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AA_Rapid Review > Neurology > Flashcards

Neurology Flashcards

1
Q

Motor innervation of the tongue

A

Hypoglossal nerve – CN XII

w/ exception of palatoglossus muscle, which is innervated by the Vagus Nerve – CN X

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2
Q

General sensation (touch/pain/pressure/temp) to anterior 2/3 of tongue?

A

Mandibular branch of Trigeminal Nerve – CN V3

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3
Q

General sensation (touch/pain/pressure/temp) to posterior 2/3 of tongue?

A

Glossopharyngeal Nerve – CN IX

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4
Q

General sensation (touch/pain/pressure/temp) to posterior area of the tongue root?

A

Vagus Nerve – CN X

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5
Q

Gustatory sensation (taste buds) to anterior 2/3 of tongue?

A

Chorda Tympani of Facial Nerve – CN VII

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6
Q

Gustatory sensation (taste buds) to posterior 2/3 of tongue?

A

Glossopharyngeal Nerve – CN IX

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7
Q

Gustatory sensation (taste buds) to posterior area of the tongue root & taste buds of the larynx & upper esophagus?

A

Vagus Nerve – CN X

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8
Q

Afferent limb of pupillary light reflex?

transmits light → pretectal nucleus → Edinger Westphal nucleus

A

Optic Nerve (CN II)

Marcus Gunn pupil = afferent pupillary defect due to optic nerve damage or retinal detachment

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9
Q

Efferent limb of pupillary light reflex?

Pretectal nucleus → iris sphinctor & ciliary muscle → constricts pupil

A

Parasympathetic fibers of Oculomotor Nerve (CN III)

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10
Q

Afferent & efferent limbs of Corneal reflex?

A

A = CN V1 ophthalmic (nasociliary branch)

E = CN VII (temporal branch: orbicularis oculi)

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11
Q

Nerve that allows ability to close eyelid?

A

Facial Nerve (CN VII)

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12
Q

Where is lesion?

Medially directed eye that cannot abduct

A

Abducens nerve (CN VI)

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13
Q

Where is lesion?

Eye looks down & out, ptosis, pupillary dilation, loss of accommodation

A

Oculomotor Nerve (CN III)

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14
Q

Where is lesion?
Eye moves upward, particularly w/ contralateral gaze & ipsilateral head tilt
(problems going down stairs)

A

Trochlear Nerve (CN IV)

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15
Q

Where is lesion?

Horizontal nystagmus w/ normal convergence

A

MLF

Internuclear Ophthalmoplegia

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16
Q

Controls circadian rhythm?

A

Suprachiasmatic nucleus (Hypothalamus)

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17
Q

Controls heating, sympathetic?

A

Posterior Hypothalamus

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18
Q

Controls cooling, parasympathetic?

A

Anterior Hypothalamus

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19
Q

Controls satiety; lesion → hyperphagia?

A

Ventromedial area (Hypothalamus)

stimulated by Leptin

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20
Q

Controls huger; lesion → anorexia?

A

Lateral area (Hypothalamus)

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21
Q

NE → Location of synthesis?

A

Locus Ceruleus (Pons)

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22
Q

Dopamine → Location of synthesis?

A

Ventral Tegmentum & Substantia Nigra (SNc; midbrain)

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23
Q

5-HT → Location of synthesis?

A

Raphe Nucleus (Pons)

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24
Q

ACh → Location of synthesis?

A

Basal nucleus of Meynert

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25
Q

GABA → Location of synthesis?

A

Nucleus accumbens

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26
Q

Location?

Reward center, pleasure, addiction, fear

A

Nucleus Accumbens & Septal Nucleus

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27
Q

Intention Tremor = Characteristic lesion where in the brain?

A

= Cerebellar dysfunction

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28
Q

Hemiballismus = Characteristic lesion where in the brain?

A

Contralateral subthalamic nucleus

e.g. lacunar stroke

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29
Q

Chorea = Characteristic lesion where in the brain?

A

Basal ganglia

e.g. Huntington’s

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30
Q

Athetosis = Characteristic lesion where in the brain?

A

Basal ganglia

e.g. Huntington’s

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31
Q

Lesion Localization?

Kluver Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)

A

Amigdala (bilateral)

  • ass’d w/ HSV-1
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32
Q

Lesion Localization?

Disinhibition & deficits in concentration, orientation, & judgment; may have re-emergence of primitive reflexes

A

Frontal lobe

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33
Q

Lesion Localization?
Spatial neglect syndrome
(agnosia of the contralateral side of the world)

A

Right parietal lobe

34
Q

Lesion Localization?
Reduced levels of arousal & wakefulness
(e.g. coma)

A

Reticular activating system (midbrain)

35
Q 
Lesion Localization?
Wernicke-Korsakoff syndrome
- Confusion, ophthalmoplegia, ataxia
- Memory loss (anterograde & retrograde amnesia)
- Confabulation, personality changes
A

Mammilary Bodies (bilateral)

  • ass’d w/ Thiamine (B1) deficiency & alcoholics
  • can be precipitated by giving glucose w/out B1 to a B1-deficient patient
36
Q

Lesion Localization?

May result in tremor at rest, chorea, or athetosis

A

Basal ganglia (Parkinson’s Disease)

37
Q

Lesion Localization?

Intention tremor, limb ataxia, & loss of balance

A

Cerebellar hemispheres

  • affects lateral limbs, ipsilaterally
38
Q

Lesion Localization?

Contralateral hemiballismus

A

Subthalamic nucleus

39
Q

Lesion Localization?

Truncal ataxia, dysarthria

A

Cerebellar vermis

  • “centrally” located, affects “central” body
40
Q

Lesion Localization?

Anterograde amnesia

A

Hippocampus

41
Q

Lesion Localization?

Eyes look away from side of lesion

A

Paramedian Pontine Reticular Formation (PPRF)

42
Q

Lesion Localization?

Eyes look toward lesion

A

Frontal eye fields

43
Q

Lesion Localization?

Parinaud Syndrome - paralysis of conjugate vertical gaze

A

Superior Colliculi

e.g. pinealoma; pineal body lies just above the superior colliculi

44
Q

What nerve root controls the Biceps reflex?

A

C5

45
Q

What nerve root controls the Triceps reflex?

A

C7

46
Q

What nerve root controls the Patella reflex?

A

L4

47
Q

What nerve root controls the Achilles reflex?

A

S1

48
Q

Which cranial nerve nuclei lie in the Midbrain?

A

CN III & IV

49
Q

Which cranial nerve nuclei lie in the Pons?

A

CN V-VIII

50
Q

Which cranial nerve nuclei lie in the Medulla?

A

CN IX, X, XII

51
Q

Which cranial nerve nuclei lie in the Spinal Cord?

A

CN XI

52
Q

Afferent & effent limbs of lacrimation reflex?

A

A = V1
(loss of reflex does not preclude emotional tears)

E = VII

53
Q

Afferent & effent limbs of jaw-jerk reflex?

A

A = V3 (sensory - muscle spindle from masseter)

E = V3 (motor - masseter)

54
Q

Afferent & effent limbs of pupillary light reflex?

A

A = II

E = III

55
Q

Afferent & effent limbs of gag reflex?

A

A = IX

E = X

56
Q

Lesion Localization?

Paralysis of upper & lower face

A

CN VII, LMN
- Ipsilateral
(Facial nerve palsy)

57
Q

Lesion Localization?

Paralysis of lower face w/ forehead spared

A

Lesion of motor cortex OR corticobulbar tract (cnxn btwn cortex & CN VII)

  • Contralateral, UMN
  • Forehead sparing due to bilateral UMN innervation
58
Q

Lesion Localization?

Jaw deviation to one side

A

Ipsilateral CN V

unopposed force from opp. pterygoid muscle

59
Q

Lesion Localization?

Uvula deviation to one side

A

Contralateral CN X

60
Q

Lesion Localization?

Weakness turning head to one side w/ shoulder droop on other side

A

CN XI lesion on side of shoulder droop (trapezius)

  • SCM causes weakness turning head
61
Q

Lesion Localization?

Tongue deviation to one side

A

Ipsilateral CN XII lesion

62
Q

Lesion Localization?
“Waiter’s tip”
(Limb hangs by side, medially rotated, forearm pronated)

A

Upper Trunk of Brachial Plexus (C5 & C6 roots)

  • Lesioned by trauma (seen in infants w/ trauma following delivery)
  • Paralysis of Abductors, Lateral rotators, & Biceps, respectively
63
Q

Lesion Localization?

Total Claw hand (Klumpke’s palsy)

A

Lower Trunk of Brachial Plexus (C8, T1)

  • Loss of function of all lumbricals
  • Compressed by cervical rib or by Pancoast tumor of the lung
64
Q

Lesion Localization?

Wrist drop

A

Posterior Cord of Brachial Plexus OR Radial Nerve

Radial Nerve:

  • compressed in axilla by incorrect use of crutch
  • lesioned by midshaft fracture of humerus
  • stretched by subluxation of radius
65
Q

Winged scapula

A

Long Thoracic Nerve (C5, 6, 7)

66
Q

Deltoid paralysis

A

Axillary Nerve

lesioned by:

  • fracture of surgical neck
  • dislocation of humerus
  • intramuscular injections
67
Q

Difficulty flexing elbow, variable sensory loss

A

Musculocutaneous Nerve

68
Q

“Pope’s blessing”:

2nd & 3rd digits remain extended when asked to make a fist & thumb remains unopposed

A

Proximal Median Nerve lesion

compressed in:

  • carpal tunnel syndrome
  • dislocated lunate
69
Q

“Claw hand” of pinky & ring finger when trying to open the hand

A

Ulnar Nerve lesion

  • Loss of medial lumbricals function
  • lesioned by trauma to heel of the hand; fracture of hook of hamate
70
Q

Loss of sensation over the dorsum of the foot along w/ loss of dorsiflexion & eversion

A

Lesion to common perineal nerve:
Deep Peroneal Nerve = dorsiflexion
Superficial Peroneal = eversion & sensation to dorsum of foot

(Fibular neck fracture = common injury)

71
Q

Loss of sensation over sole of the foot along w/ loss of plantar flexion & inversion of the foot

A

Tibial nerve

common injury = as it passes through the middle of the popliteal fossa

72
Q

Loss of sensation on the medial aspect of the leg

A

Saphenous Nerve lesion (branch of femoral nerve)

73
Q

Function of the intrinsic Lumbrical muscles of the hand?

A
  • Flex MCP joints

- Extend DIP & PIP joints

74
Q

“Claw hand” of index & middle finger when trying to open hand completely

A

Distal Median Nerve lesion

  • Loss of lateral lumbrical function
75
Q 
"Ape Hand":
Unopposable thumb (inability to abduct thumb)
A

Proximal median nerve lesion
(similar to “Pope’s Blessing”)

  • Loss of Opponens Pollicis muscle function
76
Q

Anterior Hip Dislocation – potential nerve damaged & symptoms?

A

Obturator Nerve (L2-4)

Motor Deficit = Thigh adduction
Sensory Deficit = Medial Thigh

77
Q

Pelvic Fracture – potential nerve damaged & symptoms?

A

Femoral Nerve (L2-4)

Motor Deficit = Thigh flexion & leg extension
Sensory Deficit = Anterior thigh & medial leg

78
Q

Trauma or compression of lateral aspect of leg – potential nerve damaged & symptoms?

A

Common Peroneal Nerve (L4-S2)

Motor Deficit = Foot eversion & dorsiflexion; Toe extension (foot drop, foot slap, steppage gait)
Sensory Deficit = Anterolateral leg & dorsal aspect of foot

79
Q

Fibula neck fracture – potential nerve damaged & symptoms?

A

Common Peroneal Nerve (L4-S2)

Motor Deficit = Foot eversion & dorsiflexion; Toe extension (foot drop, foot slap, steppage gait)
Sensory Deficit = Anterolateral leg & dorsal aspect of foot

80
Q

Posterior Hip Dislocation – potential nerve damaged & symptoms?

A

Superior Gluteal Nerve (L4-S1)
Motor Deficit = Thigh abduction (Trendelenburg Sign - contralateral hip drops when standing on leg ipsilateral to site of lesion)

Inferior Gluteal Nerve (L5-S2)
Motor Deficit = Can’t jump, climb stairs, or rise from seated position; can’t push inferiorly (downwards)

81
Q

Polio – potential nerve damaged & symptoms?

A

Superior Gluteal Nerve (L4-S1)
Motor Deficit = Thigh abduction (Trendelenburg Sign - contralateral hip drops when standing on leg ipsilateral to site of lesion)

82
Q

Sciatic nerve roots? What nerves does it become/split into?

A

L4-S3
Posterior thigh, splits into Common Peroneal & Tibial Nerve

(PED - Peroneal Everts & Dorsiflexes, if injured foot dropPED)
(TIP - Tibial Inverts & Plantarflexes, if injured can’t stand on TIP-toes)

AA_Rapid Review (15 decks)

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