q

what causes conduction aphasia?

A

Lesion to arcuate fascicles.

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7
Q

Global aphasia

1) speech fluidity
2) comprehension
3) repetition

A

1) nonfluent
2) impaired
3) impaired
* broca’s, wernickes, arcuate all affected.

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8
Q

transcortical motor aphasia?

A

Lesion in frontal lobe around Broca area but sparing Broca area

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9
Q

transcortical motor aphasia

1) speech fluidity
2) comprehension
3) repetition

A

1) nonfluent
2) intact
3) intact

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10
Q

transcortical sensory aphasia?

A

Temporal lobe area around Wernicke’s affected, but WErincke’s spared.

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11
Q

transcortical sensory aphasia

1) speech fluidity
2) comprehension
3) repetition

A

1) fluent
2) impaired
3) intact

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12
Q

transcortical mixed aphasia?

A

Broca and Wernicke areas and arcuate fascicles remain intact; surrounding watershed areas affected

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13
Q

transcortical, mixed aphasia

1) speech fluidity
2) comprehension
3) repetition

A

1) nonfluent
2) impaired
3) intact

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14
Q

What is kluver-bucy associated with?

A

HSV-1 encephalitis

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15
Q

Frontal lobe lesion presents with

A

1) disinhibition

2) deficits in concentration, orientation, judgment

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16
Q

What do reemergence of primitive reflexes suggest?

A

frontal lobe lesion

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17
Q

Lesion to nondominant parietal cortex presents with…

A

hemispatial neglect syndrome

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18
Q

hemispatial neglect syndrome?

A

Agnosia of the *contralateral side of the world.

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19
Q

Lesion to dominant parietal cortex presents with…

A

Gerstmann syndrome -agraphia, acalculia, finger agnosia, left-right disorientation.

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20
Q

Where is the reticular activating system?

A

midbrain

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21
Q

Presentation of lesion to reticular activating system?

A

Reduced levels of arousal and wakefulness (eg, coma)

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22
Q

What can precipitate wernicke’s?

A

Giving glucose without B1 to a B1-deficient patient.

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23
Q

Lesion to basal ganglia presents with…

A

tremor at rest, chorea, athetosis

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24
Q

Damage to cerebellar hemisphere presents with..

A

1) intention tremor
2) limb ataxia
3) loss of balance
* Hemispheres are laterally located and affect lateral limbs.

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25
Q

What is cerebellar degeneration associated with?

A

chronic alcoholism

26
Q

presentation of lesion to cerebellar vermis

A

truncal ataxia, dysarthria

27
Q

Presentation of bilateral lesion to hippocampus..

A

Anterograde amnesia–(no new memories)

28
Q

Presentation of lesion to paramedic pontine reticular formation…

A

Eyes look away from side of lesion.

29
Q

Presentation of lesion to frontal eye fields…

A

Eyes look toward lesion

30
Q

Homunculus look likes..

A

FA 465

31
Q

What functions are located near the mouth near bottom of homunculus?

A

1) vocalization
2) salivation
3) mastication

32
Q

Cerebral perfusion

A

Relies on pressure gradient between MAP and ICP.

33
Q

CPP and causes of decreased

A

Cerebral perfusion pressure.

Hypotension or increased ICP.

34
Q

Calculating CPP

A

MAP - ICP

35
Q

Decreased ICP w with hyperventilation mechanism

A

hyperventilation –> decreased PCO2 –> vasoconstriction –> decreased cerebral blood flow –> decreased ICP.

36
Q

Cutoff for CPP and hypoxemia

A

Hypoxemia increases cerebral perfusion pressure only when PO2 drops to below 50 mm Hg.

37
Q

Relation of CPP to PCO2

A

CPP is linear to PCO2 until PCO2 exceeds 90 mmHG, at which point CPP doesn’t increase anymore.

38
Q

ACA/MCA/PCA distribution

A

FA 466

39
Q

What are the watershed zones

A

1) between ACA and MCA distribution
2) between PCA/MCA distribution
* think of the boundaries between the colored diagram in FA.

40
Q

How does watershed hypoperfusion present?

A

1) Upper leg/upper arm weakness

2) Defects in higher-order visual processing.

41
Q

How will MSA stroke present?

A

1) contralateral paralysis and sensory loss of face and upper limb.
2) Aphasia if in dominant (usually left) hemisphere).
3) hemineglect if lesion affects non dominant (usually right) side.

42
Q

ACA supplies

A

motor and sensory cortices for lower limb.

43
Q

How will ACA stroke present?

A

Contralateral paralysis and sensory loss in lower limb.

44
Q

Lenticulostriate artery supplies…

A

Striatum + IC

45
Q

lenticulostriate artery stroke presentation?

A

1) contralateral paralysis and/or sensory loss of face and body
2) Absence of cortical signs (eg, neglect, aphasia, visual field loss).

46
Q

Common scenario of lenticulo-striate artery stroke.

A

Lacunar infarct in a patient with unmanaged HTN.

47
Q

ASA supplies

A

1) lateral corticospinal tract
2) medial lemniscus
3) caudal medulla-hypoglossalq nerve

48
Q

Medial medullary syndrome presentation

A

1) contralateral paralysis–upper and lower limbs
2) decreased contralateral proprioception
3) tongue deviates ipsilaterally (ipsilateral hypoglossal dysfunction)

49
Q

Cause of Medial medullary syndrome

A

Infarct of paramedic branches of ASA and/or vertebral arteries.

50
Q

PICA supplies…

A

lateral medulla–vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguus, sympathetic fibers, inferior cerebellar peduncle.

51
Q

Lateral medullary (Wallenberg) syndrome presentation

A

Vomiting + vertigo + nystagmus + decreased pain and temp sensation from ipsilateral face and contralateral body

  • dysphagia
  • hoarseness
  • decreased gag reflex
  • ipsilateral Horner syndrome
  • ataxia
  • dysmetria
52
Q

Pathognomonic findings for Wallenberg syndrome…

A

Nucleus ambiguus effects

53
Q

AICA supplies

A

lateral pons–cranial nerve nuclei (vestibular nuclei, facial nucleus, spinal trigeminal nucleus, cochlear nuclei), spinothalamic tract, CS tract, sympathetic fibers.
- middle and inferior cerebellar peduncles

54
Q

What effects are pathognomic to AICA lesions?

A

Facial nucleus effects

55
Q

Lateral pontine syndrome presentation

A

1) vomiting, vertigo, nystagmus, ***paralysis of face, decreased lacrimation, salivation, decreased taste from anterior 2/3 of tongue.
2) ipsilateral decrease in pain and temp of face, decreased contralateral pain and temp sensation of body
3) ataxia, dysmetria

56
Q

Basilar artery supplies

A

Pons, medulla, lower midbrain, CS and corticobulbar tracts, ocular cranial nerve nuclei,
parmedian pontine reticular formation.

57
Q

Basilar artery stroke presentation…

A

1) “Locked-in syndrome”
preserved consciousness + vertical eye movement, blinking, quadriplegia, loss of voluntary facial, mouth, and tongue movements.

58
Q

PCA stroke presentation

A

Contralateral hemianopia with macular sparing.

59
Q

Medial lemniscus

A

part of dorsal column pathway. after dorsal column fibers decussate in medulla, remaining fibers are medial lemniscus.

60
Q

Thalamic stroke

A

Code: Henry, guide: Giant Kai thaler with headband on standing on shore (thalamus code)/thalamic stroke. Half his body is an ice cube + full of magnets/damage to ventral posterior lateral nucleus or ventral posterior medial nucleus resulting in complete contralateral sensory loss (both upper and lower extremities). A lesion in the thalamus can disrupt ALL sensory information from both the body and the face. He’s stumbling around + a big taxi on shore/proprioceptive defects may cause unsteady gait.
o Location: Lunch spot by silver pond

61
Q

Lateral pontine syndrome

A

Code: Pon outside, lateral to tent/lateral pontine syndrome. President Ike Eisenhaur in back eating a PICA/stroke of AICA. Facial nucleus effects are specific to AICA lesions. Right side of face frozen + drooling everywehere + has antlers on + left side of body in ice cube + anterior 2/3s tongue cut off + face drooping/presentation = vomiting + vertigo + nystagmus + **paralysis of face + decreased lacrimation + salivation + decreased taste from anterior 2/3 of tongue + decreased ipsilateral pain and temperature of face + decreased contralateral pain and temperature of the body.
o Location: Drying room

62
Q

Asomatognosia

A

/lack of knowledge about one’s own body. /lesion of nondominant right parietal lobe. /hemiasomatognosia occurs with hemineglect. Patients will deny that half of their body actually belongs to them.

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