Neurology (F.A.) Flashcards
what are the walls and cavities of the Telencephalon
walls- cerebral cortex
cavity- lateral ventricles
what are the walls and cavities of the Diencephalon
walls- thalamus/hypothalamus
cavity- 3rd ventricle
what are the walls and cavities of the Mesencephalon
walls- midbrain
cavity - cerebral aqueduct
what are the walls and cavities of the Metencephalon
walls- pons/cerebellum
cavity- 4th ventricle
what are the walls and cavities of the Myelencephalon
walls- medulla
cavity- 4th ventricle
what relays sensation from anterior 2/3 tongue? taste?
sensation - CNV3
taste- CN VII
what relays sensation from posterior 1/3 tongue? taste?
sensation+taste- CN IX
what is the motor innervation to tongue?
XII- hypoglossus, genioglossus, styloglossus
X- palatoglossus
what is meissner’s corpuscles location and main function?
un-hairy skin surfaces
light touch,
what is merkel disk’s location and main function?
fingertips, superficial skin deep touch (like shapes/edges)
what is pacinain corpuscles location and function?
deep skin
pressure
what is ruffini’s corpuscles location and function?
finger tips/joints
joint angle change, slippage
What is ACh location of synthesis? D(x)
basal nucleus of Meynert
decreased in Alzheimer’s, decreased Huntington’s, increased in Parkinson’s
What is NE location of synthesis? D(x)
locus ceruleus (post. rostral pons) increased in anxiety, decreased in depression
What is 5HT location of synthesis? D(x)
Raphe Nucleus
decreased in anxiety and depression
What is Dopamine location of synthesis? D(x)
Substantia Nigra
decreased in Parkinson’s, increased in Schitzophrenia
What is GABA location of synthesis? D(x)
nucelus accumbens
decreased in Huntington’s, decreased in anxiety
What EEG waveform is associated with awake, eyes open?
Beta
What EEG waveform is associated with awake, eyes closed?
Alpha
What EEG waveform and action is associated with NONREM stage 1?
Theta
What EEG waveform and action is associated with NONREM stage 2?
Spindle
Bruxism
What EEG waveform and action is associated with NONREM stage 3?
Delta
night terrors, sleep walking, bedwetting
REM EEG waveform and action?
Beta
muscle paralysis, increased ACh, erection/dreaming
Papez Circuit constituents?
hippocampus, mammillary bodies, cingulate gyrus, anterior thalamic nucleus, entorhinal cortex
decerebrate (extensor) posturing
below red nucleus (pons)
lack of rubrospinal tract (therefore cant flex UE)
decorticate (flexor) posturing
above red nucleus (pons)
loss of descending inhibition
what travels through foramen spinosum
middle meningeal artery
actions of CN VII
motor: all facial muscles of face (except mastication)
eyelid closing, lacrimation, SUBMANDIBULAR/SUBLINGUAL salivation, stapedius m (auditory modulation)
sensory: taste from ant 2/3 of tongue,
actions of CN IX
sensory: taste and sensation from post 1/3 tongue&;tonsils&;middle ear and upper pharynx, carotid body/sinus chemoreceptors
motor: swallowing, elevation of pharynx/larynx, PAROTID salivation
actions of CN X
sensory: taste and sensation from extreme posterior of tongue and supraglottic
motor: efferent gag reflex, uvula, talking, cough, soft palate elevation
where should you do a lumbar puncture?
L3-L5 (level of cauda equina
use iliac crest as landmark (= L4)
reflex: achilles
S1, S2
reflex: patellar
L3,L4
reflex: biceps
C5, C6
reflex: triceps
C7, C8
reflex: cremaster
L1, L2
reflex: anal wink
S3, S4
Gerstmann Syndrome
lesion in DOMINANT parietal cortex
acalculia, agraphia, L-R disorientation, finger agnosia
Hemispatial Neglect Syndrome
lesion in NONdominant parietal cortex
agnosia of contralateral wall
Wernicke-Korsakoff Syndrome
Can O' (beer) = Wernicke Confusion Ataxia Nystagmus Ophthalmoplega
Korsakoff= confabulation, antero/retrograde amnesia
Kluver-Bucy Syndrome
amygdala lesion
disinhibited behavoir- hypersexual/agressive
Parinaud Syndrome
superior colliculus lesion
paralysis of vertical gaze
clasp knife spasticity
initial resistance to passive extension, then suddent release
Internal capsule lesion (pure motor)
within 24 hr of brain ischemia
red neurons
within 3 days (24-72 hr) of brain ischemia
neutrophils and necrosis
around 3-5 of brain ischemia
microglia
around 1-2 weeks after brain ischemia
reactive gliosis (astrocytes) and vascular proliferation
> 2 wks after brain ischemia
glial scar (astrocytes)
Posterior Inferior Cerebellar A stroke symptoms? “lateral medullary (Wallenberg) Syndrome”
(Nucleus Ambiguus effects)- dysphagia, hoarseness, lack of gag reflex
(dont) PICA hoarse (that) can’t eat
Anterior Inferior Cerebellar stroke symptoms? “Lateral Pontine Syndrome”
(Facial Nucleus Effects)- face droop
Basilar A stroke
“locked in” syndrome
lesion in subthalamic nucleus?
pure hemiballismus
Anterior Spinal Artery Stroke symptoms (Medial Medullary Syndrome)?
DCML- contralateral decrease in facial and body sensation
corticospinal tract- contralateral paralysis
hypoglossal nucleus- “tongue licks the wound”
Acute Disseminated Encephalomyelitis
progressive multifocal inflammation and demyelination following vaccine or infection
Charcot Marie Tooth
Autosomal DOMINANT
mutation in proteins of myelin synthesis
LOWER extremity symptoms- foot drop, foot deformity, pes cavus
Krabbe
autosomal recessive lysosomal storage disease
def: gangliocerebrosiidase
s(x)- buildup up gangliocerbroside destroys myelin- developmental delay, peripheral neuropathy, optic atrophy
metachromatic leukodystrophy
autosomal recessive lysosomal storage disorder
def: Arylsulfatase A
s(x)- buildup of arylsulfatase A destroys myelin, ataxia+ dementia
Adrenoleukodystrophy
X-linked, can’t metabolize VLCFA, accumulates in testes, adrenal gland, and nervous system
Sturge Weber Syndrome
congenital but sporadic. somatic mosiacism
GNAQ gene, NCC anomaly.
port wine stain
ipsilateral leptomeningeal angioma (causes seizures, and mental disability) , Train track calcifications
EYEs; episcleral hemangioma and glaucoma
Tuberous Sclerosis
autosomal dominant on TSC1/2 on chromosome 9/16 H- hamartomas in CNS and skin A- ash leaf spots M- mitral valve regurg A angiofibroma R rhbdomyoma T tuberous sclerosis O tosomal dominant M ental retard A angiomyolipoma (renal) S eizures, shagreen patches
NF1 (von recklinghausen)
autosomal dom, NF1 gene is a tumorsupressor (chromosome 17), skin lesions made of schwan, cafe-au lait, optic gliomas, pheochromocytomas, Lisch nodules
NF2
autosomal dom, Merlin gene (chromosome 21), bilateral schwanomas, juvenile cataracts, meningiomas, ependyomas
VHL
autosomal dom, chrom 3, H- hemangioblastoma A- angiomatosis R- renal cell carcinoma P- pheochromocytoma
uncal herniation symptoms
- CN III palsy= blown pupils, down and out
- PCA lesion- homonymous hemianopia w/ macular sparing
Werdnig-Hoffman disease
autosomal recessive congenital degeneration of anterior horns of spinal cord. LMN lesion only. “floppy baby”. looks like polio but is symmetric weakness
Friedrich’s Ataxia
trinucleotide expansion of GAA, autosomal recessive.
Frataxin gene- mitochondrial dysfunction
“Fred is Fratastic: he is your favorite FRAT bro always staggering and falling but he has a SWEET, BIG heart”