Quiz #2 Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

brain waves

A

delta: cortex during sleep
theta: hippocampus during attention, cortex during sleep
alpha: cortex relaxed with eyes closed
beta: cortex during attention
gamma: cortex and hippocampus during information processing (maybe memory consolidation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

anterolateral system - 3 categories

A

1) neo-spinothalamic: sharp pain, temp and crude touch – reach consciousness
2) paleospinothalamic/ spinoreticular tract: dull aching pain, older pathway, may be felt at level of thalamus and cerebral cortex (central tegmental tract - CTT) - projects to intralaminar nucelus of thalamus
3) spinomesencephalic: modulation of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

neospinothalamic tract

A

first order: dorsal root ganglion
–enter tract of lissauer 2-3 segments above entry
second order: spinal dorsal horn
—cross to anterior white commisure (opposite side)
third orderL VPL nucleus of thalamus

second order neurons lie in lamina 1,2,5 of dorsal horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

syringomyelia

A

cyst in central part of spinal cord – if it involves the area of anterior white commisure = bilateral, symetrical loss and pain and temp 2-3 segments below the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Brown-sequard syndrome

A

hemisection of the spinal cord =

  1. loss of all sensations on the SAME side at the level of the lesion
  2. loss of dorsal column sensations (fine touch and proprioception) below the lesion at the SAME side
  3. loss of pain and temp sensations carried in ALS 2-3 segments below the lesion on OPPOSITE side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

trigeminal nerve - CN 5

A

V1: opthalmic - tip of nose, top of eyes, forehead

V2: maxillary: underside of nose, upper lip, bottom of eyes, cheek

V3: mandibularL lower lip, jaw, part of ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

trigeminal nuclei

A

principal/chief:
- fine touch and proprioception – second order fo to VSTT - cross to other side
spinal nucelus - 2nd order
-pars oralis (upper 1/3): fine touch, pressure,
- pars interpolar and pars caudalis: lower part = pain, temp, crude touch

mesencephalic: only first order inside brain stem, failed to migrate out
- - jaw reflex

3rd order is in VPM of thalamus, then pass through internal capsule to primary sensory cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

layout of facial innervation

A

V1 - most ventral
more dorsal is V2 and most dorsal is V3
also, concentric: perioral – more rostral, further away from mouth is more caudal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

uncal herniation

A
trans-tentorial: 
triad
1) blown pupil - CN3 compression 
2) hemiparesis 
3) lethargy, coma, etc --> reticular activating system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

managing coma

A
ABCs
IV access 
administer naloxone, thiamine, dextrose 
neuro exam - pupils
blood tests for electrolytes and tox, organ function 
CT scan of head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

brain deat h

A

1) coma
2) absennce of brainstem reflexes
3) apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

local anesthetics

A

all act on sodium channels
- more hydrophobic = more potent
amide and ester aromatic groups

amide: lidocaine, other “icanes”
esters: procaine, other non-I “caines”

too much: metallic taste, numbness, CNS, cardio probs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

nitrous oxide

A

very high MAC (105%) and very LOW potency, low solubility — good because doesnt stick around so easy to reverse, but have to put on O2 afterwards or else bad news bears - use NO for second gas effect - speeds up onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

IV general anethietics

A

more soluble = more potent - mostly GABA – chloride channels (propofol) - potentiate

also NMDA - ketamine – glutamate, antagonize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

drugs not effective for partial epilepsy

A

ethosuximde and methsuximde (they sux) – only good for absence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

drugs for general

A

pheno, phenytoin, valproic, topiramate, perapemel, ethosux

NOT carbamazepine, gabapentin, pregablain, and such
— these will actually make generalized (myoclonics) WORSE

17
Q

anti ep drug side effects

A

perampanel - homicidal ideation
phenytoin: gingival hyperplasia, hirsuitism
carbamazepine –> hyponatremia
valproate: weight gain, hep failure – also tetratogenic
topiramte - weight loss and sweating

some are inducers: phenobarb, phenytoin, carbameza, topiramte –> make other drugs less effective

some are inhibitorsL valproate - make other drugs more effective
carbamezepine is an autoinducer - have to increase the dose

when people get old (less protein) give them less – pregnancy they may need more - mass

18
Q

effects of cerebral ischemia

A

protein synthesis and gene expression goes down

then acidosis, water shifts, glutamate release, electrical fialrue

then membrane fialure and neuronal death

early effects: Ca dependent enzymes, free radiacals, mitochondrial failure
delayed effects: changes in gene expression - hypoxia

cell injury from excess of calcium

19
Q

best drugs for general seizures

A

levitiracem, valproate, lamotrigine

20
Q

best drugs for partial seizures

A

lamotrigine, levitiracem, and oxcarbezepine

21
Q

drugs that make generalized seizures worse

A

carbamezepine, gabapentin, oxcarbezepine, pregablin, tigabine

22
Q

phenobarbitol

A

GABA receptor increase synaptic inhibition

  • works for general and partial
  • P450 – liver inducer
  • liver failure
  • not great for preg
23
Q

phenytoin

A

acts on Na channels

  • good for general and partial
  • SJS, giginval hyperplasia, lupus
24
Q

carbamazepine

A

Na channels

  • partial NOT general (makes them worse)
  • hepatic inducer
  • hyponatremia and aplastic anemia
25
Q

valproate

A
multiple mechanisms 
partial and general
liver inducer 
liver tox, weight gain
neural tube defects
26
Q

ethosuximde

A

Cacium channels
absence seizures
liver - CY3A
- allergy SJS, and blood problems (pregnancy C category so maybe not the worst

methsuximide similar

27
Q

levitiracem

A

SV2a - synaptic vesicle thing - exocytosis

  • general and partial
  • mood swings
28
Q

oxcarbazepine

A

Na channels
partial NOT general
hyponatremia
liver CYP3A

29
Q

perapamel

A

AMPA glutamte receptor antagonist
partial and general
agression and homicidal ideaton