Neuro Pre-midterm Flashcards

1
Q

Above the midbrain, define the terms: Rostral, Caudal, Dorsal & Ventral

A

Anterior/Rostral; Posterior/Caudal

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2
Q

Below the midbrain, define the terms: Rostral, Caudal, Dorsal & Ventral

A

Anterior/Ventral; Posterior/Dorsal

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3
Q

What is the official boundary between the CNS & PNS?

A

Redlich-Obersteiner’s Zone

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4
Q

Where can nerves regenerate: CNS or PNS?

A

PNS

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5
Q

What are the 5 major components of the brain?

A
  1. Telencephelon
  2. Diencephelon
  3. Mesencephalon
  4. Metencephalon
  5. Myencephalon
    (Myelon = S/C)
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6
Q

Telencephalon

A

Lateral ventricles, cerebrun, cortex (gray + white matter)

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7
Q

Differentiate between gray/white matter in the brain and spinal cord.

A

Brain: White inside

S/C: Gray inside

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8
Q

Diencephalon

A

3rd ventricle, thalamus & hypothalamus

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9
Q

Metencephalon

A

Midbrain

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10
Q

Metencephalon

A

Pons + Cerebellum

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11
Q

Myencephalon

A

Medulla

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12
Q

What are the 6 cerebral lobes?

A

Frontal, Temporal, Parietal, Occipital, Limbic & Insular

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13
Q

What are the 6 layers of the cerebral cortex (outside in)?

A
  1. Molecular layer
  2. External granular layer
  3. External pyramidal layer (small pyr)
  4. Internal granular layer
  5. Internal pyramidal (ganglionic or large pyr)
  6. Multiform/Polymorphus
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14
Q

Where are Betz cells found?

A

Layer 4 of the cerebrum / lumbar spinal motor neurons

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15
Q

Thalamic input arrives at what level of the cerebrum?

A

4

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16
Q

Corticospinal/bulbar output leaves from which cerebrum layer?

A

5

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17
Q

The efferent layers of the cerebrum are:

A

3 & 5 (2 and 6)

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18
Q

The cerebellum is responsible for

A

Motor function; posture, balance, smooth muscle coordination

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19
Q

The pons has 2 parts:

A

Dorsal: sensory (respiratory, taste, sleep/wake)
Ventral: motor

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20
Q

The 3 types of white matter:

A

Projection
Commisural
Association

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21
Q

What are basal ganglia?

A

Groups of neurons deep within white matter associated with initiation/organization of movement

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22
Q

What is the difference between T1 & T2?

A

T1 differentiates between white/gray matter

T2 shows white water (CSF) – ventricles are white

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23
Q

Differentiate between epidural, subdural, and sub-arachnoid hemorrhage.

A

Epidural: Football
Subdural: Crescent
Sub-arachnoid: Follows granulations

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24
Q

Bone Morphogenic Protein (BMP)

A

Suppresses neural differentiation; promotes epidermal tissue growth

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25
Q

Homeobox (HOX) genes

A

60 AA’s that recognize and bind specific DNA sequences; coordinate expression of genes (A-P axis)

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26
Q

Retinoic acid

A

Source: Hensen’s node

* Activates transcription of HOX genes; established gradient along length of embryo

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27
Q

Sonic hedgehog protein

A

Synthesized by notochord and floor plate; induces floor plate cells and motoneurons of the ventral spinal cord

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28
Q

EMX & OTX mutations

A

EMX: Schizencephaly
OTX: Epilepsy

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29
Q

Where do you find younger neurons on radial glia?

A

Younger neurons migrate further than older ones

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30
Q

What are radial glial cells?

A

Contact ventral and pial surface; neurons move along the scaffolding

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31
Q

Describe Cajal-Retzius/Reeler gene

A

Reelin tells neurons to stop migrating!

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32
Q

What types of cells provide an exception to the principle that radial glial cells provide migration/guidance? Name the condition.

A

GnRh cells

Kallmann’s Syndrome: no smell / no sexual development

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33
Q

What is leukemia inhibit factor?

A

Peptide released by the heart which can change phenotype; underscoring the principle that a neuron’s environment influences its commitment to function

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34
Q

Describe the role of PMP-22

A

This protein myelinates peripheral neurons

* Protein normally broken down in absence of axons

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35
Q

What is Laminin?

A

Promotes axonal outgrowth; found surrounding neurons and satellite cells

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36
Q

What is netrin?

A

A diffusable substance released by the floor plate; attracts axons to the developing spinal cord

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37
Q

What are the primary divisions of the primitive CNS?

A

Prosencephalon; Mesencephalon; Rhombencephalon

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38
Q

What is the objective of a graded potential?

A

Drive potential towards the axon hillock to threshold at which point an action potential can be generated

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39
Q

Rods/Cones convert photons into receptor potential?

A

Rods
Night vision: increase cGMP, Na-channels open
Day vision: decreased cGMP, hyperpolarization (decreased glutamate)

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40
Q

Olfactory epithelium are bipolar sensory neurons. How do they function with respect to G proteins?

A

Increase cAMP with increasing odor stimulus

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41
Q

What is spasticity?

A

Increased muscle tone; hyperexcited muscles with increase in voltage-gated Na-channels open

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42
Q

How do you differentiate between the functions of neurons and glia?

A

Neurons: action potentials
Glia: Ca-dependent signaling with gap junctions; no action potentials

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43
Q

What are the 3 layers of the cerebellum?

A

Molecular, Purkinje, Granular

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44
Q

Bipolar neurons

A

Interneurons

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45
Q

Pseudounipolar neurons

A

CNS PNS

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46
Q

What is special about herpes, polio, rabies, paravirus with respect to neurons?

A

They use retrograde transport up axons to reach the soma

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47
Q

What are the different types of glial cells?

A

Micro: macrophages
Macro: astrocytes, oligodendrocytes, ependymal, radial glia, perivascular astrocyes, tanycytes (PNS: satellite, Schwann, enteric)

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48
Q

T/F Neurons regenerate in the CNS

A

False

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49
Q

Who re-myelinates in the PNS?

A

Schwann cells

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50
Q

What is Wallerian degeneration?

A

Following injury, degeneration distral to the axonal damage

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51
Q

What is the difference between retrograde and anterograde transport?

A

Retrograde: Dyenin – axon–> soma
Anterograde: Kinesin – soma –> axon

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52
Q

What are the 3 elements of cytoskeleton important for transport in a neuron?

A
  1. Microfilaments
  2. Intermediate filaments
  3. Microtubules
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53
Q

What are the 4 classes of sensory receptors?

A

Mechano, thermo, chemo, photo - receptors

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54
Q

What are the 6 sensory systems?

A

Somatosensory, visual, vestibular, auditory, olfactory, gustatory

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55
Q

What are the 4 attributes that characterize a sensory stimulus?

A

Modality
Intensity
Duration
Location

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56
Q

Differentiate between slow and rapidly adapting receptors.

A

Slow – good for physiologic montioring; constantly depolarized
Fast – more sensitive to change

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57
Q

All neurons of the somatosensory system are..

A

Pseudounipolar neurons

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58
Q

The 5 modalities of somatosensory system:

A
  1. Touch, Proprioception, Vibration

2. Pain, Temperature

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59
Q

What are the 4 somatosensory fibers?

A

Fastest: 1-alpha, 2-beta, 3-delta, 4-C :Slowest

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60
Q

C2

A

Back of head

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61
Q

C6

A

Thumb

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62
Q

C7

A

Middle finger

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63
Q

C8

A

Little finger

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64
Q

T4

A

Nipple line

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65
Q

T10

A

Umbilicus

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66
Q

L1

A

groin

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67
Q

L5

A

Big toe

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68
Q

S1

A

Little toe

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69
Q

What are the 2 somatosensory pathways?

A
  1. Dorsal-column medical leminiscus touch/vibration/proprioception
  2. Anterolateral pain/temp
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70
Q

Describe the routes to the brain for the somatosensory pathways

A
  1. D-C/M-L – medial to lateral (leg, trunk, arm)
    Leg goes to gracile fasiculus; arm goes to cuneate fasiculus in medulla
  2. Anterolateral (spinothalamic); dorsal horn –> cross anterior white commissure –> ALS fiber tract to thalamus (Leg-lateral, arm-medial)
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71
Q

Describe Lissauer’s tract

A

Collaterals of Anterolateral system can ascend 1 or 2 levels in the dorsolateral fasiculus

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72
Q

Describe the sensory aspect of Brown-Sequard Syndrome

A

See notes

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73
Q

What is syringomyelia?

A

Pathologic enlargement of central canal of S/C
* Interrupts pain/temperature fibers that cross the anterior white commissure

Bilateral pain/temperature loss @ and below lesion;
Note Lissaeur contribution

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74
Q

What is shingles/herpes zoster?

A

Following an attack of the chickenpox, the herpes virus may become latent in dorsal root ganglion cells (or trigeminal ganglion cells). Reactivation of the virus produces painful skin irritations in the dermatomal area innervated by the related ganglion

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75
Q

Describe the 3 neuron chain for DRG & trigeminal ganglia touch, proprioception, and vibration

A

See notes

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76
Q

What are the 3 features of the primary somatosensory cortex?

A
  1. Somatotopic map
  2. Organization in columns
  3. Input to layer 4
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77
Q

With respect to 2 point discrimination, a higher resolution means…

A

Greater density of mechanoreceptors, small receptive fields, larger cortical area involved +/- lateral inhibition

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78
Q

How do we examine touch, vibration, proprioception? Basic and Complex

A

Touch w/ pain; vibration, proprioception - finger

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79
Q

What is the first somatosensation lost with peripheral neuropathies?

A

Vibration

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80
Q

What is stereogenesis and graphesthesia?

A

Stereo: place a stereo in hand, ask what it is
Graph: draw a number or letter in the palm

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81
Q

What is tapes dorsalis?

A

Destruction of DRG (loss of touch, proprioception) in syphillis

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82
Q

What is characteristic of phantom limbs?

A

Rearrangement of cortical neurons

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83
Q

Describe the 2 types of pain

A
  1. Nociceptive (stimulus driven)

2. Neuropathic (more complex/ abberent processing)

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84
Q

Describe the spinal and trigeminal pain pathways (First, second, third order neurons and tracts)

A

First order neuron: substantia gelatinosa of dorsal horn
Second order neuron: crosses midline (ant white commissure) and ascends through ALS tract to synapse at VPL in thalamus
Third order neuron: travels through posterior I/C and corona radiata to synapse in somatosensory cortex

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85
Q

Differentiate between hyperalgesia and allodynia

A

Hyperalgesia: enhanced senstion of pain in area around injury
Allodynia: Previously painful stimuli become painful

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86
Q

What is the optic fundus?

A

Back portion of the interior of the eyeball

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87
Q

Describe the layout of the eyeball

A

Cornea (sclera), a/p chambers, iris, lens; retina is innermost layer, after sclera and choriod

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88
Q

Differentiate between constriction and dilation (pupil)

A

Constriction - para - contract ciliary muscle, relax suspensory ligaments

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89
Q

Differentiate between myopia, hyperopia & emmetropia

A

Myopia: near sightedness; requires biconcave lens; eye is too long/refractive power is too strong

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90
Q

What is the condition called for loss of refractive capability with age?

A

Presbyopia

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91
Q

The lens has a higher/lower refractive power for near vision?

A

Higher

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92
Q

What part of the eye is responsible for the greatest refractive power?

A

Cornea

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93
Q

Light generally causes what type of reaction in photoreceptors?

A

Hyperpolarization (activation of cGMP phsphodiesterase)

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94
Q

Describe the wavelength of Red, Green, Blue

A

Red: longest wavelength
Blue: shortest wavelength

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95
Q

What are the 5 cell types in the retina?

A
  1. Photoreceptors
  2. Bipolar
  3. Ganglion
    (Horizontal & amacrine)
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96
Q

Describe the difference between ON and OFF cells.

A

ON cells stimulated by light, leads to depolarization, release of INHIBITORY glutamate (metabotropic)

OFF cells stimulated by darkness, leads to depolarization, release of EXCITATORY glutamate (ionotropic)

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97
Q

Which vitamin is responsible for night blindness?

A

Vitamin A

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98
Q

What is the objective of horizontal cells?

A

Inhibits the pathway in the adjacent retinal cells

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99
Q

Retinitis pigmentosa

A

Characterized by night blindness and tunnel vision; degeneration of rods

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100
Q

Differentiate between the 2 major types of color-blindness.

A

R-G most common (X-recessive)
Protanopia: L cone (red cone absent)
Deuteranopia: M cone (green cone absent)

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101
Q

Rods have more/less convergence than cones

A

More

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102
Q

Which is the active version of the visual pigment retinal: cis or trans

A

Trans

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103
Q

T/F monochromatic blue light depolarizes all 3 types of cones

A

True

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104
Q

Who is more sensitive to light: rods or cones

A

Rods

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105
Q

What is the posterior boundary of the frontal lobe?

A

Central sulcus

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106
Q

How do you differentiate between a subarachnoid hemorrhage and an epidural hemorrhage?

A

SA: meningeal irritation
Epi: lucid interval

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107
Q

What are the 2 types of brain herniation?

A

Uncal: upper
Tonsillar: lower (bottom of pons)

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108
Q

What blood vessels supply the medulla?

A

AICA, PICA, ASA

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109
Q

What blood vessels supplies the pons?

A

Basilar artery (pontine branches)

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110
Q

What blood vessels supply the midbrain?

A

Posterior cerebral and superior cerebellar

* Oculomotor nucleus

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111
Q

Where is the EW nucleus located?

A

Midbrain

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112
Q

What is aphasia?

A

Inability to speak

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113
Q

What is anisocoria?

A

Pupils different sizes

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114
Q

What reflex is associated with the flocculonodular lobe of the cerebellum?

A

Vestibulooccular – focus eye on a point while moving head

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115
Q

Biceps reflex

A

C5, 6

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116
Q

Triceps reflex

A

C7, 8

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117
Q

Abdo reflex (above/below umbilicus)

A

8,9,10; 10,11,12

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118
Q

Knee jerk reflex

A

L 2, 3, 4

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119
Q

Ankle reflex

A

S1

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120
Q

Define obtunded

A

Lower than full mental capacity

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121
Q

Where are aneurysms more likely to occur?

A

At junctions of vessels (Lg –> Small)

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122
Q

What is the chief symptom of a SA hemorrhage?

A

Thunderclap headache

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123
Q

Where is there no choriod plexus?

A

A/P lateral ventricle; cerebral aqueduct

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124
Q

Differentiate between the gracile and cuneate nuclei

A

Gracile: medial; legs
Cuneate: lateral; arms

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125
Q

Where is the lamina terminalis?

A

Anterior to the 3rd ventricle

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126
Q

What is located at the inferior horn of the lateral ventricle?

A

Hippocampus

127
Q

Where is area posterma and with what is it associated?

A

Medulla; nausea/vomiting

128
Q

Which artery supplies the acoustic meatus?

A

Labyrinth (branch of AICA)

129
Q

The lenticulostriate artery is a branch of…

A

MCA

130
Q

Which vessels are closest to the optic chiasm?

A

Posterior cerebral; ACA/MCA

131
Q

Where is the OVLT?

A

Lamina terminalis

132
Q

Where would an uncal herniation occur?

A

Tentorial notch; between brain stem and tentorial cerebelli

133
Q

What is the embryologic significance of the lamina terminalis?

A

It is where the rostral neuropore closes

134
Q

Differentiate between Broca’s and Wernicke’s aphasia.

A

Broca’s: problem with actual motor movement of speech

Wernicke’s: Gibberish

135
Q

The frontal lobe has X sulci and Y gyri

A
2 sulci
3 gyri (superior, middle, inferior)
136
Q

The parietal lobe has X gyri

A

2; superior & inferior

137
Q

The temporal lobe is similar to the X lobe because of the same number of gyri/sulci

A

Frontal

138
Q

Where is the olfactory cortex?

A

Near uncus (near the parahippocampal gyrus)

139
Q

Who is faster: ionotropic or metabotropic?

A

Ionotropic

140
Q

What is the difference between small molecule and neuropeptide NT’s?

A

Small molecule: catecholamines, glutamate, etc.
Neuropeptide: endorphorins, substance P

Neuropeptides synthesized in RER/Golgi

141
Q

Differentiate between quantum, quantum content, quantum size

A

Quantum: a single vesicle
Quantum size: how many NT/vesicle
Quantum content: # of quanta released per vesicle

142
Q

Benzodiazapines work at which recetpors?

A

GABA

143
Q

Differentiate between first and second pain.

A

First pain: A-delta

Second pain: C fibers

144
Q

Through what structure do fibers in the ALS cross over?

A

Anterior white commissure

145
Q

What substances and NT’s activate nociceptors?

A

Bradykinin, histamine, K

146
Q

Opiods mimic the action of what NT or substance

A

Enkephalin

147
Q

Serotonergic neurons come from… (descending pain)

A

Periaquductal grey, nucleus raphe magnus

148
Q

Descending pain fibers travel through…

A

Lateral/Anterior funiculi

149
Q

With respect to the gate theory, large myelinated fibers carrying touch activate inhibitory neurons where…

A

Dorsal horn of S/C (First/Second neurons)

150
Q

Which structure is mainly responsible for the refractive power of the eye? Cornea or lens

A

Cornea

151
Q

During far vision is the ciliary muscle relaxed or contracted?

A

Relaxed [ciliary muscle is a circular muscle that surrounds the lens. When it is relaxed the diameter of the circular structure is large resulting in the zonule fibers tightening & flattening the disk. This minimizes the lens’ refractive power.]

152
Q

What is presbyopia?

A

Loss of lens elasticity

153
Q

What color does the optic disk have normally and when there is increased ICP?

A

Pink normally & white when ICP is increased

154
Q

These types of cells are the persistent forms of radial glia [aid neuron migration during development] in the retina:

A

Muller cells

155
Q

OFF center ganglionic cells receive excitatory/inhibitory input from off center bipolar cells

A

Excitatory input from OFF center bipolar cells

156
Q

Type of receptor on ON & OFF center bipolar cells

A

ON: glutamate - metabotropic
OFF: AMPA (ionotropic)

157
Q

Glutamate Ca2+ channel receptor

A

NMDA

158
Q

What part of thalamus receives input from retinal ganglion cells?

A

Lateral geniculate nucleus

159
Q

What is the name of the chromophore in the visual pigment molecule?

A

Retinal

160
Q

Are able to detect low intensity light: Rods or Cones

A

Rods

161
Q

Fingers have the highest density of which of the following when compared to the rest of the body?

A

Merkle’s discs

162
Q

What remains in tact with tabes dorsalis?

A

Pain & temperature (Lose touch, vibration, proprioception)

163
Q

What is vasogenic edema?

A

Occurs due to the failure of tight junctions and astrocyte processes which normally maintain an adequate blood-brain barrier.

164
Q

What is cytotoxic edema?

A

In this type of edema the BBB remains intact. This edema is due to failure of ATP-dependent ion transport (sodium and calcium pumps). As a result there is cellular retention of sodium and water

165
Q

MS shows the following elevated in CSF

A

IgG

166
Q

What are the chief molecules lower in CSF vs. plasma

A

K, Ca, protein, glucose, pH

167
Q

When is the measurement of ICP by lumbar puncture inaccurate?

A

Ventricular obstruction

168
Q

What type of cell allows communication between extracellular fluid in the CNS & CSF?

A

Group 2 ependymal

169
Q

What are the three functions of astrocytes?

A

Buffering, lactate –> neurons, remove NT’s

170
Q

What type of cell makes up the choroid plexuses?

A

Group I ependymal

171
Q

What type of cell lines the spinal canal & extrachoroidal portions of the ventricles?

A

Group 2 ependymal

172
Q

Cerebral perfusion pressure is equal to

A

MAP - ICP

173
Q

Dandy-Walker syndrome (congenital hydrocephalus) is due to

A

Failure of Luschka/Magendie to develop

174
Q

Features Horner’s syndrome

A

(lesion of sympa) Anhydrosis, ptosis, miosis, and enopthalamos

175
Q

Which sympathetic activities are governed by M receptors?

A

Eccrine sweat, renal vasculature, smooth muscle of skeletal muscle

176
Q

Which neurotransmitters are amines?

A

ACh, serotonin, dopamine, E/NE, histamine

177
Q

Which neurotransmitter can be broken down by COMTs, MAO’s

A

COMT: NE/Epi/Dopamine
MAO: NE/Epi/Dopamine/Serotonin

178
Q

What 2 neurotransmitters are released by nociceptors in the substantia gelatinosa?

A

Glutamate, Substance P

179
Q

Which neurotransmitters are amines?

A

ACh, serotonin, dopamine, E/NE, histamine

180
Q

Which neurotransmitter can be broken down by COMTs, MAO’s

A

COMT: NE/Epi/Dopamine
MAO: NE/Epi/Dopamine/Serotonin

181
Q

What 2 neurotransmitters are released by nociceptors in the substantia gelatinosa?

A

Glutamate, Substance P

182
Q

Which neurotransmitter antagonist is often used to treat psychosis?

A

Dopamine

183
Q

Tricyclics prevent the uptake of which 2 neurotransmitters?

A

NE, Serotonin

184
Q

Which dopaminergic receptor types are excitatory?

A

D1/D5

185
Q

What rate limiting enzyme in the formation for catecholamines?

A

DOPA dc

186
Q

Glutamate Ca2+ channel

A

NMDA

187
Q

Metabotropic receptor of primary inhibitory NT in CNS

A

GABA-b

188
Q

Activity enhanced by benzodiazepines

A

GABA-a

189
Q

What parasympathetic system receptor agonist is used in the treatment of glaucoma that works by facilitating fluid drainage in the eye through the canal of Schlemm?

A

Pilocarpine

190
Q

Which neurotransmitter is synthesized in vesicles?

A

NE

191
Q

There are 2 neurotransmitters that are not rapidly removed from synaptic cleft

A

ACh, NO

192
Q

Who can block glutamate channels?

A

Mg

193
Q

Which is the inhibitory neurotransmitter of the S/C?

A

Glycine

194
Q

Why does hypocalcemia result in tetany?

A

Since extracellular Ca2+ helps screen negative charges fixed to the outer surface when it is reduced there are more negative charges distributed along the outer membrane and the Voltage across the membrane is reduced. The excitable cell is more easily excited because the new threshold is closer to the resting potential.

195
Q

Aminoglycoside antibiotics

A

Calcium channel blockers

196
Q

Bungaratoxin

A

Nm anagonist

197
Q

Omega-conotoxin

A

Ca channel blocker

198
Q

Tetanus

A

Prevents the inhibitory reflex – results in hyperflexia

199
Q

Which of the options associates with syntaxin during docking?

A

Synaptobrevin

200
Q

Which neurotransmitters are located in small dense core vesicles?

A

NE

201
Q

Which of the options are v-Snares?

A

Syntaptobrevin, synaptotagmin

202
Q

Which of the options are t-Snares?

A

Neurexin, Syntaxin

203
Q

Which of the options is responsible for trafficking and targeting vesicles to the exocytosis site?

A

RAB

204
Q

Which of the options associates with neurexin during docking?

A

Synaptotagmin

205
Q

Which of the options is thought to be involved in the formation of the fusion pore?

A

Synaptophysin

206
Q

Which of the options is involved in the retrieval of cell membrane to reform vesicles?

A

Clathrin

207
Q

The filling of vesicles with neurotransmitters is generally dependant on establishing a higher concentration of what ion within the vesicle?

A

H+

208
Q

By what transport system is choline brought back into the synaptic terminal?

A

Na-cotransport

209
Q

Binds irreversibly to actin in cholinergic nerve endings blocking ACh release?

A

Beta-bungaratoxin

210
Q

Irreversible antagonist of nAChR’s on muscles

A

Alpha-bungaratoxin

211
Q

Plant alkaloid that blocks glycine receptors in the CNS?

A

Strychine

212
Q

Bacterial toxin that enters inhibitory interneurons acting on motor neurons and prevents the normal release inhibitory transmitter by breaking down synaptobrevin?

A

Tetanus

213
Q

Bacterial toxin that causes demyelination of motor and sensory neurons?

A

Diptheria

214
Q

Binds to the receptor for the neuropeptide mu-enkephalin activating them?

A

Morphine

215
Q

For what type of neurotransmitter is diffusion out of the synaptic cleft a SIGNIFICANT mechanism of removal?

A

Neuropeptides

216
Q

Increasing the length constant result in … quicker/slower decrease in voltage/amplitude as distance increases

A

Slower

217
Q

Which neurotransmitter is released by excitatory neurons onto motor neurons?

A

Glutamate

218
Q

Which neurotransmitter is released by motor neurons onto skeletal muscle fibers?

A

Glycine

219
Q

What is the function of muscle spindles?

A

Measure muscle length when stretch gated channels open allowing cations [mostly Na+] into the cell depolarizing it

220
Q

In multipolar neurons graded potentials are summed at the ___________________ & when their summation reaches the _________________ an action potential is fired.

A

Axon hillock; threshold

221
Q

In sensory neurons graded potentials are summed near the ___________________ & when their summation reaches the _________________ an action potential is fired.

A

Sensory nerve ending; threshold

222
Q

Light shined to the Left superior quadrant ends up in the ________________ ______________ of the retina.

A

Right inferior

223
Q

The primary visual cortex receives its major blood supply from…

A

Calcarine branches of posterior cerebral a.

224
Q

LGN has 6 layers. What’s the difference?

A

2/6: M cells (magnocellular/depth + motion)

4/6: P cells (parvocellular/form + color)

225
Q

Optic nerve lesion (visual defect & cause)

A

Optic nerve Monocular blindness Optic neuritis

226
Q

Optic chiasm lesion (visual defect & cause)

A

Optic chiasm Bitemporal hemianopia Pituitary tumor

227
Q

Optic tract lesion (visual defect & cause)

A

Optic tract Homonymous hemianopia Temporal tumor

228
Q

Temporal/Parietal radiation (visual defect & cause)

A

Temporal radiation Homonymous superior quadrant anopia Temporal/occipital tumor

Parietal radiation Homonymous inferior quadrant anopia Parietal/occipital tumor

229
Q

Visual cortex lesion (visual defect & cause)

A

Visual cortex Homonymous hemianopia Posterior cerebral a. occlusion

230
Q

Describe color agnosia (achromtopsia)

A

Inability to distinguish color (cortical color blindness)

231
Q

Describe the two columnar organizations of V1, the primary visual cortex

A

Ocular dominance (Ipsilateral & Contralateral); Orientation (vertical/horizontal)

232
Q

Describe the difference between Magnocellular and Parvocellular neurons.

A

Magno: depth/motion (dorsal/parietal); Parvo: color/form (ventral/temporal tract)

233
Q

Where in the visual cortex does the macula innervate?

A

Close to the occipital pole (also gets MCA blood supply; macula sparing)

234
Q

Define gaze, palsy, paresis

A

Gaze: Coordination of head/eye movements to look into one direction
Palsy/Paralysis: loss of motor function
Paresis: slight/incomplete paralysis

235
Q

Differentiate between the 3 major types of eye movement

A

Conjugate: Saccadic-normal eye movement from point to point, Vestiboccular, Optokinetic
Non-conjugate: Cross-eyed (convergence/divergence)
Dysconjugate: fucked up eyes

236
Q

Which are the two extraocular eye muscles not controlled by oculomotor nerve?

A

SO4 (trochlear)

LR6 (abducens)

237
Q

Where in the cerebrum is the initiation of saccadic eye movements?

A

Frontal eye field

238
Q

What is the significance of the parieto-occipital eye field?

A

This is where the dorsal/parietal pathway (motion/3D) ends up; optokinetic eye movement

239
Q

Describe the cortical pathway of saccadic eye movement

A

Frontal eye field –> pons (cross midline) PPRF –> CN6 activation; CN6 –> cross midline MLF tract –> CN3 activation

240
Q

What is MLF and PPRF?

A

MLF – in the midbrain; involved in saccadic eye movments; PPRF – in the pons; receive signal from the frontal eye field

241
Q

What is diplopia?

A

Visual fields of both eyes do not match

242
Q

Internuclear opalmoplegia

A

MLF lesion; Prevents adduction of the one eye on the side of the lesion during attempted lateral gaze

243
Q

PPRF lesion

A

Conjugate gaze towards the side of the lesion is impaired (left gaze palsy, left lesion)

244
Q

One and one-half syndrome

A

MLF + PPRF lesions

245
Q

Endolymph has a high concentration of this ion.

A

K+

246
Q

Depolarization of hair cells is generated by…

A

Influx of K+ ions

247
Q

Aside from the ion that causes depolarization, resulting inward current of _____ causes release of excitatory transmitter at the base of hair cells.

A

Ca++

248
Q

Otolith/Semicircular canals; Linear/Angular acceleration

A

Otolith: Linear
Semicircular: Angular

249
Q

What are the 2 otolith organs?

A

Utricle and saccule

250
Q

The center of the utricle and saccule is called the…

A

Striola

251
Q

What is the anatomical difference between the utricle and saccule’s hair cells with respect to the striola?

A

Kinocilum is TOWARDS the striola in utricle; away is saccule

This allows for activation and inactivation simultneously

252
Q

What is embedded in the otolith membrane?

A

Calcium carbonate crystals

253
Q

Rotation of the head to the left causes excitation/inhibition of semicircular canal labyrinth of left

A

Excitation; causes the endolymph to move to the right

254
Q

Conjugate eye movements are in the same direction/opposite to head movement.

A

Opposite

255
Q

T/F Visual input is required for conjugate eye movements in the VOR reflex.

A

False – can occur in complete darkness

256
Q

What is nystagmus?

A

Rhythmically alternating movements of the eye

257
Q

Meniere’s disease

A

Abnormalities of endolymph circulation can lead to significant dilation of endolymph compartments and degeneration of hair cells. The disease affects the vestibular and auditory system and is characterized by recurrent sudden vertigo, tinnitus, sensorineural hearing loss

258
Q

Describe the effect of ETOH on the vestibular system

A

The spinning bed phenomenon
* interactions of blood alcohol with the endolymph which can cause convection endolymph flows within the semicircular canals

259
Q

What are possible consequences of long-term antibiotics?

A

Destruction of vestibular hair cells

260
Q

What are the 2 terms for each eye of a bilateral pupillary response?

A

Direct + Consensual

261
Q

How does the pupil know to constrict if you are only telling the LGN that there is light?

A

Some fibers innervate the EW pre-tectal nucleus of the midbrain; travel with CN3 & ciliary ganglion –> short ciliary nerves

262
Q

Describe the corneal reflex

A

Nocioceptors in the cornea –> pons via V1 –> descend through pons/medulla (pain pathway) to CN5 spinal nucleus –> facial nuclei in lower pons

263
Q

Describe the CN involved in the opening and closing of the eyes

A

Open: 3 (lev palpebrae superioris) & sympa (tarsal)
Close: 7 (orbicularis oculi)

264
Q

Differentiate between conduction and sensorineural hearing loss.

A

Conduction: outer/middle ear
Sensorineural: cochlea/auditory n.

265
Q

What are the two factors that contribute to sound amplification in the middle ear.

A
  1. Oval window = small; big force

2. Ossicles act like a lever system

266
Q

The scala vestibuli and scala tympani are continuous through the …

A

Helicotremma

267
Q

What forms the lateral wall of the scala media & what type of ions does it secrete?

A

Stria vasucalris (actively secretes K ions)

268
Q

Differentiate between where on the basilar membrane high vs. low frequencies are best detected.

A

High: Oval window (narrow/stiff)
Low: Helicotremma (wide/floppy)

269
Q

What is the name of the concept : where the place (or location) of a nerve cell encodes for a specific stimulus feature?

A

Place code

270
Q

Except for 3 different types of lesions, there are no lesions that produce unilateral hearing loss. What are they?

A
  1. Damage to ear
  2. Damage to CN8
  3. Damage to cochlear nuclei
271
Q

A lesion of the inferior colliculus will disrupt one’s ability to…

A

Disrupt ability to localize sound

272
Q

Where is the primary auditory cortex?

A

Transverse temporal gyrus of Heschl

273
Q

Differentiate between the location of high/low frequencies in the tonotopically organized primary auditory cortex.

A

Low frequency: lateral (rostral)

High frequency: medial (caudal)

274
Q

What is the difference between EE & EI columns in the primary auditory cortex?

A

EE: both ears, summation
EI: one ear, suppression

275
Q

Where in the brain is the “coincidence detection” pathway?

A

Superior olive (Medial SO)

276
Q

Two sound signals approach the ears. A larger/smaller EPSP is recorded for a sound that reaches both ears simultaneously.

A

Larger

277
Q

Localization of sound is performed in the __________ region of the brainstem. The two methods of coincidence detection and interaural amplitude differences are located __________________.

A

Superior olive

  • Coincidence detection: medial
  • Interaural amplitidue differences (most effective for high frequencies): lateral – includes inhibitory neurons
278
Q

What is Weber’s Test?

A

Lateralization; tuning fork to the mid-scalp/forehead
*Reaches inner ear directly through bone

Normal Hear in both ears
Conductive loss Sound lateralizes to ipsilateral side (side of disease)
Sensorineural Sound lateralizes to the contralateral side (side of normal hearing)

279
Q

What is Rinne’s Test?

A

Tests bone/air conduction (air&raquo_space; bone because of amplification in middle ear)

  1. Tuning fork to the mastoid
  2. Tuning fork to air (air should be better than bone in normal subjects)
  • Conductive hearing loss: bone&raquo_space; air (decreased sound perception during air)
280
Q

Otosklerosis

A

Causes conductive hearing loss
* Gradual replacement of normal bone of bony labyrinth and stapes by lamellar new bone. Leads to fusion of stapes with borders of oval window.

281
Q

Vestibular Schwannoma

A

Causes Sensorinueral hearing loss
Acoustic neuroma; benign tumor of Schwann cells of CN8; compresses the vestibulocochlear nerve of IAM; hearing loss + tinnitus

282
Q

Cochlear implants

A

Microphone, electronic processor, and array of stimulating electrodes can help restore hearing; adjacent fibers attached to inner hair cells may still be in tact
* Surgical implantation into the cochlea

283
Q

How often are new olfactory sensory cells made?

A

Every 60 days

284
Q

What is the vomeronasal organ?

A

Chemoreceptive for pheromones; one study demonstrated that menstrual cycles can be manipulated based on armpit odorless pheromones

285
Q

What is special about the olfactory system?

A

Information reaches temporal/limbic lobes before relaying in the thalamus

286
Q

What is the mode of communication of the olfactory system?

A

cAMP

287
Q

Describe the pathway for taste. Does this pathway cross the midline?

A

Does not cross midline
* Pseudounipolar –> Geniculate/Inferior ganglion –> pontomedullary junction –> Solitary nucleus –> Ipsilateral VPM of thalamus –> primary gustatory cortex (insular lobe/posterior central gyrus)

288
Q

Differentiate cranial nerves of taste.

A

Ant 2/3: CN7
Pos 1/3: CN9
Way back: CN10

289
Q

Describe the 4 major taste buds and the signaling mechanism.

A

Salty: Na+ in
Sour: H+ w/ Na or H+ blocks K
Sweet: cAMP
Bitter: PLC–> IP3 –> Ca++

290
Q

Where on the tongue are the taste buds?

A

Anterior: salty, sour, sweet
Posterior: sour/bitter

291
Q

What is Wallenburg’s syndrome?

A

Wallenberg (Lateral Medullary) Syndrome may arise from occlusion of the posterior inferior cerebellar artery (PICA).

292
Q

What might cause olfactory hallucinations?

A

Partial epileptic seizures around the region of uncus

293
Q

Differentiate between hypogeusea, ageusea, hyposmia, anosmia.

A

Hypogeusea: decreased taste (oral pathology)
Ageusea: loss of taste (Wallenburg)
Hyposmia: decreased smell (more common than taste)
Anosmia: Meningioma (loss of smell)

294
Q

4 main types of EEG waves

A

Beta: highest frequency, frontal active, thinking open eyes
Alpha: awake, closed eyes, occipital
Theta: drowsy
Delta: deep sleep/coma

295
Q

How do you differentiate between different types of EEG waves?

A

L vs. R
Spikes = bad
Slow waves = bad

296
Q

Differentiate between primary and secondary epilepsy

A

Primary: genetic
Secondary: symptomatic, partial, focal

297
Q

Small, reactive pupils

A

Cortex, or diencephalon

298
Q

Fixed, dilated pupils

A

Pre-tectal, midbbrain

299
Q

Pinpoint pupils

A

Pons

300
Q

One pupil fixed and dilated

A

Uncal, fixed, dilated

301
Q

GCS

A

E: 4 – spontaneous, verbal, pain, X
V: 5 – oriented, confused, inapprop, incompre, X
M: 6 – comands, loc pain, w/draw pain, flex, extend, X

302
Q

Ventral tegmental system

A

Reward pathway–nucleus accumbens

303
Q

D2 antagonist

A

Haldol / anti-psychotic

304
Q

What is the relationship b/t Parkinson’s and psychosis

A

Treatment for one can lead to the other

305
Q

Sedatives

A

ETOH, benzo, barb, opiods

306
Q

Hallucinogens

A

Ketamine, LSD, angel dust

307
Q

Stimulants

A

Amphetamine, cocaine, ecstacy, nicotine

308
Q

Withdrawal from a sedative causes…

A

Stimulation

309
Q

Treating withdrawal

A

Anti-adrenergic: CNS – clonidine
Anti-convulsant: diazapam
Anti-psychotic: haldol

310
Q

T/F Opiod detox is life threatening

A

False; can be treated with methadone

311
Q

Differentiate between transmission and burst EEG

A

Transmission: normal, high frequency
Burst: deep sleep, coma, low frequency

312
Q

3 Treatments for epilepsy

A

Block excitation by blocking Na+ channels (phenytoin, carbamazepine)
Increase inhibition: GABA-ergic, benzo’s, barbs
Anti-convulsant: Levetiracetam (Keppra)

313
Q

3 characteristics of grand mal seizure

A

Tonic-grunt/cry, clonic-jerky movements, post-tictal