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aNeuro exam 4: Lindsey's > Neuro Review- First Aid- pg 480-485 > Flashcards

Neuro Review- First Aid- pg 480-485 Flashcards

1
Q

This is the central area of the retina.

A

the macula

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2
Q

What is the motor component of CNIII?

A
  • output to ocular muscles
  • defect –> ptosis, down and out gaze
  • damage caused from vascular disease (ie DM)
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3
Q

What are the histologic/gross findings in Alzheimer’s disease?

A
  • widespread cortical atrophy
  • widening of sulci, narrowing of gyri
  • decreased ACh
  • senile plaques (beta-amyloid)
  • neurofibrillary tangles (tau protein)
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4
Q

Dx?

  • rapidly progressive (weeks-months) dementia
  • startle myoclonus
  • spongiform cortex
  • prion disease (beta-pleated sheets)
A

Creutzfeldt-Jakob disease

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5
Q

What is the Charcot classic triad of MS?

A

SIN

  • s = scanning speech
  • I - intention tremor/incontinence/internuclear opthalmoplegia (INO)
  • n = nystagmus
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6
Q

Lewy body dementia

A
  • dementia
  • visual hallucinations
  • parkinsonian features
  • alpha-synuclein defect
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7
Q

Dx?

  • dementia
  • visual hallucinations
  • parkinsonian features
  • alpha-synuclein defect
A

Lewy body dementia

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8
Q

normal pupillary light reflex

A

light enters retina –> CNII signals pretectal nuclei in midbrain –> activate Edigner-Westfall nuclei BILATERALLY –> pupils contract BILATERALLY

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9
Q

Dx?

  • separation of neurosensory layer (rods/cones) from outermost layer (pigmented epi) of retina
  • causes photoreceptors to degenerate –> vision loss
  • due to retinal breaks, diabetic traction, inflammatory effusions
  • “like a curtain drawn down”
  • surgical emergency!
A

retinal detachment

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10
Q

CNIII: sensory, motor, or both?

A

motor

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11
Q

light enters retina –> CNII signals pretectal nuclei in midbrain –> activate Edigner-Westfall nuclei BILATERALLY –> pupils contract BILATERALLY

A

normal pupillary light reflex

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12
Q

MS spinal tap findings

A
  • increased IgG
  • oligoclonial bands
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13
Q

MS MRI findings

A
  • periventricular plaques (oligodendrocyte loss and reactive gliosis)
  • destruction of axons
  • multiple white matter lesions separated in space and time
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14
Q

What neurons and CNs control miosis (pupillary constriction)?

A
  1. Edinger-Westfall nucleus –> ciliary ganglion via CNIII
  2. short ciliary nerves –> pupillary sphincter muscles
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15
Q

Dx?

  • dementia
  • aphasia
  • parkinsonians
  • change in personality
  • pick bodies (tau protein)
  • frontotemporal atrophy
A

Pick disease (frontotemporal dementia)

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16
Q

Tx for MS

A
  • beta-interferon
  • immunosuppression
  • natalizumab
17
Q

What is the NT change in Alzheimer’s disease?

A

decreased ACh

18
Q

retinal detachment

A
  • separation of neurosensory layer (rods/cones) from outermost layer (pigmented epi) of retina
  • causes photoreceptors to degenerate –> vision loss
  • due to retinal breaks, diabetic traction, inflammatory effusions
  • “like a curtain drawn down”
  • surgical emergency!
19
Q

MS definition

A
  • autoimmune inflammation and demyelination of CNS
  • optic neuritis (Marcus Gunn pupils)
  • internuclear ophthalmoplegia (INO)
  • hemiparesis
  • hemisensory symptoms
  • bladder/bowel incontinence
  • white women 20-30yo
20
Q

What is a Marcus Gunn pupil? What’s is assoc. with?

A
  • an afferent pupillary defect (APD)
  • optic nerve damage or severe retinal injury- MS***
  • decreased bilateral pupillary constriction when light is shone in affected eye relative to unaffected eye
  • test with swinging flashlight test
21
Q

What is the parasymp. component of CNIII?

A
  • output, esp. on periphery
  • defect –> diminished/absent pupillary light reflex, blown pupil, down and out gaze damage due to compression (PCA aneurism, uncal herniation)
22
Q

Dx?

  • autoimmune inflammation and demyelination of CNS
  • optic neuritis (Marcus Gunn pupils)
  • internuclear ophthalmoplegia (INO)
  • hemiparesis
  • hemisensory symptoms
  • bladder/bowel incontinence
  • white women 20-30yo
A

MS

23
Q

Dx?

  • widespread cortical atrophy
  • widening of sulci, narrowing of gyri
  • decreased ACh
  • senile plaques (beta-amyloid)
  • neurofibrillary tangles (tau protein)
A

Alzheimer’s disease

24
Q

What is the macula?

A

the central area of the retina

25
Q

What protein is protective for Alzheimer’s? What chromosome is it found on?

A

ApoE2 (Ch.19)

26
Q

Dementia

A

a decrease in cognitive ability, memory, or function with intact consciousness

27
Q

Creutzfeldt-Jakob disease

A
  • rapidly progressive (weeks-months) dementia
  • startle myoclonus
  • spongiform cortex
  • prion disease (beta-pleated sheets)
28
Q

Dx?

  • disorder of conjugate lateral gaze
  • medial longitudinal fasciculus (MLF) lesions
  • CN III and VI
  • affected eye adducts minimally, if at all
  • contralateral eye abducts with nystagmus
  • divergence of the eyes leads to horizontal diplopia
  • convergence preserved
  • common in MS
A

internuclear opthalmoplegia (INO)

29
Q

Pick disease (frontotemporal dementia)

A
  • dementia
  • aphasia
  • parkinsonians
  • change in personality
  • pick bodies (tau protein)
  • frontotemporal atrophy
30
Q

Name the finding.

  • an afferent pupillary defect (APD)
  • optic nerve damage or severe retinal injury- MS***
  • decreased bilateral pupillary constriction when light is shone in affected eye relative to unaffected eye
  • test with swinging flashlight test
A

Marcus Gunn pupil

31
Q

What does damage to CNIII result in?

A
  • diminished/absent pupillary light reflex
  • blown pupil
  • ptosis
  • down and out gaze
32
Q

Alzheimer’s disease altered proteins and associated chromosomes

A
  • early onset =
    • APP (Ch21)
    • presenilin-1 (Ch14)
    • presenilin-2(Ch1)
  • late onset = ApoE4 (Ch19)
33
Q

a decrease in cognitive ability, memory, or function with intact consciousness

A

dementia

34
Q

SIN

  • s = scanning speech
  • I - intention tremor/incontinence/internuclear opthalmoplegia (INO)
  • n = nystagmus
A

Charcot classic triad of MS

35
Q

How is amyloid-beta synthesized?

A

cleaving amyloid precursor protein (APP) by gamma-secretase

36
Q

What is internuclear opthalmoplegia (INO)?

A
  • disorder of conjugate lateral gaze
  • medial longitudinal fasciculus (MLF) lesions
  • CN III and VI
  • affected eye adducts minimally, if at all
  • contralateral eye abducts with nystagmus
  • divergence of the eyes leads to horizontal diplopia
  • convergence preserved
  • common in MS
37
Q

What neurons and CNs control mydriasis (pupillary dilation)?

A
  1. hypothalamus –> ciliospinal center of Budge (C8-T2)
  2. exit at T1 –> superior cervical ganglion
  3. plexus along internal carotid –> cavernous sinus –> orbit as long ciliary nerve –> pupillary dilator muscles

aNeuro exam 4: Lindsey's (37 decks)

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