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FA > Neuro Path (mostly blood things) > Flashcards

Neuro Path (mostly blood things) Flashcards

1
Q

When do primitive reflexes usually disappear?

A

within 1st year of life

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2
Q

Galant Reflex

A

Stroke one side of spine while newborn is face down –> lateral flexion of lower body toward that side

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3
Q

Gallbladder pain referral

A

C3-5 (phrenic nerve) to right shoulder

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4
Q

C2 dermatome

A

Posterior half of skull

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5
Q

C3 dermatome

A

Neck brace/turtleneck

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6
Q

C4 dermatome

A

Low collar shirt

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7
Q

Xyphoid process dermatome

A

T7

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8
Q

Dermatome of the knee caps

A

L4

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9
Q

Frontal eye field lesion

A

Eyes look toward lesion (leader has to be brave)

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10
Q

Paramedian pontine reticular formation lesion

A

Eyes look away from lesion (buried away in brain-too afraid to look)

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11
Q

Medial longitudinal fasciculus lesion

A

INO (ipsilateral eye can’t adduct; contralateral eye nystagmus with abduction [hyperactive trying to get friend to come along])

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12
Q

What disease is associated with MLF lesions?

A

MS

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13
Q

What is Gerstmann syndrome? (4 signs)

A

Lesion of dominant parietal cortex = agraphia, acalculia, finger agnosia, left-right disorientation

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14
Q

Lesion of the subthalamic nucleus

A

Contralateral hemiballismus

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15
Q

What type of infection is associated with Kluver-Bucy syndrome?

A

HSV-1 encephalitis

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16
Q

What is Kluver-Bucy syndrome?

A

Bilateral lesion of amygdala–> disinhibited behavior (hyperphagia, hypersexuality, hyperorality)

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17
Q

What is Parinaud syndrome?

A

Lesion of the SC; paralysis of conjugate vertical gaze (eyes can’t nod up and down)

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18
Q

What side will the deficits appear on with cerebellar hemisphere lesions?

A

Ipsilateral; fall toward side of lesion

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19
Q

When does irreversible damage begin following hypoxia in the brain?

A

5 minutes

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20
Q

What imaging is used to exclude hemorrhage prior to treating a stroke?

A

Noncontrast CT

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21
Q

___ can detect ischemia within 3-30 min.

A

Diffusion weighted MRI

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22
Q

When will you see the following histologic changes following an ischemic event?

  • Microglia (often myelin/lipid filled)
  • Red neurons (eosinophilic cytoplasm + pyknotic nuclei)
  • Glial scar
A
  • 3-5 days
  • 12-24 hours
  • > 2 weeks
23
Q

When will you see …?

  • Necrosis + neutrophils
  • Vascular proliferation + reactive gliosis
A
  • 24-72 hours

- 1-2 weeks

24
Q

When do you begin to see liquefactive necrosis on a gross scale?

A

1 wk to 1 mo

25
Q

Where are direct clots (usually over an atherosclerotic plaque) likely to form?

A

MCA (thrombotic strokes)

26
Q

In addition to aspirin, what medical therapy could you give to decrease risk of stroke?

A

Clopidogrel

27
Q

What vascular structure is likely damaged?
Intracranial hemorrhage w/:
-Lucid interval
-Rapid expansion under systemic pressure –> transtentorial herniation
-Possible CN III palsy
-Skull fracture (likely at pterion)

A

Middle meningeal artery (branch of maxillary).

Epidural hematoma biconvex/doesn’t cross suture lines

28
Q

What does a hypodense crescent-shaped hemorrhage on CT likely indicate?

A

Chronic subdural hematoma (mild trauma, cerebral atrophy, elderly, alcoholism)

29
Q

What type of intracranial hemorrhage is associated with shaken babies?

A

Subdural hematoma

30
Q

What is “acute on chronic” hemorrhaging?

A

Varying CT densities associated with a sub-acute subdural hematoma

31
Q

What vasculature is damaged in subdural hematoma?

A

Bridging veins

32
Q

Which type of hematoma is associated with a lucid interval?

A

Epidural hematoma

33
Q

What will the spinal tap of a patient with subarachnoid hemorrhage look like?

A

Xanthochromic (yellow) or bloody

34
Q

__ is used to prevent/reduce vasospasm following SAH.

A

Nimodipine

35
Q

__ is seen with ____ (as recurrent lobar hemorrhagic strokes in elderly).

A

Intraparenchymal hemorrhage; amyloid angiopathy

36
Q

Systemic HTN is the most common cause of ___, intraparenchymal hemorrhages into the basal ganglia and internal capsule following microaneurysm of lenticulostriate vessles.

A

Charcot-Bouchard microaneurysms

NOT VISIBLE ON ANGIOGRAPHY

37
Q

If significant edema following TBI, (raise/lower) PaCO2 –> vasoconstriction–> (raise/lower) ICP

A

lower the PaCO2 to lower the ICP

38
Q

Where’s the lesion: Left sided paralysis and sensory loss of lower limb

A

Right ACA

39
Q

Common manifestations of lenticulostriate a. stroke:

A

CONTRALATERAL paralysis and/or sensory loss- both face and body

ABSENCE of CORTICAL SIGNS (neglect, aphasia, visual field deficits)

40
Q

Microatheromas and lipohyalinosis are common signs of ______ found in the lenticulostriate arteries due to unmanaged HTN.

A

lacunar infarcts

41
Q

Artery damaged in medial medullary syndrome

A

ASA- anterior spinal artery

42
Q

Triad of medial medullary syndrome

A

1) Contralateral upper and lower limb paralysis (LCT)
2) Dec. contralateral proprioception (medial lemniscus)
3) Ipsilateral deviation of tongue (CN XII)

43
Q

___ supplies the lateral medulla.

A

PICA

44
Q

Sx of lateral medulla damage

A

1) Dysphagia, hoarseness, dec. gag reflex (nuc. ambiguus)
2) Vomiting, vertigo, nystagmus (Vestibular nuc.)
3) Dec. PCT from contra body, ipsi face (Lateral spinothalamic and spinal trigeminal nuc)
4) Ipsi Horner (Symp fibers)
5) Ataxia, dysmetria (Inf. cerebellar peduncle)

45
Q

1) Facial paralysis w/ dec. lacrimation, salivation, taste from anterior 2/3
2) Vomiting, vertigo, nystagmus
3) Dec. PCT from contra body, ipsi face
4) Ipsi Horner
5) Ataxia, Dysmetria (Middle/inferior cerebellar peduncles)

A

AICA syndrome = Lateral pontine syndrome

Your face is more anterior than your throat

46
Q

What artery is occluded in “locked in syndrome”?

A

Basilar a.

47
Q

What allows for consciousness to be preserved in “locked in syndrome?”

A

Sparing of RAS (reticular activating syndrome)

48
Q

How do you lose horizontal eye movements in “locked in syndrome?”

A

Damaged PPRF and ocular CN nuclei

49
Q

Where is/was the lesion in central post-stroke pain syndrome? paresthesias –> allodynia and dysethesia

A

Thalamus

50
Q

What is the difference between aphasia and dysarthria?

A

Higher order inability to speak/comprehend vs. motor defecit

51
Q

Damage to the ___ can cause conduction or global aphasias.

A

Arcuate fasciculus

52
Q

Repetition intact aphasias are caused by ____, but the respective ____ are intact.

A

transcoritcal injury; broca’s, wernicke, and arcuate areas are intact

53
Q

PCom compression results in…

A

ipsilateral CN III palsy –> mydriasis (“blown pupil”), possible ptosis, “down and out”

FA (8 decks)

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