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Block 5: Neuro > RAT 3 > Flashcards

RAT 3 Flashcards

1
Q

optic ataxia

A

impaired visually guided reaching in peripheral field

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2
Q

where do corticospials come from

A

1/3 primary motor cortex 1/3 premotor/sma 1/3 post central gyrus

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3
Q

vertical gaze center

A

rostral interstitial nucleus of the MLF

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4
Q

horizontal gaze center

A

PPRF of the pons

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5
Q

LOTC

A

lateral occipital temporal cortex composed of the middle temporal gyrus (posterior middle temporal) and the lateral occipital lobe important part of the tool use network

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6
Q

identify

A

level of the inferior colliculus of the midbrain

circled is the trochlear nerve CN 4 (“egg and nest”)

  • innervates superior oblique muscle (“down and out”)
    • innervates contralaterally (R CN 4 innervates L superior oblique)
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7
Q

Identify

A

Level of the superior colliculus of the midbrain

identifying the oculomotor nucleus (CN III)

  • innervates the medial rectus, superior and inferior rectus and inferior oblique
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8
Q

Identify lesion

A

Middle alternating hemiplesia

  • ipsilateral abducens issue
  • contralatera T&E paralysis/weakness due to corticospinals
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9
Q

Identify lesion C

A

superior alternating hemiplesia

  • CN III ipsilaterally
  • contralateral T&E paralysis/weakness due to corticospinals
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10
Q

conjugate

A

both eyes move same direction at same rate

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11
Q

vergence

A

focus shifts between near and far objects - eyes move in opposite directions

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12
Q

convergence

A

visual axis of eyes convere (near focus)

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13
Q

divergence

A

visual axis of eyes diverge (far focus)

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14
Q

identify

A

horizontal gaze center (PPRF)

pons

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15
Q

identify

A

the vertical gaze center ( riMLF)

midbrain

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16
Q

identify red circle

A

spinal nucleus of V

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17
Q

pretectal area

A

important in pupillary light reflex; can easily identify if you see the pineal gland

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18
Q

near reflex

A

eyes converge

pupils constrict

lens round

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19
Q

IV innervation

A

contralateral superior oblique –> which pulls the eye down and out

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20
Q

cranial IV nerve palsy

A

can present with strabismus and/or compensatory head tilt; the head tilt allows for the other eye to be lined up since it cant intort, so the patients other eye will compensate by intorting the other eye and tilting her head

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21
Q

vestibular system

A

rapid estimates of head movement; cortex gives us conscious awareness

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22
Q

vestibular end organ

A

has five receptive elements

  1. uticle
  2. saccule
  3. three semi ciruclar canals
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23
Q

funciton of uticle and saccule

A

detect linear motions of head and orientation of head

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24
Q

funciton of the semicircular canal

A

detect rotational movement of head

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25
Q

innervation of III

A

ipsilateral medial, supeiror, inferior rectus, inferior oblique, levator palpibrae

26
Q

innervation of VI

A

ipsilateral lateral rectus

27
Q

how to the pontine nuclei affect the gazing situation

A

receive input from the ipsilateral cerebral cortex and project to the contralateral cerebellum, which pojects to the ipsilateral VIII nucleus

28
Q

most common aneurysm causing CN III palsy?

A

PComm

29
Q

horner’s syndrome lesion localization

A

can be due to carotid dissection or a blunt trauma to the sympathetic chain (neck region)

30
Q

internuclear opthalmoplegia

A
  • produced by MLF lesion
  • by definition, the side of the INO is the side of the lesion in the MLF
  • convergence is spared because that input comes from pretectal area and does not go thru MLF
31
Q

1 and a half syndrome

A
  • lesion to MLF and adjacent abducens nucelus or PPRF
  • ipsilateral eye cannot move at all horizontally
  • contralateral eye can only abduct, and cannot adduct
32
Q

thinking about tool use, what is dorsal

A

reaching

33
Q

thinking about tool use, what is ventral

A

grasping

34
Q

Parinaud’s Syndrome

A
  • lesions compressing dorsal midbrain and pretectal area
  • symptoms incl
    • impairment of looking up
    • large irregular pupils (“light-near dissociation”)
    • eyelid abnormalities
    • impaired convergency, sometimes convergence-retraction nystagmus
  • causes
    • pineal region tumors
    • MS
    • vascular disease of midbrain/pretectal area
    • hydrocephalus - esp in children
35
Q

blink to visual threat

A

lack represnts visual field deficit

36
Q

ID lesion and list some associated symptoms

A

Infarct in midbrain tegmentum

  • posterior cerebral artery (and perhaps the top of the basilar artery)
  • intermittent memory loss
  • diplopia
  • sparkling lights
  • somnolence
  • limited upward gaze
  • enlarged pupil, ptosis
  • bilateral ataxia
37
Q

crista

A

a ridge in each ampulla in which the hair cells are located

detect angular acceleration

associated with the semicircular canals

38
Q

maculae

A

detect linear acceleration and head tilt

associated with the utricle and saccule

39
Q

lateral vestibulospinal tract

A

important for balance and extensor tone

40
Q

medial vestibulospinal tract

A

important for head and neck positioning

41
Q

what reflex lets your eyes stay fixed on something as your head moves?

A

vestibulo-ocular reflex

42
Q

what does the VPM receive

A

ventral posterior medial nucleus of the thalamus receives VTT info

43
Q

conductive hearing loss

A

bone conduction is greater than air conduction because bone conduction bypasses problems in the external or middle ear

Weber test = tuning fork placed on vertex of skull in midline –> LOUDER on affected side

causes: otitis, tympanic membrane perforation, sclerosis of the middle ear ossicles

44
Q

sensorineural hearing loss

A

air conduction is greater than bone conduciton in both ears (normal finding)

hearing is decreased in the affected ear

Weber test = tuning fork placed on vertex of skull in midline –> quieter on affected side

causes: meningitis, ototoxic drugs, viral infections, Menieres disease, cerebellopontine angle tumors, loud sounds

45
Q

benign paroxysmal positionl vertigo

A

brief episodes of vertigo last for a few seconds and occur with change of position

after first episode, usually brief and only occurs with change of posioin

46
Q

Meniere’s disease

A

recurrent episodes of vertigo

progressive hearing loss and tinnitus

“full feeling” in the ear

Tx: salt restriction and diuretics

47
Q

difficulty using familiar tools with either hand

A

inferior parietal lobule, LOTC

48
Q

vertebrobasilar ischemia or infarct

A

a central nervous system cause of vertigo

49
Q

gentamicin

A

bilateral vestibular dysfunciton; unsteadniess of gait and oscillopsia (perception of oscillating vision)

50
Q

impedence matching

A

compensate for some of the sound energy losses that occur when sound encounters the air-fluid barrier

51
Q

middle ear amplifier

A

two lever mechanisms

  1. ratio of TM surface area to oval window surface area
    • this is the major mechanism; 20:1 with 26dB gain
  2. ratio of length of malleus to length of incus
    • this is the minor mechanism; 1.3:1 with 2dB gain
52
Q

scala media

A

endolymph

53
Q

what chambers are filled with perilymph?

A

scala tympani and scala vestibuli

54
Q

what do the inner hair cells do?

A

responsible for hearing

55
Q

what do the outer hair cells do?

A

supportive

56
Q

hair cells

A

neuroepithelial cells that are responsible for conversion of acoustic (mechanical) energy into action potentials (electrochemical signals)

57
Q

Apraxia

A

Apraxia results in a person’s inability to carry out a familiar purposeful movement

58
Q

ataxia

A

they can carry out the movement but with little coordination.

59
Q
A
60
Q
A

Block 5: Neuro (8 decks)

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