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Pathology I Flashcards

1
Q

effects of lesion in frontal lobe

A

Disinhibition and problems with concentration, judgement

Reemergence of primitive reflexes

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2
Q

effects of lesion in frontal eye fields

A

If its a destructive lesions such as MCA stroke - eyes look towards side of lesion

If its an irritive lesion such as seizure - eyes look towards shaking limb

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3
Q

effects of lesion in paramedian pontine reticular formation

A

ipsilateral gaze palsy (cannot look toward the side of the lesion)

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4
Q

What is the paramedian pontine reticular formation

A

Brain region in the pons that coordinates eye movements - especially horizontal gaze/saccades

Coordinates the eyes looking in the same direction

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5
Q

What is the medial longitudinal fasciculus?

A

Links the nerves that control eye movements (CN III, CN IV, CN VI) and integrates eye movements with head movements

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6
Q

Findings with a lesion in the medial longitudinal fasciculus

A

Impaired adduction of eye on ipsilateral side and nystagmus of eye on contralateral side with abduction

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7
Q

effects of lesion in dominant parietal cortex

A

Agraphia, acalculia, finger agnosia, left-right disorientation (confusion of left and right limbs)

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8
Q

effects of lesion in nondominant parietal cortex

A

agnosia of the contralateral side of the world

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9
Q

a lesion in the dominant parietal cortex results in which syndrome?

A

Gestmann syndrome

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10
Q

a lesion in the nondominant parietal cortex results in which syndrome?

A

hemispatial neglect syndrome

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11
Q

effects of lesion in hippocampus (bilateral)

A

anteriograde amnesia

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12
Q

effects of lesion in basal ganglia

A

can result in tremor at rest, chorea, athetosis

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13
Q

effects of lesion in subthalamic nucleus

A

contralateral hemiballismus

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14
Q

effects of lesion in mammillary bodies

A

memory loss

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15
Q

An example of a lesion to the mammilary bodies is seen in which syndrome?

A

Wernicke-Korsakoff

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16
Q

Wernicke-korsakoffe presentation

A

confusion, ataxia, nystagmus, opthalmoplegia, memory loss, confabulation, personality changes

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17
Q

effects of lesion in amygdala (bilateral)

A

Results in Kluver-Busy syndrome - disinhibited behaviour - hyperphagia, hypersexuality, hyperorality

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18
Q

Viral cause of Kluver-Busy syndrome?

A

HSV-1 encephalitis

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19
Q

Lesion in dorsal midbrain causes which syndrome?

A

Parinaud syndrome

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20
Q

Parinaud syndrome presentation

A

vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus

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21
Q

effects of lesion in reticular activating system

A

reduced levels of arousal and wakefulness (coma)

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22
Q

effects of lesion in cerebellar hemisphere

A

intention tremor, limb ataxia, loss of balance

IPSILATERAL deficits

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23
Q

effects of lesion in red nucleus (midbrain)

A

Decorticate posturing if lesion is above red nucleus

Decerebrate posturing if lesion is at or below red nucleus

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24
Q

effects of lesion in cerebellar vermis

A

truncal ataxia, nystagmus

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25
Chronic alcohol use is associated with a lesion where?
cerebellar vermis
26
Which scan detects ischemic injury within 3-30 min?
MRI
27
Which scan detects ischemic injury within 6-24 hours?
CT
28
Histology of ischemic stroke at 12-24 hours
Eosinophilic cytoplasm + pyknotic nuclei (red neurons)
29
Histology of ischemic stroke at 24-72 hours
necrosis + neutrophils
30
Histology of ischemic stroke at 3-5 days
macrophages
31
Histology of ischemic stroke at 1-2 weeks
reactive gliosis (astrocytes) + vascular proliferation
32
Histology of ischemic stroke at >2weeks
glial scar
33
What is neonatal intravenricular hemorrhage
bleeding into the ventricles
34
which babies are at risk for intravenricular hemorrhage
premature and low-birth-weight infants
35
Where does the bleeding orginate in neonatal intravenricular hemorrhage?
germinal matrix (highly vascularized region within the subventricular zone)
36
how does neonatal intravenricular hemorrhage present?
altered consciousness, buldging fontanelle, hypotension, seizures, coma
37
Which artery is rupted in a epidural hematoma?
middle meningeal
38
presentation of epidural hematoma
loss of consciousness -> recovery (lucid interval) -> rapid deterioration due to hematoma expansion
39
what will a CT of an epidural hematoma look like
biconvex hyperdense blood collection that does not cross suture lines
40
What ruptures in a subdural hematoma?
bridging veins (venous bleed)
41
causes of a chronic subdural hematoma?
mild trauma, cerebral atrophy, elderly, alcoholism, shaken baby
42
what does a subdural hematoma look like on CT ?
crescent-shaped hemorrhage that crosses suture lines. May cause a midline shift.
43
Causes of a subarachnoid hemorhage?
bleeding due to trauma, ruupture of an aneurysm, arteriovenous malformation
44
What will be seen on a lumbar puncture of someone with a subarachnoid haemorrhage?
bloody or yellow lumbar puncture
45
What is a common complication of someone with a subarachnoid hemorrhage?
Vasospasm or rebleed 3-10 days laters | Increased risk of communicating/obstructive hydrocephalus
46
How to prevent vasopspasm/rebleed in a patient who has had a subarachnoid hemorrhage?
nimodipine
47
What is the most common cause of an intraparenchymal haemorrhage?
systemic hypertension
48
What is amyloid angiopathy associated with?
Intraparenchymal hemorrhage
49
Where do intraparynchemal hemorrhages commonly occur?
putamen/internal capsule
50
Complication of intraparenchymal hemorrhage
Contralateral hemiparesis and hemisensory loss
51
Which areas of the brain may be effected with a MCA stroke?
``` motor and sensory cortexes --- upper limb and face Temporal lobe (wernickes), frontal lobe (brocas) ```
52
What areas of the brain may be effected with a ACA stroke?
motor and sensory cortexes of the lower limb
53
Which areas may be effected with a stroek in the lenticulostriate-artery?
striatum, internal capsule
54
How will a patient who has had a stroke in the lenticulostriate artery present?
Contralateral paralysis without cortical signs (aphasia, visual loss, etc).
55
presentatin of a patient who has had a MCA stroke?
contralateral paralysis and sensory loss ---- face and upper limb If in dominant hemisphere -aphasia If in nondominant hemisphere - hemineglect
56
Which areas will be affected in a patient with an anterior spinal artery stroke?
Lateral corticospinal tract Medial lemniscus caudal medulla (hypoglossal nerve)
57
Medial medullary syndrome cause
infarct of the paramedian branches of the ASA and or vertebral arteries
58
areas effected in someone with a posterior inferior cerebellar artery stroke
Lateral medulla (nucleus ambiguus CN IX, X, XI) Vestibular nuclei Lateral spinothalamic tract, spinal trigeminal nucleus Sympathetic fibers Inferior cerebellar peduncle
59
Presentation of someone with an ASA stroke
Tongue deviated towards side of lesion (ipsilateral) Contralateral paralysis of upper and lower limbs Decreased contralateral proprioception
60
Presentation of someone with a PICA stroke
Dysphagia, hoarseness, decreased gag reflex, hiccups Vomiting, vertigo, nystagmus Decreased pain and temp sensation from contrateral body and ipsilateral face Ipsilateral horner syndrome, ipsilateral ataxia
61
What is the name of the syndrome seen in someone with a PICA stroke?
Lateral medullary (Wallenburg) syndrome
62
Areas effected in someone with an AICA stroke
Lateral pons (facial nucleus) Vestibular nuclei Spinothalamic tract, spinal trigeminal nucleus Sympathetic fibers, middle and inferior cerebellar peduncles Labyrinthe artery
63
Presentation of someone with an AICA stroke?
paralysis of the face - decreased lacrimation, decreased salivation, decreased taste from anterior tongue vomiting, vertigo, nystagmus, decreased pain and temp sensation from controlateral body and ipsilateral face Ipsilateral horner syndrome Ipsilateral ataxia, dysmetric Ipsilateral sensorineural deafness/vertigo
64
What is the name of the syndrome seen in someone with an AICA stroke?
Lateral pontine syndrome
65
Areas effected in someone with a basilar artery stroke?
pons, medulla, lower midbrain Corticopsinal and corticobulbar tracts Ocular cranial nerve nuclei, paramedian pontine reticular formation
66
Presentation of someone with a basilar artery stroke?
RAS spared so there is preserved consciousness Quadriplegia: loss of voluntary facial mouth and tongue movements Loss of horizontal but not verticle eye movements
67
What is the name of the syndrome seen in someone who has had a basilar artery stroke?
Locked in syndrome
68
What area is affected in someone who has had a posterior cerebral artery stroke?
occipital lobe
69
Presentation of someone who has had a PCA stroke?
contralateral hemianopia with macular sparing | Alexia without agraphia
70
What is central poststroke pain syndrome?
neuropathic pain due to thalamic lesoins Initial parasthesias followed by allodynia (10% of stroke patients)
71
What causes diffuse axonal injury?
traumatic shearing forces during rapid acceleration/decceleration
72
Presentation of patient with diffuse axonal injury
coma or persistant vegetative state
73
MRI findings of patient with diffuse axonal injury
multiple lesions (punctate hemorrhages) involving the white matter tracts

neurology (9 decks)

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