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Other Flashcards

1
Q

Lacunar Stroke:
usually caused by…
associated with…
pathology…

A
  • caused by occlusion of a single small penetrating artery
  • long-standing HTN or DM
  • lipohyalinosis or microatheroma and narrowing
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2
Q

Supplies the internal capsule + basal ganglia + corona radiata:

A

Lenticulostriate branches of the MCA

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3
Q

Pure motor hemiparesis:

MC caused by…

A

infarction of contralateral internal capsule

can be seen with infarct of corona radiata or pons

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4
Q

Pure motor hemiparesis:
s/s?
not present?

A

face arm and leg are equally affected

No evidence of sensory loss, homonymous hemianopia, aphasia, or hemineglect

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5
Q

Supplies the thalamus…

A

Thalamoperforate branches of the PCA

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6
Q

Pure sensory:

MC caused by…

A

infarction of the thalamus

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7
Q

Pure sensory:

S/s?

A
  • Sensory loss throughout the contralateral side (but partial hemisensory defects may occur)
  • Sensation is decreased for all sensory modalities w/ NO other neurological deficits
  • Abnormal sensations such as “pins and needles” or skin tightness
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8
Q

What is Dejerine-Roussy Syndrome?

Tx?

A

Complication of thalamic infarction
- Severe intractable pain and allodynia (pain produced by tactile stimuli) on the effected side

gabapentin or TCA

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9
Q

Vascular infarct associated with sensorimotor stroke?

What structures are affected?

A

Paramedian penetrating branches of the basilar artery supplying the pons

Infarction MC in pons, internal capsule or corona radiata

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10
Q

Dysarthria Clumsy Hand Syndrome:
Infarction of…
s/s…

A

internal capsule or pons

dysarthria, UE ataxia, facial weakness, dysphagia, weakness in UE/LE

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11
Q

Cause of NEUROCYSTICERCOSIS?

Buzzwords?

A

Pork tapeworm (taenia solium)

Seizure + Mexico (Guatemala, etc)

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12
Q

Neurocysticercosis:
s/s?
complications?

A

occipital HA + Sz + focal signs (subacute onset)

  • can obstruct ventricles
  • can predispose to srtoke (arteritis –> clots)
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13
Q

Neurocysticercosis:

Dx?

A
  • ELISA
  • CT w/ multiple calcifications and space occupying lesions
  • swiss cheese appearance on MRI
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14
Q

Neurocysticercosis:

Tx?

A
  • Give steroids to decrease ICP
  • Sz meds
  • albendazole and praziquantil
  • Shunt if CSF not flowing
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15
Q

Edema highlighted on T2-FLAIR =

A

chronic, inflammatory condition

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16
Q

substitution of one letter for another (wife -> wafe)

substitute one word of same type for another (wife vs mom)

A

Literal

semantic

17
Q

PPx of meningococcal and H flu:

A

rifampin or cipro

18
Q

Lesion of the superior part of SNS causes…

A

miosis + enophthalmos + anhidrosis

Horner’s syndrome

19
Q

SNS to eye originates in… (brain structure)

Then what path does it follow?

A

hypothalamus

exits spinal cord with T1 –> enters Cervical Sympathetic Chain –> attaches to ICA

20
Q

Tumor in chest wall will catch which cord first?

A

medial

21
Q

Tingling or numbness above the wrist is caused by…

Tingling or numbness in hand, 5th digit and half of 4th…

A

root or cord lesion

ulnar nerve

22
Q 
Causes of Horner's according to pathway:
Brainstem (3): 
 Cervical Cord (2): 
T1 Root (2): 
ICA (2) :
A

Brainstem: Glioma + Infarction + Syringobulbia

Cervical Cord: Glioma + Syringomyelia

T1 Root: Neurofibroma + Brachial Plexus lesion

ICA: Occlusion + Dissection

(also: cluster HA, pancoast tumor)

23
Q

Brain Death criteria?

A
  • Clinical/neuroimaging evidence of acute CNS problem compatible with brain death
  • Exclusion of complicating medical condition that may confound clinical assessment (eg metabolic)
  • No drug intoxication or poisoning
  • Core temp of 32 ̊C (90 ̊F)
24
Q

Cardinal findings in brain death?

A
  1. coma (no cerebral motor response to pain)
  2. absent brainstem reflexes (pupils, EOM, facial sensation and motor resp, gag reflex)
  3. apnea testing (core of 36.5’C, SBP of 90, euvolemic, normal arterial PO2)
25
Q

Requirements for repeat exams for brain death criteria?

A

o Children: < 2mo perform repeat exam after 48h

o 2mo-1yo: repeat after 24h

o 1y-18y: repeat 12h

o Adults: 6h later except for subjects w/ anoxic-ischemic brain damage that get it 24h later

26
Q

B12 deficiency causes,,,

A

Subacute combined Degeneration of corticospinal and dorsal columns

Myelopathy + PN = combination of areflexia + sensory ataxia + paraparesis + Extensor plantar response

27
Q

Location and arterial supply of:
Broca’s?
Wernicke’s?
Acruate fasiculus?

A

Inferior frontal gyrus
Ant division of MCA on dominant (left) side

Posterior superior temporal lobe
Post. Div. Of MCA

Supramarginal gyrus

28
Q

Symptoms of:
Broca’s?
Wernicke’s?
Acruate fasiculus?

(fluent, comprehension, repetitions, paresis, etc)

A
  • Nonfluent
  • intact comprehension
  • Naming/repetition/writing are all poor
  • reading is variable
  • disordered grammar
  • hemiparesis is common
  • Fluent paraphasic
  • Comprehension, Naming, Repetition, and writing are poor
  • Repetitions of substitutions
    (hemiparesis is infreq)
  • Fluent paraphasic
  • Poor repetition
  • intact comprehension
  • Poor writing
    (hemiparesis infreq)
29
Q

Artery compressed in brain herniation?

A

ACA

30
Q

Type of herniation associated with ventricle compression?

A

Cingulate (subfalcine)

31
Q

Uncal herniation:

  • Causes stretching of… (s/s?)
  • Causes compression of… (s/s?)
A

Stretching of CN III: IPSI dilated pupil + ptosis

Compression of:

  1. ipsilateral PCA: CONTRA homonymous hemianopia
  2. contralateral crus cerebri: IPSI paresis
32
Q

What are Duret hemorrhages?

A

uncal herniation causes caudal displacement of brain stem (kernohan’s notch) –> paramedian aa. rupture

33
Q

Cerebral hemisphere mass

  • Causes herniation of…
  • Causes compression of…(s/s?)
A

lateral tentorial herniation (temporal lobe through tentorial hiatus) = shift of midline structures

Compression of:

  • reticular formation = deteriorating level of consciousness
  • CN3 palsy = compression of both the nerve + nucleus in MB = ipsilateral fixed dilated pupil
34
Q

Cerebral hemisphere mass:

PE reflex finding?

A

Long track signs: upgoing plantar responses

35
Q

What causes Central tentorial Herniation?

A

diffuse cerebral swelling or unchecked lateral herniation

(Vertical displacement of structures through the tentorial hiatus; downward traction on the pituitary stalk and hypothalamus)

36
Q

S/s of Central tentorial Herniation?

A
  • Conscious level deteriorates
  • pupils are initially small –> ultimately fixed and moderately dilated
  • Impaired upgaze due to pressure on the superior midbrain
37
Q

Cause of tonsillar herniation?

A
  • subtentorial mass or unchecked tentorial herniation –> through foramen magnum
  • Posterior fossa mass –> upward herniation through the tentorial hiatus
38
Q

S/s of tonsillar herniation?

A
  • neck rigidity + head tilt
  • Conscious level deteriorates ultimately w/ respiratory arrest
  • HTN + bradycardia

Neuro (7 decks)

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