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USMLE STEP 1 > Neuroscience > Flashcards

Neuroscience Flashcards

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USMLE® Step 1 flashcards
1
Q

Week of gastrulation

A

3

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2
Q

Who induces the formation of neuro system

A

Notochord

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3
Q

Notochord secrets __________ to induce the formation of nervous system

A

Sonic hedgehog

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4
Q

Open neural tube defects double marker

A

Alfa feto protein

Acetilcolinesterasis

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5
Q

Primary vesicles

A

Forebrain
Midbrain
Hindbra

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6
Q

Optic nerve secondary vesicle of brain

A

Telencephalon

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7
Q

Rostral failure of neural tube

A

Anencephaly

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8
Q

Caudal failure of neural tube

A

Spina bifida

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9
Q

Open neural caudal failure

A

Myeloschisis

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10
Q

Spina bifida clinic

A

Tuft of hair

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11
Q

Arnold Chiari type I

A

Asymptomatic

Downward displacement of cerebelar tonsils

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12
Q

Arnold Chiari type II

A

Symptomatic
Compression of IV ventricle
Associated with meningomyelocele

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13
Q

Dandy Walker malformation

A

Agenesis of cerebelar vermis

Dilatation of IV ventricle

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14
Q

Holoprosencephaly

A

Incomplete separation of cerebral hemispheres

Trisomy of 13 (Patau)

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15
Q

Arnold Chiari type I association

A

Syringomyelia

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16
Q

Arnold Chiari type II association

A

Meningomyelocele

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17
Q

Superior cervical glanglion in the head innervates

A

Sweat glands
Dilator pupilae
Superior tarsal m

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18
Q

Horner’s syndrome sings

A

Ptosis
Miosis
Anhydrosis

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19
Q

3 lesion sites that causes Horner’s Syndrome

A

T1 (Pancoast)
Carotid dissection
Descending hypothalamic axons

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20
Q

What do the Nissil stains

A

Rough endoplasmatic tissue

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21
Q

Energy source of anterograde axonal transport

A

Kinesin

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22
Q

Energy source of retrograde axonal transport

A

Dynein

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23
Q

Form myelin for axons in CNS

A

Oligodendrocytes

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24
Q

Form myelin for axons in PNS

A

Schwann cells

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25
Q

Symptoms lost in time and space

Impaired myelination

A

Multiple sclerosis

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26
Q

Symptoms of Multiple Sclerosis

A 
Optic neuritis 
Internuclear ophthalmoplegia
Motor/sensory deficits
Vertigo
Neuropsychiatric
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27
Q

All Cranial Nerves are from PNS EXCEPT

A

Optic nerve

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28
Q

Acute

Symmetric ascending inflammatory neuropathy of PNS

A

Guillain-Barrè syndrome

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29
Q

Supports blood-brain barrier

A

Astrocytes

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30
Q

axon injury: distal part

A

Degenerates

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31
Q

Axon injury: proximal part

A

Chromatolysis

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32
Q

Most common primary tumor

A

Glioblastoma

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33
Q

High malignancy
Cross midline - butterfly glioma
Areas of necrosis

A

Glioblastoma

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34
Q

Second most common primary tumor

Psammoma bodies

A

Meningioma

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35
Q

Hearing loss
Tinitus
CN V+VII signs

A

Schwannoma

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36
Q

Schwannoma if bilateral

A

Neurofibromatosis type 2

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37
Q

Rathke’s pouch tumor

A

Craniopharyngioma

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38
Q

Compress optic chiasm
Common in children
Adamantinoma

A

Craniopharyngioma

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39
Q

SHH mutation

Blue, round, small cells with pseudorosettes

A

Meduloblastoma

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40
Q

Fried egg appearance primary tumor

A

Oligodendroglioma

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41
Q

Rosenthal fibers

Immunostaining with GFAP

A

Astrocytoma

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42
Q

Connects 3rd to 4th ventricle

A

Cerebral aqueduct

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43
Q

Who produces CSF

A

Choroid plexus

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44
Q

Non communicating hydrocephalus

A

Blockage

Dandy walker

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45
Q

Communicating hydrocephalus

A

Drainage problem

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46
Q

Normal pressure hydrocephalus triad

A

Dementia
Apraxic gait (magnetic)
Urinary incontinence

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47
Q

Upper limp spinal nerves

A

C5-T1

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48
Q

Lower limbs spinal nerves

A

L1-S2

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49
Q

_______ matter are neurons cell bodies, and _______ matter are tracts of axons

A

Gray, white

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50
Q

Renshaw cells

A

Prevent excessive motor contractions

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51
Q

Upper motor neurons form _________ tract

A

Corticospinal

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52
Q

Spastic paresis

Hyperreflexia

A

UMN lesion

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53
Q

Flaccid paralysis

Arreflexia

A

LMN lesion

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54
Q

Babinski’s sign

A

UMN lesion

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55
Q

Fasciculations

A

LMN severe lesion

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56
Q

Where the UMN crosses midline

A

Pyramidal decussation

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57
Q

LMN is always ____________ to the innervated muscle

A

Ipsilateral

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58
Q

Motor system is a ____ neurons pathway, and sensory system is a _____ neurons pathway.

A

2,3

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59
Q

Second sensory neurons courses in the spinal cord as _________ or ______

A

Lemniscus or tract

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60
Q

Proprioception and touch (vibratory, fine, pressiona and 2-point discrimination)

A

Medial lemniscus

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61
Q

Dorsal column has 2 fasciculus

A

Cuneatus and Gracilis

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62
Q

Fasciculus cuneatus is ________ and gracilis is __________

Medial/lateral

A

Lateral, medial

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63
Q

Pain and temperature

A

Spinothalamic tract

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64
Q

Lesion of fasciculus cuneatus

A

Loss of vibratory sensation

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65
Q

What is brown-sequard syndrome

A

Hemissection of the spinal cord

  • corticospinal
  • dorsal columns
  • sponothalamic
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66
Q

Brown-sequard syndrome signs

A

IPSILATERAL spastic paresis below the injury
IPSILATERAL loss of joint position sense, tactile and vibratory sensuous below the lesion
CONTRALATERAL loss of pain and temperature 2 segments below the lesion

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67
Q

Polio symptoms

A

bilateral flaccid paralysis
Muscle atrophy
Fasciculations
Arreflexia

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68
Q

Polio destroys ______ motor neurons

A

Lower

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69
Q

Tabes dorsais what is

A

Late stage of neurossiphilys

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70
Q

Tabes dorsalis symptoms

A

3p: pins and needles (paresthesias)
Pain
Polyuria
Supressed reflexes

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71
Q

Amyotrophic lateral sclerosis

A

Flaccid paralysis in upper limbs (LMN)
Spastic paralysis in lower limbs (UMN)
Increased tone and reflexes

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72
Q

Anterior spinal artery occlusion

A

Spastic bladder
Mid thoracic levels
Dorsal columns sparred

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73
Q

Subacute combined degeneration cause

A

Dramatic loss of vit B12

Pernicious anemia

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74
Q

Subacute combined degeneration symptoms

A

Paresthesias
Bilateral spastic weakness
Babinski
Sensory ataxia

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75
Q

Syringomyelia

A

Progressive enlargement of the central canal of the spinal cord

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76
Q

What cranial nerves are not from the brain stem

A

I, II e IX

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77
Q

What CN arise from midbrain

A

III, IV

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78
Q

What CN arise from pons

A

V, VI, VII e VIII

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79
Q

What CN arise from upper medulla

A

IX, X e XII

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80
Q

Marker of upper medulla

A

Inferior olivary nucleus

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81
Q

CN I

A

Olfactory

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82
Q

Lesion of CN I

A

Anosmia

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83
Q

CN II

A

Optic

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84
Q

Only CN affected by multiple sclerosis

A

Optic

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85
Q

Lesion in optic nerve

A

Loss of light reflex

Visual field deficits (anopsia)

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86
Q

CN III

A

Oculomotor

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87
Q

Raises eyelid
Constrict pupil
Accommodates

A

Oculomotor

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88
Q

Muscles innervated by CN III

A

Superior rectus
Inferior rectus
Medial rectus
Inferior oblique

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89
Q

Muscle and nerve that ADDUCT eye (look in)

A

Medial rectus

CN III

90
Q

Eye movement from CN III

A

Adduct (look in)

Look up

91
Q

Lesion in CN III

A 
Diplopia
External strabismus 
Ptosis
Loss of light reflex
Loss of near response
92
Q

CN VI

A

Abducens

93
Q

Eye movement from CN VI

A

ABDUCT (look out)

94
Q

Muscle and CN that abduct the eye

A

Lateral rectus

CM VI

95
Q

Lesion of CN VI

A

Diplopia
Internal strabismus
Loss of parallel gaze
“Pseudo ptosis”

96
Q

CN IV

A

Trochlear

97
Q

Muscle of CN IV

A

Superior oblique

98
Q

Eye movement of CN IV

A

Look down and out

Intorts

99
Q

Lesion of CN IV

A

Weakness looking down
Trouble going downstairs
Head tilts away from lesioned side

100
Q

CN V

A

Trigeminal

101
Q

CN V branches

A

Ophthalmic (v1)
Maxillary (v2)
Mandibular (v3)

102
Q

V1 territory

A

Forehead
Scalp
Cornea

103
Q

V2 territory

A

Palate/nasal/maxillary face and teeth

104
Q

V3 territory

A

Mandibular face and teeth

Anterior 2/3 tongue

105
Q

CN V lesion

A

Loss of blink reflex
Complete facial anesthesia ipsilateral
Jaw deviation toward week side

106
Q

Trigeminal neuralgia

A

Intractable pain of V2/V3 territory

107
Q

CN VII

A

Facial

108
Q

CN VII innervation

A

Facial expression
Salivation
Taste anterior 2/3 tongue
Tears

109
Q

Bell’s palsy

A

CN VII lesion

110
Q

Bell’s palsy signs

A 
Mouth droops
Can’t close eyes
Can’t wrinkle forehead 
Loss blink reflex
Hyperacusia
Loss of taste
Dry eye
111
Q

CN VIII

A

Vestibulocochlear

112
Q

CN VIII lesion

A

Sensory hearing loss
Loss of balance
Nystagmus

113
Q

CN IX

A

Glossopharyngeal

114
Q

CN IX innervation

A

Salivation (parotid gland)

Sensation to posterior 1/3 tongue

115
Q

Which reflex is from CN IX

A

Gag reflex

116
Q

Gag reflex stimulates

A

Swallowing
Palate elevates
Pharynx constricts
Larynx closes

117
Q

CN X

A

Vagus

118
Q

Structures from CN X

A

Palate, pharynx, larynx

119
Q 
Nasal speech
Regurgitation 
Dysphagia
Palate droop
Uvulectomia affected side
Hoarseness 
Loss of gag and cough reflex
A

CN X lesion

120
Q

CN XI

A

Acessory

121
Q

Lesion of CN XI

A

Shoulder drop

122
Q

Muscles innervated from CN XI

A

Sternocleidomastoid

Trapezius

123
Q

CN XII

A

Hypoglossal

124
Q

Lesion of CN XII

A

Tongue pointing to affected side on protusion

125
Q

CN VII innervation is _______ to forehead and shut eye, and _________ nostrils and mouth
(Uni/bilateral) (ipsi/contralateral)

A

Bilateral/ contralateral

126
Q

Presbyacusia

A

Loss of hair cells

127
Q

Only place where the sensory hearing loss will be ipsilateral

A

CN VIII

128
Q

Function of the medial longitudinal fasciculus (MLF)

A

Ability to adduct an eye

129
Q

Lesion of the vestibular nuclei

A

Vestibular nystagmus

130
Q

Caloric test

A

COWS
cold water - opposite side nystagmus
Warm water - same side

131
Q

Lesion in MLF

A

Internuclear ophthalmoplegia

132
Q

Branches of vertebral artery

A

Anterior spinal artery - medial medulla

Posterior inferior cerebelar Artery - lateral medulla

133
Q

Lesion in posterior cerebral artery

A

Contralateral hemianopsia with macular spairing

134
Q

Every Brain stem syndrome

A

Contralateral long tract + CN sign

135
Q

Contralateral spastic paresis
Contralateral loss of tactile, vibration and conscious proprioception
Ipsilateral flaccid paralysis of tongue with tongue deviation on protusion to the lesion side

A

Medial medullary syndrome

136
Q

Contralateral loss of pain and temperature
Absence of gag reflex
Ipsilateral paralysis of larynx, pharynx and palate (dysarthria and dysphagia)
Ipsilateral lower limb ataxia

A

Lateral medullary syndrome

137
Q

Paramedian Artery lesion causes

A

Medial pontine syndrome

138
Q

Contralateral loss of tactile, vibration, position
Contralateral spastic hemiparesia
Medial strabismus

A

Medial pontine syndrome

139
Q

Posterior inferior cerebelar artery lesion causes

A

Lateral pontine syndrome

140
Q

Ipsilateral ataxia
Contralateral loss of pain and temperature
Ipsilateral hearing loss
Ipsilateral Horner’s syndrome
Ipsilateral facial paralysis, loss of taste, lacrimation, salivation, hyperacusia
Vertigo, nausea, vomiting, nystagmus

A

Lateral pontine syndrome

141
Q

Medial midbrain syndrome other name

A

Weber syndrome

142
Q

Ipsilateral oculomotor palsy
Contralateral spastic hemiparesia
Contralateral hemiparesia of lower face

A

Medial midbrain syndrome

143
Q

Lesion in corticobulbar tract

A

Contralateral hemiparesis of lower face

144
Q

Dorsal midbrain syndrome other name

A

Parnaud syndrome

145
Q

Cause of dorsal midbrain syndrome

A

Pineal tumor

146
Q

Paralysis of upward gaze
Pupillary abnormalities
Non communicating hydrocephalus

A

Dorsal midbrain syndrome

147
Q

Function of cerebellum

A

Fine tuning of skeletal muscle contralateral

Planning

148
Q

Cerebellar vermis function

A

Trunk and proximal muscle

149
Q

Intermediate cerebellar

A

Distal muscle

150
Q

Lateral cerebellum

A

Motor planning

151
Q

Where does the information comes in and out

A

Cerebelar peduncle

152
Q

Layers of cerebellum Cortex

A

Molecular
Purkinje
Granule

153
Q

Climbing fibers

A

Error detectors

154
Q

Mossy fibers

A

Stimulates granule cells that stimulates purkinje cells

155
Q

Deep cerebelar nuclei (4)

A

Fastigial
Globose
Emboliform
Dentate

156
Q

Tremor in movement and absent at rest

A

Cerebellar lesion

157
Q 
Ipsilateral intention tremor 
Dysmetria
Dysdiachokinesia
Scanning dysarthria 
Gaze dysfunction 
Supresa muscle stretch reflex
A

Hemisphere cerebellar lesion

158
Q

Can’t do the finger-to-nose test

A

Hemisphere cerebellar lesion

159
Q

Gait balance

Difficult to maintain posture

A

Lesion in vermis region

160
Q

Basal ganglia function

A

Iniciate skeletal muscle contraction

161
Q

Basal ganglia

A

Caudate nucleus and putâmen
Globus pallidus
Substancia nigra
Subthalamic nucleus

162
Q

Direct pathway of basal ganglia

A

Drives motor cortex
Promotes movement
Enhanced by DOPA

163
Q

Indirect pathway of basal ganglia

A

Inhibits motor cortex
Suppress unwanted movement
Enhanced by Ach

164
Q

Tremor at rest

A

Basal ganglia disease

165
Q

Loss of dopa in substancia nigra
Direct pathway
Lewy bodies

A

Parkinson

166
Q

Pill rolling
Shuffling gait
Masked face

A

Parkinson

167
Q

Degeneration of GABA in the indirect pathway

Autosomal dominant

A

Huntington disease

168
Q

Can’t suppress involuntary movement

Chorea

A

Huntington

169
Q

Autosomal recessive

Defect in copper transport

A

Wilson disease

170
Q

Pathognomonic of Wilson disease

A

Kayser-Flesher ring

171
Q

Parkinsonian or Chorea

Wing beating tremor

A

Wilson disease

172
Q

Wild, flinging movements of limbs

A

Hemiballism

173
Q

Unilateral
Indirect pathway
Hypertensive patients with lacunar stroke

A

Hemiballism

174
Q

Tourette syndrome

A

Motor/ vocal tics

Treatment with antipsychotic

175
Q

Inhibits prolactin

A

Dopamine

176
Q

Lesion in lateral hypothalamic

A

Starvation

177
Q

Lesion in ventromedial

A

Hyperphagia, obesity

178
Q

Lesion in supraoptic and paraventricular nuclei

A

Diabetes insipid is

179
Q

Blue sclera

A

Osteogenesis imperfeita

180
Q

Age related macular degeneration

A

Central Scotomas

181
Q

Open angle glaucoma

A

Drainage problem in the canal of Schlem

Peripheral visual loss

182
Q

Pretectal lesion

A

Bilateral internuclear ophthalmoplegia

Convergence is intact

183
Q

Lesion in pretectal area

Pineal tumor, neurosyphylis, diabetes

A

Argyll Robertson pupil

184
Q

Pupils don’t constrict to light response bilateral

A

Argyll Robertson pupil

185
Q

Optic nerve lesion
Seen in multiple sclerosis
Diagnostic by swinging flashlight

A

Relative afferent pupil (Marcus Gunn)

186
Q

Transtentorial herniation

A

Lesion CN III

fixed and dilated pupil

187
Q

Ciliary ganglia lesion

Unilateral

A

Adil pupil

188
Q

Visual defect

Small pituitary adenoma

A

Heteronyms superior quadrantopsia

189
Q

Visual defect

Big pituitary adenoma

A

Bitemporal heteronyms hemianopsia

190
Q

Visual defect

Acromegaly

A

Bitemporal heteronyms hemianopsia

191
Q

Visual defect

Meyers loop lesion

A

Contralateral homonyms superior quadrandopia

192
Q

Visual defect

Temporal lobe tumor

A

Contralateral homonyms superior quadrantopia

193
Q

Visual defect

Posterior cerebral artery

A

Contralateral homonyms hemianopsia with macular sparring

194
Q

Most common place for an aneurysm

A

Anterior communicating artery

195
Q

Broca’s area

A

Motor speech

196
Q

Wernickes area

Angular gyrus

A

Language comprehension

197
Q

Lesion in left frontal lobe

A

Motor, non fluent, expressive aphasia

198
Q

Can’t speak full sentence

Patient is aware and frustrated

A

Expressive/motor aphasia

199
Q

Right frontal lobe lesion

A

Can’t add emotional tone

200
Q

Lesion in left temporal lobe

A

Fluent, receptive, sensory aphasia

201
Q

Can’t understand what is said
May/maynnot be able to read
Misusing words
Unaware of their defect

A

Receptive/fluent/sensory aphasia

202
Q

Receptive aphasia artery lesion

A

Middle cerebral artery

203
Q

Lesion in left parietal lobe

A

Gerstmann syndrome (angular gyrus)

204
Q

Can’t understand what is written (alexia)
Finger agnosia
Right-to-left disorientation
Acalculia

A

Gerstmann syndrome

205
Q

Lesion of arcuate fasciculus

A

Conduction aphasia

206
Q

Can’t count backwards 10-1
Can’t repeat words
Aware and frustrated

A

Conduction aphasia

207
Q

Right parietal lobe lesion

A

Asomatognosia

208
Q

Asomatognosia

A

Unilateral neglect (unaware of left side of the body)

209
Q

What connects both hemispheres

A

Corpus callouses

210
Q

Lesion of corpus callosus Artery

A

Anterior cerebral Artery

211
Q

Can’t move by command the left arm

A

Transcortical apraxia

Lesion in corpus callosum

212
Q

What region of internal capsule is highly susceptible in lacunar stroke

A

Genu and posterior limb

213
Q

Genu lesion

A

Contralateral lower face (corticobulbar axons)

214
Q

Posterior limb lesion

A

(Corticospinal fibers)
Complete contralateral upper and lower limb spastic weakness
(Thalamic fibers)
Complete face and contralateral body anesthesia

215
Q

Lesion in anterior cerebral artery

A

Contralateral spastic paralysis and anesthesia of lower limb

216
Q

Cause of kluver-bercy syndrome

A

Bilateral watershed strokes

217
Q 
Anterograde amnesia
Placidity
Hypersexuality 
Psychic blindness
Increases oral exploratory behavior 
Hypermetamorphosis
A

Kluver-Bercy syndrome

218
Q

Jaw weakness

Loss of facial sensation

A

Trigeminal lesion at pons

219
Q

Weakness of vertical gaze
Argyll Robertson pupil
Increased intracranial pressure

A

Parinaud syndrome

220
Q

Motor deficits in vascular problem in primary motor cortex

A

Contralateral lower limb

221
Q

Aphasia
Neglect
Contralateral hemiparesis
Homonymous hemianopsia

A

Middle cerebral artery stroke

USMLE STEP 1 (3 decks)

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