Neurology Amboss Flashcards
Genioglossus
Styloglossus
Hyoglossus
CN 12
- Protrude tongue
- draw side of tongue upward to create trough
- Hyoglosseus retract and depress tongue
Closing of the Jaw nerve
CN V3 Motor
Jugular Foramen
CN IX X XI, jugular vein
Glucose intolerance and malignant otitis externa
A subtype of otitis externa characterized by a necrotizing inflammation of the external auditory canal. Most frequently caused by Pseudomonas aeruginosa. Risk factors are poorly controlled diabetes mellitus and immunosuppression.
Otitis media most likely caused by
Strep Pneumonia
and for children externa is H influenzae or pseudomonas for diabetic patients etc.
Pus filled mastoid air cells is caused by
infection in middle ear traveling to mastoid air cells
Glycogen synthase kinase 3
Activation of glycogen synthase kinase-3 and other protein kinases induces increased phosphorylation of tau which leads to cluster formation and development of tangles.
Prion Beta pleated sheets are rapidly progressing dimentia
Helicotrema
located near the apex of cochlea. Lower frequency sound waves vibrate the basilar membrane of the helicotrema, which converts this input into nerve signals that encode auditory information
Otitis Media can cause conduction hearing loss by
damaging tympanic membrane
Rasagiline Selegilline Side effects
Nausea, headache, confusion, hallucination
COMT (catechol-O-methyl transferase)
Blocked by Entacapone, tolcapone
in circulation L dopa —> 3OMD
in brain
dopamine —> 3-MT
Side effects:
dyskinesia, hallucinations, confusion, nausea, orthostatic hypotension, diarrhea
Lymphocytic infiltrate of endoneurium
GBS
Immune complex deposition of arterial endothelium
Vasculitis and found in Lupus, commonly will have purpura in vasculitis
Spirochete protein cross reactivity in the meninges
aseptic meningitis in Lyme disease
Osmotically mediated Schwann cell damage
diabetic neuropathy
Pituitary adenoma can be secreting what
- lactotrophs most commonly
2. somatotrophs GH
Lateral gaze paralysis and horizontal nystagmus can be found in
Alcoholics
Essential tremor
worsens with movement
Internal capsule compartments
Determine fibers pass in each parts of the internal capsule :
- Anterior limb → thalamo cortical fibers
- Genu → cortico bulbar fibers
- Posterior limb → cortico-spinal & somatic sensory fibers
Ventral thalamus infarct vs Posterior limb of internal capsule
Ventral thalamus is pure sensory but posterior limb motor function is off
Deviation of Uvula vs Tongue?
Uvula will move to the side where the lesion is not for CN X and expect also hoarseness
Tongue will deviate to side of lesion is CN 12 damage, or other side if upper neuron cortex damage
Spinal acessory nerve
arises from upper cervical spine C1-C5
Trisomy 21
1st trimester BHCG up, PAPPA down
2nd trimester BHCG up, inhibin A up, estriol down, AFP down
Mutations in the sonic hedgehog signaling pathway cause holoprosencephaly. This may be seen in
trisomy 13 or fetal alcohol alcohol syndrome.
Warfarin in pregnancy
warfarin is known to cross the placenta, and its teratogenic effects are well documented, as seen in this neonate: nasal and midface hypoplasia; shortened limbs and digits; calcifications of the vertebral, humeral, and femoral epiphyses (stippled epiphysis); and, as shown by the MRI image, Dandy-Walker syndrome (superior displacement and hypoplasia of the superior vermis).
Unfractioned heparin/low molecular weight heparin is better suited… but is not good for reducing thomboembolic events if there is a mechanical heart valve
Surface ectoderm
Epidermis, adenohypohysis (from rathke pouch), lens of eye, epithelial lining of oral cavity, sensory organs of ear, olfactor epithelium, below pectinate line in anal canal, parotid, sweat, mammary gland
Prader Willi patient
Obese, intellectual disability hypogonadism
Angelman
ataxia, seizures, inappropriate laughter
The anterior neuropore closure occurs at approximately
day 24 and the posterior neuropore occurs at 28 days
Ions in stereocillia hair
Mechanically gated potassium (K+) channels on the tips of stereocilia open when stretched, causing K+ influx and depolarization, triggering voltage-gated calcium (Ca2+) channels to open. This Ca2+ influx into the hair cell causes release of excitatory neurotransmitters from synaptic vesicles, which diffuse through the perilymph to spiral ganglia neurites.
Presbycusis
Age-related degeneration of the organ of Corti (or presbycusis) is a type of sensorineural hearing loss that is part of the normal aging process. It is the most common cause of sensorineural hearing loss in the elderly and manifests with gradually worsening high-frequency hearing loss. The cause of presbycusis is degeneration of the proximal hair cells of the organ of Corti (depicted in the drawing), which lie in the proximal portion of the basilar membrane (farthest from the helicotrema or apex and closest to the ossicles and oval window). This is the thinnest and least compliant portion of the basilar membrane and is responsible for sensing high-frequency sounds.
Osteogenesis Imperfecta
decreased production of collagen type 1 bone (skin tendon, dentin, fascia, cornea)
Brittle bone disease, COL1A1, COL1A2, AD, multiple fractures bone deformities, blue sclerae, translucent connective tissue over chordial veins, tooth abnormalities, conductive hearing loss (OSSICLE damage)
Glycosylation—glycosylation of pro-α-chain hydroxylysine residues and formation of procollagen via hydrogen and disulfide bonds (triple helix of 3 collagen α chains).
LENS 4 letters type 4 collagen
type 1 CORNY
Type 2 HUMOURS (vitrious)
Menkes disease
Cross-linking—reinforcement of many staggered tropocollagen molecules by covalent lysine-hydroxylysine cross-linkage (by copper-containing lysyl oxidase) to make collagen fibrils. Problems with cross-linking Menkes disease.
X-linked recessive connective tissue disease caused by impaired copper absorption and transport due to defective Menkes protein (ATP7A, vs ATP7B in Wilson disease). Low copper levels (vs high levels in Wilson disease). Leads toactivity of lysyl oxidase (copper is a necessary cofactor) defective collagen. Results in brittle, “kinky” hair, growth retardation, hypotonia,risk of cerebral aneurysms.
MENKE IS IN THE HEAD
hypotonia…. dead vibes… cerebral aneurysms, HAIR fucked, growth fucked like a dumbo
is found in patients with Marfan syndrome, a connective tissue disorder that results from a genetic defect in fibrillin. Patients with Marfan syndrome do not have an increased risk for fractures.
Arachnodactyly
Damage to the vestibulocochlear nerve (CN VIII)
would result in sensorineural hearing loss and potentially equilibrium disturbances. However, patients with cranial nerve VIII lesions have hearing loss in the high-frequency range and exhibit problems with speech discrimination.
Damage to the cochlea
result in sensorineural hearing loss, but would not result in vertigo. Presbycusis, age-related sensorineural hearing loss from hair cell degeneration, is usually symmetric and tends to affect high-frequency sound perception.
Ménière disease
idiopathic disorder that usually affects people between the ages of 30 and 60 and involves episodes of vertigo that typically last for hours. Nystagmus is present during the vertiginous attacks, but would not be seen on exam of this patient who is not acutely symptomatic at presentation. Patients also have fluctuating difficulty hearing that often progresses to permanent, low-frequency sensorineural hearing loss in both ears. Aural fullness and tinnitus are also associated.
Craniopharyngioma
Rathke pouch, most common non glial brain tumor in children, mimodal age distribution,
arise from epithelial nest
Tryptophan is the precursor for
Serotonin
Anti Jo1 antibodies
histidyl tRNA synthetase and most commonly found in patients with idiopathic inflammatory myopathies, specifically polymyositis. Weakness in proximal muscles
GBS remember is antibodies is myelin and is ascending paralysis
Lambert Eaton Myasthenic syndrome
antibodies against calcium channels in presynaptic nerve terminal.
Proximal muscle weakness, decreased deep tendon reflexes, post tetanic potentiation (that is why it improves with movement)
Gamma motor neurons
Small diameter motor neurons that innervate the intrafusal muscle fiber within a muscle spindle. The motor neurons maintain intrafusal fiber tension during extrafusal muscle fiber contraction
Extrafusal fibers
constitute bulk of the contracting muscle belly. They produce the muscle tension
Golgi Tendon organs
they initiate inverse stretch reflex, in which muscle contraction is inhibited during excessive stretch. These receptors are found in the tendon near the muscle tendon junction. When a weight lifter drops weight the muscle contraction is inhibited by this reflex.
Metabolic acidosis by TCA>
Yes, and overuse of diuretics causes metabolic alkalosis
