Neurology Flashcards
What is the central nervous system?
Brain
Spinal cord
Oligodendrocytes
What is the peripheral nervous system?
Everything other than Brain and Spinal cord
Schwann cells
What is the autonomic nervous system?
Automatic stuff
What is the somatic nervous system?
Moving your muscles
What is the parasympathetic system?
Rest-and-Digest
(=> slows stuff down)
How does the parasympathetic system behave?
DUMBBELS
Diarrhea
Urination
Miosis “constrict”
Bradycardia
Bronchoconstrict
Erection “point”
Lacrimation
Salivation
What is the sympathetic system?
Fight-or-Flight
(=> speeds stuff up)
How does the sympathetic system behave?
Opposite of Parasympathetics
Constipation
Urinary retention
Mydriasis “eyes wide with fright”
Tachycardia
Bronchodilate
Ejaculation “shoot”
Xerophthalmia (dry eyes)
Xerostomia (dry mouth)
Where is NE synthesized?
Locus cerulean of the pons
What happens to NE in anxiety?
Goes up
What happens to NE in depression?
Goes down
Where is dopamine synthesized?
Ventral tegmentum and SNc in the midbrain
What happens to dopamine in Huntington’s?
Goes up
What happens to dopamine in Parkinson’s and depression?
Goes down
Where is serotonin synthesized?
Raphe nucleus
What happens to serotonin in Parkinson’s?
Goes up
What happens to serotonin in anxiety and depression?
Goes down
Where is ACh synthesized?
Basal nucleus of Meynert
What happens to ACh in Parkinson’s?
Goes up
What happens to ACh in Alzheimer’s and Huntington’s?
Goes down
What does the forebrain or prosencephalon give rise to?
Telencephalon -> Cerebral Hemispheres
Diencephalon -> Thalamus
What does the midbrain or mesencephalon give rise to?
Mesencephalon -> midbrain
What does the hindbrain or rhombencephalon give rise to?
Metencephalon -> pons and cerebellum
Myelencephalon -> medulla
What is Cushing’s triad?
HTN
Bradycardia
Elevated ICP
What is Budd-Chiari?
Hepatic vein obstruction
What is anencephaly?
Notochord did not make contact w/ brain => only have medulla
What is an Encephalocele?
Brain tissue herniation
What is a Dandy-Walker malformation?
No cerebellum
Distended 4th/lateral ventricles
What is an Arnold-Chiari malformation?
Herniation of cerebellum through foramen magnum
Type I = cerebellar tonsils (asymptomatic)
Type II = cerebellar vermis/medulla => hydrocephalus, syringomyelia (loss of pain/temp)
What is spina bifida occulta?
Covered by skin w/ tuft of hair
What is spina bifida aperta?
Has opening
(High AFP)
What is a meningocele?
Sacral pocket w/ meninges in it
What is a meningomyelocele?
Sacral pocket w/ meninges and nerves in it
What is open-angle glaucoma?
Overproduction of fluid
- painless ipsilateral dilated pupil
- gradual tunnel vision
- optic disc cupping
What is closed-angle glaucoma?
Obstruction of canal of Schlemm
- sudden onset
- pain
- emergency
What are the watershed areas?
Hippocampus
Splenic flexure
What are the contents of the cavernous sinus?
CN III
CN IV
CN V1
CN V2
CN VI
Postganglionic sympathetic fibers
What bug loves the frontal lobe?
Rubella
What bug loves the temporal lobe?
HSV
What bug loves the parietal lobe?
Toxoplasma
What bug loves the hippocampus?
Rabies
What bug loves the posterior fossa?
TB
= mycobacterium tuberculosis
What bug loves the DC/ML tract?
Treponema
How do migraines present?
Aura
Photophobia
Numbness
Tingling
Throbbing HA
Nausea
How do tension headaches present?
“Band-like” pain
Starts in posterior neck, worse as day progresses, sleep disturbance
How do cluster headaches present?
Rhinorrhea
Unilateral orbital pain
Suicidal
Facial flushing
Worse w/ lying down
How does temporal arteritis present?
Pain with chewing
Blind in one eye
How does trigeminal neuralgia present?
Sharp, shooting face pain
What are 2 kinds of partial seizures?
Simple (aware)
Complex (not aware)
What are 3 kinds of generalized seizures?
Tonic-Clonic = “grand mal”
Absence = “petit mal”
Status epilepticus
How does an epidural hematoma present?
Intermittent consciousness
“Lucid interval”
How does an epidural hematoma look on CT?
Biconvex lens
(Does not cross suture lens)
How does a subdural hematoma present?
Headache 4 wks after trauma
Elderly (loose brain)
How does a subdural hematoma look on CT?
Crescent-shaped
Crosses suture lines
Contains midline shift
How does a subarachnoid hemorrhage present?
“Worst headache of my life”
H/o berry aneurysm
What is an astrocytoma?
1 in kids with occipital mass
Rosenthal fibers
What is an ependymoma?
Rosettes
In 4th ventricle
Hydrocephalus
What is seen with a craniopharyngioma?
Motor oil biopsy
Tooth enamel
Rathke’s pouch
ADH problem
Bitemporal hemianopsia
What is associated with Glioblastoma multiforme?
Pseudopalisading
Necrosis
Worst prognosis
Intralesional hemorrhage
What is a hemangioblastoma associated with?
Cerebellum
Von-Hippel-Linda’s
Blood vessel tumor
What is associated with a medulloblastoma?
Pseudorosettes
Compresses the brain
Early morning vomiting
What is associated with a meningioma?
Parasagittal
Psammoma bodies
Whorling pattern
Best prognosis
What are the most common places to metastasize to the brain?
From lung, breast, skin
See at white-grey matter junction in brain
What is associated with an oligodendroglioma?
Fried-egg appearance
Nodular calcification
What is associated with pinealoma?
Loss of upward gaze
Loss of circadian rhythms (=> precocious puberty)
What is associated with a schwannoma?
CN VIII tumor
Unilateral deafness
What is associated with neurofibromatosis?
Cafe au lait spots (hyperpigmentation)
=> peripheral nerve tumors, axillary freckle
Type 1 = Von Recklinghausen’s
- peripheral (chr 17)
- optic glioma
- Lisch nodules
- scoliosis
Type 2
- “Acoustic neuroma”
- central (chr 22)
- cataracts
- bilateral deafness
What is associated with Sturge-Weber?
Port-wine stain (big purple spot) on forehead
Angioma of retina
What is associated with tuberous sclerosis?
Ash leaf spots (hypopigmentation)
Primary brain tumors
Heart rhabdomyomas
Renal cell carcinoma
Shagreen spots (leathery)
