Neurology Flashcards
What is the central nervous system?
Brain and spinal cord, oligodendrocytes
What is the peripheral nervous system?
Everything else, Schwann cells
What is the autonomic nervous system?
Automatic stuff
What is the somatic nervous system?
Moving your muscles
What is the parasympathetic nervous system?
Rest and digest —> slows stuff down
How does the parasympathetic nervous system behave?
“DUMBBELS” Diarrhea Urination Miosis (constrict) Bradycardia Bronchoconstriction Erection (point) Lacrimation Salivation
What is the sympathetic nervous system?
Fight or flight —> speeds stuff up
How does the sympathetic system behave?
Opposite of parasympathetic: Constipation Urinary retention Mydriasis (“eyes wide with fright”) Tachycardia Bronchodilate Ejaculation (shoot) Xerophthalmia (dry eyes) Xerostomia (dry mouth)
Where is norepinephrine synthesized?
Locus ceruleus of the pons
What happens to norepinephrine in anxiety and depression?
Up in anxiety
Down in depression
Where is dopamine synthesized?
Ventral tegmentum and substantia nigra (SNc) in the midbrain
What happens to dopamine in Huntington’s, Parkinson’s, and depression?
Up in Huntington’s
Down in Parkinson’s
Down in depression
Where is serotonin synthesized?
Raphe nucleus
What happens to serotonin in Parkinson’s, depression, and anxiety?
Up in Parkinson’s
Down in depression
Down in anxiety
Where is acetylcholine (Ach) synthesized?
Basal nucleus of Meynert
What happens to Ach in Parkinson’s, Alzheimer’s, and Huntington’s?
Up in Parkinson’s
Down in Alzheimer’s
Down in Huntington’s
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
Cushing’s triad
Hypertension
Bradycardia
Increased intracranial pressure
Budd-Chiari
Hepatic vein obstruction
Arnold-Chiari malformation
Foramen magnum obstruction
Herniation of cerebellum through foramen magnum
Type I: cerebellar tonsils (asymptotic)
Type II: cerebellar vermis/medulla —> hydrocephalus, syringomyelia (loss of pain/temperature sensation)
Anencephaly
Notochord did not make contact with brain —> only have medulla
Encephalocele
Brain tissue hernia
Dandy Walker malformation
No cerebellum
Distended 4th/lateral ventricles
Spina bifida occulta
Covered by skin with tuft of hair
Spina bifida aperta
Has opening
High AFP
Meningocele
Sacral pocket with meninges in it
Meningomyelocele
Sacral pocket with meninges and nerves in it
Open-angle glaucoma
Overproduction of fluid
Painless ipsilateral dilated pupil
Gradual tunnel vision
Optic disc cupping
Closed-angle glaucoma
Obstruction of canal of Schlemm
Sudden onset
Pain
Emergency
Watershed areas
Hippocampus
Splenic flexure
What are the contents of the cavernous sinus?
CN 3, 4, 5 (1 and 2), and 6
Postganglionic sympathetic fibers
What bug loves the frontal lobe?
Rubella
What bug loves the temporal lobe?
HSV
What bug loves the parietal lobe?
Toxoplasmosis
What bug loves the hippocampus?
Rabies
What bug loves the DCML tract?
Treponema
What bug loves the posterior fossa?
TB
How do migraines present?
Aura Photophobia Numbness and tingling Throbbing headache 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 with 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 the two kinds of partial seizures?
Simple (aware)
Complex (not aware)
What are the three 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
Not crossing suture lines
How does a subdural hematoma present?
Headache 4 weeks after trauma
Elderly (loose brain)
How does a subdural hematoma look on CT?
Crescent shaped
Crosses suture lines
Midline shift
How does a subarachnoid hematoma/hemorrhage present?
“Worst headache of my life”
History of berry aneurysm
Astrocytoma
Rosenthal fibers #1 in kids with occipital
Ependymoma
Rosettes
4th ventricle
Hydrocephalus
Craniopharyngioma
Motor oil biopsy Tooth enamel Rathke’s pouch ADH problem Bitemporal hemianopsia
Glioblastoma multiforme
Pseudopalisading
Necrosis
Worst prognosis
Intralesional hemorrhage
Hemangioblastoma
Cerebellum
von-Hippel-Lindau
Blood vessel tumor
Meduloblastoma
Pseudo rosettes
Compresses brain
Early morning vomiting
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/gray matter junction
Oligodendroglioma
Fried egg appearance
Nodular calcification
Pinealoma
Loss of upward gaze
Loss of circadian rhythm
Precocious puberty
Schwannoma
CN 8 tumor
Unilateral deafness
Neurofibromatosis
Café au lait spots (hyperpigmentation) – peripheral nerve tumors, axillary freckle
Type I “von Recklinghausen’s”: peripheral, chromosome 17, optic glioma, Lisch nodules, scoliosis
Type II “Acoustic neuroma”: central, chromosome 22, cataracts, bilateral deafness
Sturge-Weber
Port wine stain (big purple spot) on forehead
Angioma of retina
Tuberous sclerosis
Ash leaf spots (hypopigmentation) Primary brain tumors Heart rhabdomyomas Rental cell carcinoma Shagreen spots (leathery)
