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Pathophys II > Neurology > Flashcards

Neurology Flashcards

1
Q

Obstruction is within the ventricular system

Ex: tumor in the region of the cerebral aqueduct

A

Non-communicating hydrocephalus

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2
Q

Obstruction is within the subarachnoid space or arachnoid villi

A

Communicating hydrocephalus

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3
Q

Enlargement of one or more ventricles (ventriculomegaly) caused by an obstruction of the bulk flow of CSF

A

Hydrocephalus

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4
Q

Ventriculomegaly that results from a loss of brain tissue (brain atrophy)

A

Hydrocephalus ex vacuo

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5
Q

Clinical symptoms of increased intracranial pressure

A

Headache, N/V, papilledema

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6
Q

Mean arterial pressure minus the mean ICP

A

Cerebral perfusion pressure (CPP)

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7
Q

Causes of increased ICP

A

Mass lesion, hydrocephalus, diffuse brain edema, obstruction, idiopathic intracranial hypertension

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8
Q

Dilated ipsilateral pupil from compression of parasympathetic fibers in CN III is a clinical sign of what?

A

Uncal herniation

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9
Q

Increase in brain volume due to an increase in fluid

A

Brain edema

Causes brain swelling that may produce a mass effect

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10
Q

Type of brain edema that is extracellular edema due to BBB breakdown. Is this mainly found in the gray or white matter?

A

Vasogenic Brain Edema

Mainly in the white matter

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11
Q

Type of brain edema that is intracellular edema due to an osmotic imbalance between the cell and the extracellular fluid. Is this mainly found in the gray or white matter?

A

Cytotoxic Brain Edema

Mainly in the gray matter

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12
Q

Type of brain edema that is extracellular edema in periventricular white matter due to the transependymal flow of CSF in hydrocephalus.

A

Interstitial Brain Edema

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13
Q

Condition where sutures of the skull fuse too early in development. These children will have developmental problems because the brain needs room to grow.

A

Syndesmosis

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14
Q

Child presents with ataxia, gait disturbance, and unilateral or bilateral abducens nerve palsy

A

Pontine Glioma

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15
Q

Is Parkinson’s a disease of the pyramidal or extrapyramidal motor system?

A

Extrapyramidal

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16
Q

Is ALS a disease of the pyramidal or extrapyramidal motor system?

A

Pyramidal

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17
Q

What is the main structure affected in chronic traumatic encephalopathy?

A

Septum pellucidum

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18
Q

Comprehension preserved but language output is impaired and non-fluent

A

Broca’s aphasia

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19
Q

Comprehension is severely impaired, while language is fluent.

A

Wernicke’s aphasia

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20
Q

Expanded areas in the brain that hold CSF (not ventricles(

A

Cisterns

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21
Q

Craniorachischisis totalis

A

Failure of closure of the entire neural tube

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22
Q

Failure of neural tube closure is limited to region of the anterior neuropore

A

Anencephaly

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23
Q

Failure of neural tube closure is limited to region of posterior neuropore

A

Myelomeningocele

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24
Q

Large granules in the neuron body from the RER

A

Nissl substances

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25
Q

Cellular constituents of the neuron

A

Microtubules, neurofibrils, rough ER, and ribosomes

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26
Q

Nuclei are cell bodies located in the ______ while ganglia are cell bodies located in the ________.

A

CNS, PNS

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27
Q

Dendritic branches allow one neuron to receive messages from several presynaptic cells at the same time

A

Convergence

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28
Q

Axon branching allows several target cells to simultaneously receive a message from one neuron

A

Divergence

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29
Q

Most common structural type of neuron

A

Multipolar

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30
Q

Which structural type of neuron is specifically for special sensory?

A

Bipolar

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31
Q

Neuroglia (Glial cells) are ____ to _____ times more numerous than neurons

A

5, 10

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32
Q

Type of neuroglia that fills the spaces between neurons and surround the blood vessels in the CNS

A

Astrocytes

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33
Q

Type of neuroglia that deposit myelin within the CNS

A

Oligodendroglia

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34
Q

Type of neuroglia that remove debris in the CNS (known as the brain macrophages)

A

Microglia

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35
Q

Type of neuroglia that line the CSF-filled cavities of the CNS and create CSF

A

Ependymal cells

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36
Q

Glial cells that wrap around and cover axons in the PNS; form and maintain the myelin sheath

A

Schwann cells

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37
Q

Ability of the CNS to change

A

Plasticity

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38
Q

By age 3, ____% of synaptic connections have been made

A

80

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39
Q

During the first 10 years, a child’s brain is _____ as active as the adult brain

A

Twice

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40
Q

After age _____, growth levels off and pruning begins

A

10

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41
Q

What is not used is pruned, and what is repeatedly used develops _______ ________

A

Stronger connections

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42
Q

60% of the nutrition taken in by a baby is used by the ______ during the first year

A

Brain

Decreases to 30% by age 3

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43
Q

Period when a particular thing is learned better, stronger, faster. If this is missed, developing human may never be able to gain it back

A

Windows of Learning/Opportunity

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44
Q

Which windows of opportunity are crucial in a child up to 1 year old?

A

Trust, attachment, cause and effect thinking skills, early sounds

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45
Q

Which windows of opportunity are crucial in a child up to 2 years old?

A

Motor development, vision, language skills, and vocabulary

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46
Q

Can nerves in the CNS repair?

A

No

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47
Q

How do nerves in the PNS repair?

A

Wallerian Degeneration

**only myelinated neurons

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48
Q

In Wallerian Degeneration, which cells are responsible for creating the tube to guide regeneration?

A

Schwann cells

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49
Q

Excitatory postsynaptic potentials send _________ signals, while inhibitory postsynaptic potentials send _________ signals

A

Depolarization

Hyperpolarization

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50
Q

The two inhibitory neurotransmitters of the nervous system are:

A

GABA and Glycine

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51
Q

Always the first signaler on efferent pathways to the PNS

A

Acetylcholine

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52
Q

Catecholamines such as _________, _________, and _________ are made from the amino acid _________ and are destroyed by ____________

A

Dopamine, Epinephrine, Norepinephrine
Made from tyrosine
Destroyed by monoamine oxidase (MAO)

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53
Q

Serotonin is made from the amino acid _________, and is more of a modulator than a true transmitter. Almost always is released with another transmitter.

A

Tryptophan

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54
Q

Serotonin is ______ in muscle pathways, and ________ in sensory pathways

A

Excitatory, inhibitory

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55
Q

Always acts as the second neurotransmitter in the PNS

A

Acetylcholine

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56
Q

Second transmitter in the sympathetic SNS

A

NE or Epi

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57
Q

Neurotransmitter that always acts on skeletal muscles in the somatic NS

A

Acetylcholine

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58
Q

Region of the brain responsible for “consciousness, control, and motion”

A

Frontal Lobe

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59
Q

Region of the brain that controls memory for habits and motor activities

A

Frontal Lobe

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60
Q

Region of the brain that is the emotional control center

A

Frontal Lobe

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61
Q

Region of the brain responsible for “hearing, memory, association”

A

Temporal Lobe

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62
Q

Primary and associative olfactory regions are in what region of the brain?

A

Temporal Lobe

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63
Q

Region of the brain that contains the associative vision regions

A

Temporal Lobe

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64
Q

Region of the brain that links one’s past and present sensory/emotional experiences into a continuous “self”

A

Temporal Lobe

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65
Q

Hippocampus is “tucked out of sight” on the medial side of the _______ lobe

A

Temporal

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66
Q

Which region of the brain is responsible for storing, processing and retrieving memories?

A

Hippocampus

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67
Q

In autism, patients have a heightened ability to store memories in the _____________

A

Hippocampus

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68
Q

Region of the brain responsible for “touch” and “sense integration”

A

Parietal Lobe

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69
Q

Region of the brain that contains the location for touch perception and visual attention

A

Parietal Lobe

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70
Q

Region of the brain that controls reading

A

Parietal Lobe

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71
Q

Region of the brain that is the center of visual perception

A

Occipital Lobe

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72
Q

Region of the brain where many cranial nerves enter and leave brain. Has centers for cough, gag, swallow, sneeze and vomit

A

Medulla Oblongata

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73
Q

Region of the brain with a cardiac and respiratory center

A

Medulla Oblongata

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74
Q

Region of the brain responsible for “sleep/wake” and “relaying information”

A

Pons

75
Q

Region of the brain with control of respiratory patterns and conscious arousal

A

Pons

76
Q

Region of the brain that relays sensory information between the cerebrum and cerebellum

A

Pons

77
Q

Large mass of gray matter deeply situated in the forebrain. Relays information to the cerebral cortex that it receives from diverse brain regions –> last stop for associative information going to cortex

A

Thalamus

78
Q

Axons from every sensory system (except olfaction) synapse here as the last relay site beofre the information reaches the cerebral cortex

A

Thalamus

79
Q

Region of the brain responsible for many regulating functions including the autonomic nervous system, emotions and behavior, body temperature, hunger, thirst, and sleep-waking cycles

A

Hypothalamus

80
Q

Region of the brain that plays a role in regulating complex moods, such as anger, placidity, and fatigue

A

Hypothalamus

81
Q

What surgery may be performed in epileptic patients with global seizures?

A

Commissurotomy (removal of the corpus callosum)

82
Q

Region of the brain known as the “emotional response area”

A

Amygdala

83
Q

If pressure becomes elevated in the dural sinuses, blood can shift from the sinus out to the ________ space, decreasing intracranial sinus pressure

A

Subgaleal

84
Q

What the the dural sinuses attached to?

A

Falx cerebri

85
Q

Small veins that carry blood between the superior sagittal sinus and the subgaleal space

A

Emissary Veins

86
Q

Flow in the emissary veins typically travel from ______ to _______

A

Scalp to sinus

87
Q

Emissary veins can be torn in scalp trauma, leading to intracranial blood from the sinuses moving into the subgaleal space, causing a _______ _________

A

Subgaleal hematoma

88
Q

Infection on the scalp can be carried into the SSS via the emissary veins, causing a _______

A

phlebitis

89
Q

The outermost layer of dura mater forms the internal __________ of the skull

A

Periosteum

90
Q

The inner layer of the dura mater, or the ________ layer, forms the double-thickness sheet of tissue

A

Meningeal

91
Q

The choroid plexuses, structures that produce CSF, arise from the ______ ______

A

Pia mater

92
Q

What kind of hemorrhages happen below the pia mater?

A

Subarachnoid

93
Q 
The subarachnoid space:
A: contains CSF
B: lies above the dura mater
C: lies below the pia mater
D: adheres to the brain and spinal cord
A

Contains CSF

94
Q

Typically, ______ to _______ mL of CSF are present in the ventricles at any given time

A

125 to 150

95
Q

Approximately _______ mL of CSF are produced every day

A

600

96
Q

CSF travels through these to be reabsorbed into the SSS after traveling through the ventricles

A

Arachnoid Granulations

97
Q

Glucose in CSF should be about _______ the level that plasma has

A

2/3

98
Q

Protein and albumin levels in CSF should be ________ than in plasma

A

Lower

99
Q

What should not be found in CSF normally?

A

WBCs
RBCs
Bacteria

100
Q

What might cause elevated CSF protein?

A
  1. Presence of cells that should be there: RBCs, WBCs, bacteria
  2. Lots of diseases that include inflammation
101
Q

What might cause decreased CSF glucose?

A
  1. Critters in the CSF eating the glucose (bacteria)

2. Sometimes presence of cancer cells or lots of WBCs

102
Q

What might cause decreased ICP?

A
  1. Lower systemic pressure (dehydration, shock, etc).

2. A hole in the meninges where CSF is leaking out

103
Q

What might cause increased ICP?

A
  1. things that block CSF drainage (tumor, sinus thrombosis)

2. other liquids in CSF space (blood, etc.)

104
Q

“Soft liquidy stuff in the middle of the intervertebral disk”

A

Nucleus pulposus –> absorbs shock

105
Q

End of the spinal cord, located around L1/L2

A

Conus medullaris

106
Q

Nerve bundle at the end of the spinal cord; extends to S5

A

Cauda equina

107
Q

Upper Motor Neurons use ___________ as their neurotransmitter. Do not leave the CNS

A

Glutamate

108
Q

Lower Motor Neurons use _______ as their neurotransmitter. Leave the CNS to go to target organ

A

Acetylcholine

109
Q

The corticospinal tract is responsible for ________ _________

A

Voluntary motion

Motor

110
Q

The spinothalamic tract is responsible for __________

A

Sensory

Proprioception, pain, temperature, light touch and pressure

111
Q

The dorsal column tract is responsible for _________

A

Sensory

Proprioception, deep touch, vibration

112
Q

Brachial plexus = ?

A

C5, C6, C7, T1

113
Q

Where do fibers decussate in the posterior column?

A

Lower Medulla

114
Q

Where do fibers decussate in the spinothalamic tract?

A

At the level where they entered the dorsal horn

115
Q

Where do fibers decussate in the corticospinal tract?

A

Medulla

10% remain ipsilateral

116
Q

What is the most common cause of central cord syndrome?

A

Hyperextension of the spinal cord

117
Q

Characterized by disproportionately greater motor impairment of the arms than the legs, with variable sensory loss below the level of injury

A

Central Cord Syndrome

118
Q

Sacral sparing typically occurs in this

A

Central Cord Syndrome

Will have better rectal tone than anterior leg function

119
Q

Most common cause of anterior cord syndrome

A

Hyperflexion

120
Q

Patients present with some degree of motor and sensory loss below the level of injury. However, deep touch, position sense, and vibration still in tact

A

Anterior Cord Syndrome

121
Q

Most common cause of Brown-Sequard Syndrome

A

Penetrating injury

122
Q

Characterized by motor loss and dorsal column sensory loss on the same side and spinothalamic sensory loss on the opposite side of the injury

A

Brown-Sequard Syndrome

123
Q

Demyelination of the posterior columns and corticospinal tracts caused by B12 deficiency

A

Subacute Combined Degeneration

124
Q

In subacute combined degeneration, demyelination of the ______ ________ and ________ _________ occurs

A

Posterior columns and corticospinal tracts

125
Q

Symptoms of Subacute Combined Degeneration

A

Abnormal tinging and numbness, weakness of legs, arms or other areas
Symptoms are bilateral and progressive

126
Q

Gradual loss of myelin with the posterior columns of the spinal cord

A

Tabes Dorsalis

127
Q

Symptoms of tabes dorsalis

A

Decreased ability to sense proprioception, light touch, and vibration below the site of the lesion

128
Q

10-15% of TIA patients have a stroke within ___ months

A

3

129
Q

50% of strokes after TIAs occur within _____ hours

A

48

130
Q

Ischemia due to occlusion of a blood vessel

A

Focal, territorial, local

131
Q

Ischemia due to cardiac arrest, systemic hypotension, or increased intracranial pressure

A

Global, generalized

132
Q

About _____ of subarachnoid hemorrhage patients experience rebleeding of aneurysm in first 4 weeks

A

40%

133
Q

85% of berry aneurysms occur in _______ circulation, while 15% occur in ________ circulation

A

Anterior; posterior

134
Q

Tangle of abnormal arteries and veins with no intervening capillary bed. Often wedge-shaped, involving brain and leptomeninges

A

Arteriovenous Malformation

135
Q

Important signs of arteriovenous malformation

A

Seizures and bleeds

136
Q

What is the tell tale sign of subarachnoid hemorrhage?

A

Acute hemorrhage seeping through sylvian fissure

137
Q

In cerebral infarction, the _____ ______ is common obliterated

A

Sylvian fissure

138
Q

Stain for myelin

A

Methyl blue

139
Q

Oligodendrocytes show up as “fried egg” on this stain

A

Pink

140
Q

Disease of myelin formation or maintenance by intrinsic cause

A

Leukodystrophy

141
Q

Disease of normally formed myelin caused by extrinsic cause

A

Demyelinating disease

142
Q

Immune mediated or inflammatory demyelinating diseases

A

MS, encephalomyelitis, leukoencephalitis

143
Q

Viral demyelinating diseases

A

PML, AIDS

144
Q

Toxic/Metabolic demyelinating diseases

A

Vapor abuse, soak glue/paint rags and inhaling

145
Q

Characterized by loss of oligodendrocytes and fibrillary astrocytic gliosis

A

MS

146
Q

Caused by papovavirus (JC strain) infection

A

Progressive Multifocal Leukoencephalopathy

147
Q

Occurs as a complication for HIV patients with relatively short clinical course

A

Progressive Multifocal Leukoencephalopathy

148
Q

“Rat bitten appearance to the white matter of the brain”

A

Progressive Multifocal Leukoencephalopathy

149
Q

Caused by a rapid correction of serum electrolyte imbalance, resulting in rapid or excessive rise in serum sodium in hyponatremic patients

A

Central Pontine Myelinolysis

150
Q

Perivascular presence of multinucleated giant cells, expressing HIV viral antigens

A

AIDS Leukoencephalopathy

151
Q

Toxic cytokinds from activated macrophages/microglia may play an important role

A

AIDS Leukoencephalopathy

152
Q

Inherited metabolic diseases primarily affecting white matter; caused by a mutation of the gene for the myelin protein or specific enzyme for myelin lipid metabolism

A

Leukodystrophy

153
Q

Perturbation in the formation or maintenance of the myelin sheath

A

Leukodystrophy

These are very sick children that are very compromised from cognitive standpoint

154
Q

The autonomic nervous system is located in both the _____ and the _____. It coordinates and maintains a steady state.

A

CNS, PNS

155
Q

Preganglionic neurons in the ANS are __________, while postganglionic neurons in the ANS are __________

A

Myelinated, unmyelinated

156
Q

The sympathetic nervous system involves the _______________ (thoracolumbar/craniosacral), while the parasympathetic involves the _____________ (thoracolumbar/craniosacral)

A

Sympathetic - thoracolumbar

Parasympathetic - craniosacral

157
Q

The ___________ (sympathetic/parasympathetic) nervous system involves collateral ganglia, which are other ganglia that are not within the sympathetic trunk

A

Sympathetic

158
Q

Unlike the SNS, the PNS doesn’t have a trunk of ganglia. They all exist in the _________, close to the ________ they innervate.

A

Periphery

Organs

159
Q

Parasympathetics do NOT go to:

A
  • Cardiac muscle cells (they do go to pacemaker cells)
  • Uterus
  • Sweat glands
  • Goosebump muscles
  • Skeletal muscles
  • Adrenal gland
  • Only select blood vessels
160
Q

Sympathetic preganglionic fibers - Neurotransmitter:

A

Acetylcholine

161
Q

Sympathetic preganglionic fibers - Receptor:

A

Cholinergic

162
Q

Sympathetic postganglionic fibers - neurotransmitter

A

Norepinephrine

163
Q

Sympathetic postganglionic fibers - receptor

A

Adrenergic

164
Q

Parasympathetic pre and postganglinoic fibers - Neurotransmitter

A

Acetylcholine

165
Q

Adrenal medulla: Preganglionic and Postganglionic neurotransmitters?

A

Pre - Ach

Post - E, NE to bloodstream

166
Q

A1- adrenergic receptors

A

Excitation

Most common alpha receptors

167
Q

A2- adrenergic receptors

A

Relaxation/Inhibition

168
Q

B1- adrenergic receptors

A

Increases heart rate and contractility; causes release of renin
Think heart and kidney

169
Q

B2-adrenergic receptors

A

Relaxes muscles in the bronchi, bladder

170
Q

B3- adrenergic receptors

A

Mediates lipolysis and thermogenesis

Think endocrine

171
Q

All the ACh receptors on the postganglionic autonomic cells’ dendriates are ________ (nicotinic/muscarinic)

A

Nicotinic

172
Q

All muscle cell receptors at neuromuscular junctions are __________ (nicotinic/muscarinic)

A

Nicotinic

173
Q

These ACh receptors are found in the CNS, exocrine glands, and the cardiac conducting system

A

Muscarinic

174
Q

These ACh receptors are on GI and smooth muscle, and help these muscles contract

A

Muscarinic

175
Q

Nicotinic Receptors are ___________ (gated ion channels/G protein coupled receptors) while Muscarinic receptors are ___________

A

Gated Ion Channels

G protein coupled receptors

176
Q

CNS neuron injury can lead to widespread release of ____________ neurotransmitters. This results in cell death and degradation of postsynaptic cells

A

Excitatory

177
Q

Characterized by a complete loss of reflex function, flaccid paralysis, sensory deficit, and loss of bladder and rectal control in all segments below the level of the lesion

A

Spinal Shock

178
Q

Transient drop in blood pressure and poor venous circulation are typical in this type of shock

A

Spinal Shock

179
Q

Loss of thermal control is common in this type of shock, therefore warming is very important

A

Spinal Shock

180
Q

Characterized by a cervical or upper thoracic cord injury, and is caused by absence of sympathetic activity from loss of supraspinal control and unopposed parasympathetic tone mediated by the intact vagus nerve

A

Neurogenic Shock

181
Q

Syndrome of sudden massive reflex sympathetic discharge with little to no opposing parasympathetic discharge to bring it down

A

Autonomic Dysreflexia

182
Q

This type of shock causes vasodilation, hypotension, bradycardia, and hypothermia

A

Neurogenic Shock

183
Q

Symptoms of autonomic dysreflexia

A 
Hypertension
Bradycardia
Pounding headache
Blurred vision
Sweating above lesion
Piloerection

Pathophys II (1 decks)

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