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SF2 NBME / Misc Flashcards

1
Q

Lentiform Nucleus (components)

A

Putamen + Globus Pallidus

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2
Q

Nerves of Corneal Reflex

A

V1 -> VII

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3
Q

Spina Bifida Occulta.

A

(Neural Tube Defect) Failure of caudal neuropore to close, but no herniation. Usually seen at lower vertebral levels. Dura intact.

Associated with tuft of hair or skin dimple at level of bony defect

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4
Q

Structures passing through Jugular Foramen

A

CN IX, X, XI, and Jugular Vein

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5
Q

Pathological Location of Serotonin Synthesis

A

Raphe Nucleus

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6
Q

Developmental Origin of PNS Neurons and Schwann Cells

A

Neural Crest

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7
Q

Athetosis

A

Slow, snake-like, writihing movements; especially seen in fingers

Characteristic of Basal Ganglia lesion + Huntington’s Disease

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8
Q

First Order Neuron: Lateral Corticospinal Tract

A

UMN cell body in the Primary Motor Cortex. Descends ipsilaterally (through posterior limb of internal capsule). Most fibers decussate at Caudal Medulla. Descends CONTRALATERALLY

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9
Q

Preoptic Nucleus

A

Regulate thermoregulation and sexual behavior. Releases GnRH.

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10
Q

Senses and Location: Ruffini Corpuscles

A

Pressure, slippage of objects of skin, joint angle change

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11
Q

Clinical sign: Anencephaly

A

Polyhydramnios (No swallowing center in brain). Fetus doesn’t swallow amniotic fluid

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12
Q

Lesion of Subthalamic Nucleus

A

Contralateral Hemiballismus

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13
Q

Cerebellar Tonsillar Herniation into Foramen Magnum

A

Coma and death result when these herniations compress the brainstem

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14
Q

Astigmatism

A

Abnurmal curvature of cornea. Different refractive power at different axes.

Correct with cylindrical lenses

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15
Q

Tonic-Clonic Seizure

A

Alternating stiffening and movement, postictal confusion, urinary incontinence, tongue biting

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16
Q

Myoclonic Seizure

A

Quick, repetitive jerks

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17
Q

Lissencephaly

A

Failure of neuronal migration resulting in a “smooth brain” that lacks sulci and gyri. May be associated with microcephaly and ventriculomegaly

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18
Q

Passage Through Cranial Cavity: CN XII

A

Hypoglossal Canal

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19
Q

Outer Ear

A

Visible portion of ear (pinna), includes auditory canadal and tympanic membrane.

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20
Q

Resting Tremor

A

Uncontrolled movement of distal appendages; termor alleviated by intentional movement

Substantia Nigra issue (Parkinson’s esp)

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21
Q

Myeleomeningocele

A

(Neural Tube Defect) Meninges AND neural tube (eg cauda equina) herniate through bony defect

Think about how Myelo- prefix sounds like myelin to remember this includes the neural tube herniating as opposed to Meningocele

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22
Q

Normal Pressure Hydrocephalus

A

Affects the elderly; idiopathic; CSF pressure elevated only episodically; does not result in increased Subarachnoid space volume.

Triad: Urinary incontinence, gait apraxia, and congnitive dysfunction “wet, wobbly, and wacky”

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23
Q

Lesion: Paramedian Pontine Reticular Formation

A

Ipsilateral gaze palsy (inability to look toward side of lesion)

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24
Q

(Primitive Reflex) Plantar Reflex

A

Dorsiflexion of large toe and fanning of other toes with plantar stimulation. (Babinski sign if present in adults - UMN lesion)

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25
Q

Dorsal Motor Nucleus

A

Sens autonomic (parasympathetic) fibers to heart, lungs, upper GI

CN X

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26
Q

Function: Lateral Spinothalamic Tract

A

Pain and Temperature

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27
Q

Vitamin B12 Deficiency (Spinal Cord)

A

Subacute Combined Degeneration (SCD)

Demyelination of Spinocerebellar Tracts, Lateral Corticospinal Tracts, and Dorsal Columns. Ataxic gait, paresthesia, impaired position/vibration sense.

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28
Q

Endoneurium

A

Thin, supportive connective tissue that ensheaths and supports individual myelinated nerve fibers.

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29
Q

Developmental predecessor to Telencephalon and Diencephalon

A

Prosencephalon

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30
Q

Synapse: Spinothalamic Tract

A

Synapses at level of entry

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31
Q

UMN or LMN: Spastic Paresis

A

UMN

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32
Q

Pathological Location of GABA Synthesis

A

Nucleus Accumbens

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33
Q

Name of Sympathetic Ganglion going to head

A

Superior Cervical Ganglion

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34
Q

Cerebellum: Deep Nuclei (lateral to medial)

A

Dentate, Emboliform, Globose, Fastigial

“Don’t Eat Greasy Food”

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35
Q

Input to Cerebellum

A
  • Contralateral cortex via Middle Cerebellar Peduncle

* Ipsilateral Proprioceptive information via Inferior Cerebellar Peduncle from Spinal Cord

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36
Q

Decreased Mesocortical Pathway Activity

A

Leads to “negative” symptoms (eg anergia, apathy, lack of spontaneity). Antipsychotic drugs have limited effect.

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37
Q

Result of CN IV damage

A

Patient cannot look down and out. Eye rotated laterally. Difficulty walking down stairs. Head tilted.

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38
Q

Symptom: Damage to Short Ciliary Nerves

A

Mydriasis

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39
Q

Papilledema

A

Optic disc swelling (usually bilateral) due to increased ICP. Enlarged blind spot and elevated optic disc wtih blurred margins.

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40
Q

Synapse: Lateral Corticospinal Tract

A

Cell body of anterior horn

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41
Q

Internal Carotid Plexus

A

Post-Ganglion Fibers from Superior Cervical Ganglion (Sympathetics); Wrap ICA

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42
Q

Striatum (components)

A

Caudate (Cognitive) + Putamen (Motor)

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43
Q

Function: Anterior Spinothalamic Tract

A

Crude touch and pressure

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44
Q

Herniation associated with Epidural Hematoma

A

Uncal (Transtentorial)

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45
Q

Structures passing through Foramen Magnum

A

Brainstem, Spinal root of CN XI, and Vertebral Arteries

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46
Q

Asterixis

A

Extension of wrists causes “flapping” motion

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47
Q

Developmental Origin of Microglia

A

Mesoderm

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48
Q

Postganglionic Neurotransmitter in Parasympathetic Nervous System

A

Acetylcholine

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49
Q

Supraoptic and Paraventricular Nuclei

A

Synthesis Vasopression (ADH) and Oxytocin

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50
Q

Reflex Spinal Root: Patellar Reflex

A

L3, L4

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51
Q

Lucid Interval (Epidural Hematoma)

A

Epidural hematomas might present with transient loss of consciousness, a recovery period, and then rapid deterioration due to hematoma expansion

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52
Q

Myoclonus

A

Sudden, brief, uncontrolled muscle contraction

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53
Q

Craniopharyngioma

A

Most common childhood supratentorial tumor. May be confused with Pituitary Adenoma because both cause Bitemporal Hemianopia

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54
Q

Neurotransmitter Changes: Parkinson’s Disease

A

Increase: ACh

Decrease: DA, 5HT

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55
Q

Result of LMN Lesion of CN XII

A

1) Atrophy of Muscles

2) Protruded tongue deviates toward side of lesion

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56
Q

Medial Geniculate Nucleus

A

Input: Superior Olive and Inferior Colliculus of Tectum

Senses: Hearing

Destination: Auditory Cortex of Temporal Lobe

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57
Q

Neurotransmitter Changes: Depression

A

Decrease: DA, NE, 5HT

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58
Q

Inferior extent of Subarachnoid Space in Vertebrae

A

Lower border of S2

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59
Q

Huntington’s Pathology

A

Atrophy of caudate and putamen with ex vacuo ventriculomegaly. Neuronal death via NMDA-R binding and glutamate excitotoxicity

Increase: Dopamine
Decrease: GABA, ACh

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60
Q

Sensory Neurons: Free Nerve Endings

A

A∂ - Fast, Myelinated
C - Slow, Unmyelinated

“A Delta plane is fast but a taxC is slow”

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61
Q

Marcus Gunn pupil

A

aka Relative Afferent Pupillary Defect (RAPD)

When the light shines into a normal eye, constriction of both eyes if observed. When the light is then swung to the affected eye, both pupils dilate instead of constrict due to impaired conduction of light signal along the injured optic nerve

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62
Q

Postganglionic Neurotransmitter in Sympathetic Nervous System

A

Norepinephrine (exception sweat glands / ACh)

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63
Q

Parkinson’s Disease Pathology

A

Loss of dopaminergic neurons of substantia nigra pars compacta

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64
Q

Lateral Geniculate Nucleus

A

Input: CN II/chiasm/tract

Senses: Vision

Destination: Primary Visual Cortex

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65
Q

MRI Findings in Holoprosencephaly

A

Monoventricle and fusion of basal ganglia

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66
Q

Innervation: Outer Ear

A
  • CN V3
  • CN VII
  • CN IX
  • CN X
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67
Q

Cauda Equina Syndrome

A

Compression of spinal roots L2 and below, often due to intervertebral disc herniation or tumor.

Radicular pain, absent knee/ankle reflexes, loss of bladder/anal sphincter control, saddle anesthesia

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68
Q

Location of CSF flow in Meninges

A

Subarachnoid Space

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69
Q

Hormones controlled by Circadian Rhythm

A

1) ACTH
2) Prolactin
3) Melatonin
4) Norepinephrine

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70
Q

Tic Douloureux

A

Intense, stabbing pain. CN V or an be limited to single divisions of Trigeminal Nerve (Most Frequent: V2)

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71
Q

Catarct

A

Painless, often bilateral opacification of lens. Results in glare and decreased vision, especially at night.

Risk Factors:

  • Age
  • Smoking
  • Excessive alcohol use
  • Excessive sunlight
  • Prolonged corticosteroid use
  • Diabetes
  • Trauma / Infection
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72
Q

Decreased Tuberoinfundibular Pathway Activity

A

Leads to increase in Prolactin secretion. Sexual dysfunction, galactorrhea, gynecomastia (in men), and decrease in libido

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73
Q

Kallmann Syndrome

A

Failure of GnRH-producing neurons (Preoptic Nucleus - Hypothalamus) to migrate from olfactory pit

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74
Q

Preganglionic Neurotransmitter in the Autonomic System (both Sympathetic and Parasympathetic)

A

Acetlycholine

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75
Q

Stroke causing Frontal Eye Field lesion

A

MCA Stroke

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76
Q

Epineurium

A

Dense connective tissue that surrounds entire nerve (fascicles and blood vessels)

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77
Q

Pinealoma

A

Tumor of Pineal Gland. Can cause Parinaud Syndrome (Compression of tectum -> Vertical gaze palsy); obstructive hydrocephalus (cerebral aquduct); Precocious puberty in males

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78
Q

Ependymal Cells

A

Ciliated simple columnar glial cells line the ventricles and central canal of spinal cord. Apical surfaces are covered in cilia (which circulate CSF) and microvilli (which help in CSF absorption). Specialized ependymal cells (choroid plexus) produce CSF

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79
Q

Innervation: Dilator Pupil

A

Sympathetics

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80
Q

Absence Seizure

A

3 Hz spike-and-wave discharges, no postictal confusion, blank stare

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81
Q

Notochord

A

Induces overlying ectoderm to differentiate into neuroectoderm and form neural plate

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82
Q

Retinal Vein Occlusion

A

Blockage of central or branch retinal vein due to compression from nearby arterial atherosclerosis. Retinal hemorrhage and venous engorgement. Edema in affected area

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83
Q

End level of Spinal Cord (Adault)

A

Lower border of L1-L2 vertebrae

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84
Q

Suprachiasmatic Nucleus

A

Regulate Circadian rhythm

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85
Q

Accomodation

A

Thickening of lens for near vision. Parasympathetics of CN III.

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86
Q

Output from Cerebellum

A
  • Only output from Cerebellar cortex is Purkinje Cells (inhibitory)
  • Deep Nuclei
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87
Q

Second Order Neuron: Dorsal Column Ascending Tracts

A

Decussates in Medulla. Ascends contralaterally as the Medial Lemniscus. Goes to VPL (Thalamus)

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88
Q

Cause: Leaking CSF through nasal cavity

A

Fracture of Cribriform Plate

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89
Q

Chromatolysis

A

Reaction of neuronal cell body to axonal injury. Changes reflect increased protein synthesis in effort to repair damaged axon.

1) Round Cellular swelling
2) Displacement of the nucleus to the periphery
3) Dispersion of Nissl substance throughout cytoplasm

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90
Q

Muscle(s) closing jaw

A

Masseter, teMporalis, Medial pterygoid

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91
Q

Pathological Location of Acetylcholine Synthesis

A

Basal Nucleus of Meynert

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92
Q

Central Poststroke Pain Syndrome

A

Neuropathic pain due to thalamic lesions. Initial paresthias followed in weeks/months by allodynia and dysesthesia on the contralateral side.

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93
Q

Chiari II Malformation

A

(Posterior Fossa Malformation) Herniation of Cerebellar Vermis and Tonsils through Foramen Magnum with Aqueductal Stenosis (Noncommunicating Hydrocephalus).

Usually associated with Lumbosacral Myelomeningocele (may present as paralysis/sensory loss at/below level).

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94
Q

Cell affected in Guillain-Barre Syndrome

A

Schwann Cell (demyelinating disease)

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95
Q

Anencephaly

A

(Neural Tube Defect) Failure of rostral neuropore to close. No forebrain, open calvarium.

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96
Q

Reflex Spinal Root: Cremasteric Reflex (Testicles move)

A

L1, L2

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97
Q

Brown-Sequard Syndrome (Name 5 Findings jackass)

A

Hemisection of Spinal Cord. Findings:

1) Ipsilateral loss of all sensation @ level
2) Ipsilateral LMN signs @ lesion
3) Ipsilateral UMN signs below lesion
4) Ipsilateral loss of proprioception, vibration, 2pt touch, and tactile sense below lesion
5) Contralateral loss of pain, temperature, and crude touch below level of lesion (spinothalamic)

If lesion above T1, may kill sympathetics

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98
Q

Dystonia

A

Sustained, involuntary muscle contractions..

Treated with BOTOX

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99
Q

Presbyopia

A

Aging-related impaired accommodation (focusing on near objects), primarily due to decreased lens elasticity, changes in lens curvature, and weak ciliary muscle. Patients need reading glasses often

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100
Q

Hemiballismus

A

Sudden, wild flailing of 1 arm and sometimes ipsilateral leg

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101
Q

CN V Motor Lesion

A

Jaw deviates TOWARD lesion due to unopposed pterygoid muscle

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102
Q

Lesion: Cerebellar Vermis

A

Truncal Ataxia, Nystagmus

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103
Q

Formed by Neural Plate

A

Neural Tube and Neural Crest Cells

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104
Q

Developmental origin of Anterior 2/3 of Tongue

A

1st and 2nd Pharyngeal arches

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105
Q

Pathological Location of Dopamine Synthesis

A

Ventral Tegmentum and/or SNc

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106
Q

Dopamine Receptor in Indirect Pathway

A

D2 Receptor

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107
Q

Decorticate Posturing

A

Flexion of upper extremities and extension of lower extremities.

Lesion above red nucleus

108
Q

Wenicke-Korsakoff Syndrome

A

Confusion, Ataxia, Nystagmus, Ophthalmoplegia, memory loss (global), confabulation, personality changes

CAN O’beer

109
Q

Passage Through Cranial Cavity: Opthalmic Artery

A

Optic Canal

110
Q

Fracture which can cause Epidural Hematoma

A

Pterion (where the frontal, parietal, temporal, and sphenoid bones join together)

111
Q

Tabes Dorsalis

A

Caused by Teritiary Syphilis. Results from degeneration/deyelination of Dorsal Columns and roots.

Progressive Sensory Ataxia (from proprioception).

Positive romberg sign and absent deep tendon reflexes. Associated with Charcot joints, shooting pain, Argyll Robertson pupils

112
Q

Passage Through Cranial Cavity: Middle Meningeal Artery

A

Foramen Spinosum

113
Q

Synapse: Dorsal Column Ascending Tracts

A

Nucleus Gracilis / Nucleus Cuneatus (ipsilateral medulla)

114
Q

Lesion: Medial Longitudinal Fasciculus

A
  • Impaired ADduction of ipsilateral eye

* Nystagmus of contralateral eye with ABduction

115
Q

Developmental Origin of Posterior 1/3 of Tongue

A

3rd and 4th Pharyngeal arches

116
Q

Essential Tremor

A

High-frequency tremor with sustained posture, worsened with movement or when anxious

117
Q

Basal Plate

A

Neural structure on ventral neural plate. MOTOR

118
Q

Wallenburg’s Syndrome

A

Lateral Medullary Syndrome. PICA.

Dysphagia, hoarseness, dec gag reflex, hiccups. Vomiting, vertigo, nystagmus, dec pain/temp sensation from contralateral body, ipsilateral face. ipsilateral Horner syndrome. Ipsilatareal ataxia, dysmeteria

119
Q

Passage between 3rd and 4th ventricles

A

Cerebral Aqueduct of Sylvius

120
Q

Cingulate (Subfalcine) Herniation under Falx Cerebri

A

Can compress ACA

121
Q

Pathological Location of Norepinephrine Synthesis

A

Locus Ceruleus

122
Q

Neurotransmitter Changes: Alzheimer’s Disease

A

Decrease: ACh

123
Q

UMN or LMN: Flaccid Paralysis

124
Q

Neurotransmitter Changes: Huntington’s Disease

A

Increase: DA

Decrease: ACh, GABA

125
Q

Medial Medullary Syndrome

A

Infarct of ASA and/or Vertebral Arteries

Contralateral Payalysis (upper/lower limbs)
Deficit of Contralateral proproception
Ipsilateral hypoglossal dysfunction (deviates ipsilaterally)
126
Q

Passage Through Cranial Cavity: CN II

A

Optic Canal

127
Q

Pathologies which affect Oligodendrocytes

A

1) Multiple Sclerosis
2) Progressive Multifocal Leukoencephalopathy (PML)
3) Leukodystrophies

128
Q

UMN or LMN: Weakness

129
Q

Nucleus Ambiguus

A

Motor innervation of pharynx, larynx, upper esophagus

CN IX, X, XI

130
Q

Lewy Bodies

A

Composed of alpha-synuclein (intracellular eosinophilic inclusions in neuron body)

131
Q

Decreased Nigrostriatal Pathway Activity

A

Leads to Extrapyramidal Symptoms (eg dystonia, akathisia, Parkinsonism, tardive dyskinesia)

132
Q

Holoprosencephaly

A

Failure of the embyronic forebrain to separate into two cerebral hemispheres. Usually occurs during week 5-6. Maybe be related to mutations in Sonic Hedgehog Signaling pathway. Seen in Trisomy 13 (Patau) and Fetal Alcohol Syndrome

Moderate form: Cleft lip/palate
Severe: Cyclopia

133
Q

Symptoms: Bell’s Palsy

A
  1. Facial Paralysis
  2. Drooling (Buccinator)
  3. Inability to Close Eye (Oribuclaris Oculi)
  4. Loss of Taste to Anterior Tongue
  5. Pain In/Behind Outer Ear
  6. Hyperacousia (Stapedius)
134
Q

Difference in Symptoms: Acoustic Neuroma vs Parotid Tumor / Peripheral Damage

A

Acoustic Neuroma has all CN VII/VIII Symptoms. On the other hand…

Parotid Tumor/Peripheral Damage:
Only Facial Paralysis. No loss of taste, hyperacousia, decrease in secretion from glands, etc

135
Q

Ciliary Ganglion

A

Parasympathetics of CN III.

Innervate: Ciliary Muscles and Sphincter (Constrictor) Pupillae

136
Q

Causes of Ptosis

A

Damage to Sympathetics (see Horner’s Syndrome) or CN III (Levator Palpebrae Superioris)

137
Q

Kluver-Bucy Syndrome

A

Disinhibited behavior (eg hyperphagia, hypersexuality, personality changes).

Bilateral lesion of Amygdala

138
Q

Medulloblastoma

A

Most common malignant brain tumor in childhood. Commonly involves cerebellum.

Can compress 4th ventricle and cause Noncommunicating Hydrocephalus

139
Q

Innervation and Function: Hyoglossus

A

Retracts and depresses tongue

CN XII

140
Q

Neurotransmitter Changes: Schizophrenia

A

Increase: DA

141
Q

Passage Through Cranial Cavity: CN VII

A

Internal Auditory Meatus

142
Q

Huntington’s Disease

A

Autosomal dominant trinucleotide (CAG) repeat expansion in the Huntingtin gene on Chromosome 4.

CAG Repeats. CAG. Caudate loses ACh and Gaba

143
Q

Posterior Nucleus (Hypothalamus)

A

Heating. Sympathetic

144
Q

Complete Occlusion of Anterior Spinal Artery

A

Spares Dorsal Columns and Lissauer Tract

Mid-Thoracic ASA territory is watershed area, as artery of Adamkiewicz supplies ASA below T8. Aortic aneurysm repair can bring it on.

UMN deficit below the lesion (Corticospinal), LMN deicit at the level of lesion (anterior horn), and loss of pain/temp below the lesion (spinothalamic)

145
Q

Passage Through Cranial Cavity: CN VIII

A

Internal Auditory Meatus

146
Q

Jaw Jerk Reflex

A

Stretch reflex of Muscles that Close Mouth. Sensory/Motor V3

Masseter**
Temporalis
Medial Pterygoid

147
Q

Anosmia

A

Loss of sense of smell

148
Q

Ventral Posterolateral (VPL) Nucleus

A

Input: Spinothalamic and Dorsal Columns/Medial Lemniscus

Senses: Vibration, Pain, Pressure, Proprioception, Light Touch, Temperature

Destination: Primary Somatosensory Cortex

149
Q

Major locations of CSF production

A

Lateral and Fourth Ventricles

150
Q

Present with MS

A
  • Acute Optic Neuritis (w/ Relative Afferent Pupillary Defect)
  • Brainstem/Cerebellar syndromes
  • Pyramidal tract demyelination
  • Spinal Cord syndromes
151
Q

Muscle(s) opening jaw

A

Lateral Pterygoid

152
Q

Perfused by Lenticulostriate Branch of MCA

A

Basal Ganglia and Internal Capsule (Genu/Posterior Limb)

153
Q

Sensory to Cornea

A

Long Ciliary Nerves (V1)

154
Q

Open-Angle Glaucoma

A

Associated with age, Blacks, and family history. Painless, more common in U.S.

155
Q

Senses and Location: Meissner Corpuscles

A

Dynamic, fine/light touch, position sense

Glabrous (hairless) skin

156
Q

Glioblastoma Multiform

A

Highly malignant primary brain tumor found in the Cerebral Hemispheres.

Origin: Astrocytes

157
Q

Intention Tremor

A

Slow, zigzag motion when pointing/extending toward a target.

Characteristic of cerebellar dysfunction

158
Q

Ventral Lateral Nucleus (Thalamus)

A

Input: Cerebellum and Basal Ganglia

Senses: Motor

Destination: Motor Cortex

159
Q

(Primitive Reflex) Sucking Reflex

A

Sucking response when roof of mouth is touched

160
Q

Myeloschisis

A

(Neural Tube Defect) Also known as rachischisis. Exposed, unfused neural tissue without skin/meningeal covering

161
Q

Chorea

A

Sudden, jerky, purposeless movements.

Seen in lesions of the basal ganglia. Huntington’s Disease

162
Q

Alar Plate

A

Neural structure on dorsal neural plate. SENSORY

163
Q

Passage between 4th Ventricle to Subarachnoid Space

A
  • 2x Formina of Luschka (Lateral)

* Formina of Magendia (Medial)

164
Q

Atonic Seizure

A

“Drop” seizures

165
Q

Passage Through Cranial Cavity: CN V3

A

Foramen Ovale

166
Q

Perineurium

A

Blood-nerve permeability barrier. Surrounds a fascicle of nerve fibers. Must be rejoined in microsurgery for limb reattachment.

167
Q

Ossicles

A

Three bones in inner ear.

1) Malleus
2) Incus
3) Stapes

168
Q

First Order Neuron: Dorsal Column Ascending Tracts

A

Enters Dorsal Root and Ascends Ipsilaterally (Fasciculus Gracilis/Cuneatus)

169
Q

Second Order Neuron: Lateral Corticospinal Tract

A

Lower motor neuron leaves the spinal cord and onto the Neromuscular Junction

170
Q

Anterior Nucleus (Hypothalamus)

A

Cooling. Parasympathetic.

171
Q

(Primitive Reflex) Rooting reflex

A

Movement of head toward one side if cheek or mouth is stroked (nipple seeking)

172
Q

Nucleus which CN VII, IX, and X relay taste sensation to

A

Solitary Nucleus (medulla)

173
Q

Hypoxic Stroke

A

Due to hypoperfusion or hypoxemia. Common during cardiovascular surgeries, tends to affect watershed areas.

174
Q

UMN or LMN: Fasciculations

A

LMN (spontaneous motor firing)

175
Q

Communicating Hydrocephalus

A

Decreased CSF absorption by Arachnoid Granulations. Increased ICP, papilledema, and herniation

176
Q

Friedreich’s Ataxia

A

Autosomal recessive trinucleotide repeat disorder (GAA) on Chromosome 8 in gene that encodes Frataxin (iron-binding protein).

Degeneration of lateral corticospinal tract, spinocerebellar tract, dorsal columns, and dorsat root ganglia. Staggering gait, frequent falling, nystagmus, dysarthria, pes cavus, hammer toes, diabetes mellitus, hypertrophic cardiomyopathy.

177
Q

Neurotransmitter Changes: Anxiety

A

Increase: NE

Decrease: GABA, 5HT

178
Q

Akathisia

A

Restlessness and intense urge to move.

Can be seen as a side effect of Parkinson’s treatment

179
Q

Syringomyelia

A

Cystic cavity within central canal of spinal cord. Fibers crossin gin the Anterior White Commissure (SPINOTHALAMIC TRACT) are typically damaged first.

180
Q

Occlusion in Locked-In Syndrome

A

Basilar Artery

181
Q

(Primitive Reflex) Palmar Reflex

A

Curling of fingers if palm is stroked

182
Q

Innervation and Function: Palatoglossus

A

Elevates posterior tongue during swallowing

CN X

183
Q

CN XII Lesion

A

LMN. Tongue deviates toward side of lesion “lick your wounds”

184
Q

Functions of Astrocytes

A

1) Physical support / repair
2) Extracellular K+ buffer
3) Removal of excess neurotransmitter
4) Component of blood-brain barrier
5) glycogen fuel reserve buffer
6) Reactive gliosis in response to neural injury

185
Q

Function: Lateral Corticospinal Tract

A

Voluntary movement of contralateral limbs

186
Q

Passage Through Cranial Cavity: CN I

A

Cribriform Plate

187
Q

Epidural Space

A

Potential space between the dura mater and skull/vertebral column containing fat and blood vessels

188
Q

Glaucoma

A

Optic disc atrophy with characteristic cupping, usually with elevated introcular pressure and progressive peripheral visual field loss if untreated.

189
Q

Tonic Seizure

A

stiffening

190
Q

Major Dopaminergic Pathways

A

1) Mesocortical
2) Mesolimbic
3) Nigrostriatal
4) Tuberoinfundibular

191
Q

Developmental predecessor to Mesencephalon

A

Mesencephalon (HAH GOTCHA)

192
Q

Reflex Spinal Root: Triceps Reflex

193
Q

Lesion (Bilateral):Mammillary Body

A

Wernicke-Korsakoff Syndrome

194
Q

Apex of basilar membrane

A

Low frequency (wide and flexible)

195
Q

Parinaud’s Syndrome

A

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

Lesion of Dorsal Midbrain.

196
Q

Central Retinal Artery Occlusion

A

Acute, painless monocular vision loss. Retina cloudy with attenuated vessels and “cherry-red” spot at fovea. Evaluate for embolic source

197
Q

Passage between Lateral Ventricles and 3rd Ventricle

A

Foramina of Monro

198
Q

Test signs of Neural Tube defect

A

1) Elevated Alpha-Fetoprotein in Amniotic fluid and maternal serum (except spinal bifida occulta)
2) Elevated Acetylcholinesterase (AChE) in Amniotic fluid

199
Q

Parkinson’s Symptoms

A

TRAPS

Tremor (Resting)
Rigidity (Cogwheel)
Akinesia (or Bradykinesia)
Postural Instability
Shuffling Gait
200
Q

Phagocytic scavenger cells of CNS (mesodermal, mononuclear origin). Activation in response to tissue damage -> release of inflammatory mediatory (eg, nitric oxide, glutamate).

201
Q

Meningocele

A

(Neural Tube Defect) Meninges (but no neural tissue) herniate through bony defect

202
Q

Senses and Location: Free Nerve Endings

A

Pain, temperature.

All skin, epidermis, some viscera

203
Q

First Order Neuron: Spinothalamic Tract

A

Sensory Nerve Endings (A∂ and C) enter spinal cord

204
Q

Decerebrate Posturing

A

Extension of upper and lower extremities

Lesion at or below red nucleus

205
Q

Hypothalamo-Spinal Tract

A

Descending control of Autonomic Function

206
Q

Visual results of Pituitary Adenoma and Craniopharyngioma (another cancer of the Pituitary)

A
  • Press on Optic Chiasm

* Bitemporal Hemianopia

207
Q

(Primitive Reflex) Galant Reflex

A

Stroking along one side of the spine while newborn is in ventral suspension (face down) causes lateral flexion of lower body toward stimulated side

208
Q

Treatment for ALS / Lou Gehrig Disease

A

Riluzole “riLOUzole”

209
Q

UMN or LMN: Atrophy

210
Q

Dandy-Walker Malformation

A

(Posterior Fossa Malformation) Agenesis of Cerebellar Vermis leads to cystic enlargement of 4th Ventricle that fills the enlarged posterior fossa.

Associated with noncommunicating hydrocephalus and Spina Bifida

211
Q

Second Order Neuron: Spinothalamic Tract

A

Decussates in spinal cord at the Anterior White Commissure. Ascends contralaterally to VPL (Thalamus)

212
Q

Amyotrophic Lateral Sclerosis (Lou Gehrig Disease)

A

Combined UMN (Corticobulbar/Corticospinal) and LMN (medullary/spinal cord) degeneration. No sensory or bowel/bladder deficits.

LMN (Dysarthria, dysphagia, asymmetric limb weakness, fasciculations, atrophy); UMN, Pseudobulbar palsy (Dysarthria, dysphagia, emotional lability, spastic gait, clonus.

213
Q

CN X Lesion

A

Uvula deviates AWAY from lesion.

214
Q

Course of CN I into Nasal Cavity

A

Through Cribriform Plate of Ethmoid Bone

215
Q

Risk Factors: Idiopathic Intracranial Hypertension

A

Female TOAD

Female, Tetracyclines (anti-biotics), Obesity, vitamin A, Danazol

216
Q

Reflex Spinal Root: Anal Wink Reflex

217
Q

Cape-like bilateral, symmetrical loss of pain and temperature sensation in upper extremities

A

Syringomyelia

218
Q

(Primitive Reflex) Moro Reflex

A

“Hang on for life” reflex – abduct/extend arms when startled, and then draw together

219
Q

Limbic Structures

A
  • Hippocampus
  • Amygdala
  • Mammillary Bodies
  • Anterior Thalamic Nuclei
  • Cingulate Gyrus
  • Entorhinal Cortex
220
Q

Wallerian Degeneration

A

Disintegration of the axon and myelin sheath on distal side of axonal injury with macrophages removing debris

221
Q

Proximal side of a neuron during axonal injury

A

Axon retracts and the cell body sprouts new protrusions that grow toward other neurons for potential reinnervation. Serves as a preparation for axonal regeneration and functional recovery

222
Q

Conjunctivitis

A

Inflammation of the conjunctiva, leads to red eye.

Allergic - itchy eyes and bilateral
Bacteria - pus present
Viral - Most common, often adenovirus. Sparse mucous discharge, swollen preauricular node; self-resolving

223
Q

Lesion: Cerebellar Hemisphere

A

Intention tremor, limb ataxia, loss of balance.

Damage to Cerebellum = Ipsilateral deficits

224
Q

UMN or LMN: Increased Tone

225
Q

Dopamine Receptor in Direct Pathway

A

D1 Receptor

226
Q

Pituitary Adenoma

A

May be nonfunctioning (silent) or hyperfunctioning (hormone-producing).

Non-functional tumors present with Bitemporal Hemianopia (pressure on optic chiasm).

227
Q

Uncal Transtentorial Herniation

A

Uncus = Medial temporal lobe

Ipsilateral blown pupil, contralateral hemiparesis. Later: coma

228
Q

Multiple Sclerosis

A

Autoimmune inflammation and demyelination of CNS with subsequent axonal damage.

229
Q

Senses and Location: Merkel Discs

A

Pressure, deep static touch (eg shapes, edges), and position sense.

Finger tips, superficial skin

230
Q

Lateral Nucleus (Lateral Hypothalamic Area)

A

Hunger center. Stimulated by ghrelin and inhibited by leptin

231
Q

Exceptions to Cranial Nerve Innervation Being Bilateral

A

Contralateral:

  • Lower Face (CN VII)
  • Genioglossus (XII)
  • Trapezius (XI)

Ipsilateral:
* Sternocleidomastoid (XI)

232
Q

Lesion causing Hemiballismus

A

Contralateral subthalamic nucleus

233
Q

Mnemonic: Cranial Nerves - Sensory, Motor, or Both

A

Some Say Marry Money But My Brother Says Big Brains Matter Most

234
Q

Base of Basilar Membrane

A

High frequency

235
Q

Developmental predecessor to Metencephalon and Myelencephalon

A

Rhombencephalon

236
Q

Nucleus Tractus Solitarius

A

Visceral Sensory Information

CN VII, IX, X

237
Q

Structures passing through Superior Orbital Fissure

A

CN III, IV, V1, VI

238
Q

Ventromedial Nucleus (Hypothalamus)

A

Satiety. Stimulated by leptin.

239
Q

Function: Dorsal Column Ascending Tracts

A

Pressure, Vibration, Fine Touch, Proprioception

240
Q

Spinal Muscular Atrophy

A

Congenital degeneration of Anterior Horn. LMN lesion.

Autosomal recessive mutation is SMN1.

241
Q

Result of CN III damage

A

1) Lateral Strabismus
2) Ptosis
3) Mydriasis (dilated pupil - paralyzed pupillary constrictor)

242
Q

Innervation and Function: Styloglossus

A

Draw up sides of tongue to create a trough for swallowing

CN XII

243
Q

Location of Lumbar Puncture (Adult)

244
Q

Damage: Lateral Nucleus (Lateral Hypothalamic Area)

A

Anorexia and failure to thrive (infants)

245
Q

Developmental origin of CNS neurons, ependymal cells, oligodendrocytes and astrocytes

A

Neuroepithelia in the Neural Tube

246
Q

Passage Through Cranial Cavity: CN V2

A

Foramen Rotundum

247
Q

Stage of sleep sleepwalking, night terrors, and bedwetting occur

248
Q

Result of CN VI damage

A

Medial Strabismus (Paralysis of Lateral Rectus)

249
Q

Senses and Location: Pacinian Corpuscles

A

Vibration and pressure

Deep skin layers, ligaments, joints

250
Q

Increase Mesolimbic Pathway Activity

A

Leads to “positive” symptoms (eg delusions, hallucinations. Primary therapeutic target of Antipsychotic drugs

251
Q

Ventral Posteromedial (VPM) Nucleus

A

Input: Trigeminal and Gustatory Pathway

Senses: Face sensation, taste

Destination: Primary Somatosensory Cortex

252
Q

Huntington’s Signs

A
  • Chorea
  • Athetosis
  • Aggression
  • Depression
  • Dementia
253
Q

Chairi I Malformation

A

(Posterior Fossa Malformation) Ectopia of cerebellar tonsils inferior to foramen magnum.

Congenital. Usually asymptomatic in childhood, manifests in adulthood with headaches and cerebellar symptoms. Associated with spinal cavitations (eg syringomyelia)

254
Q

Reflex Spinal Root: Biceps/Brachioradialis Reflexes

255
Q

CN XI Lesion

A

Weakness turning head to opposite side. Shoulder droop on side of lesion.

256
Q

Notochord remnant in Adults

A

Nucleus Pulposus of Intervertebral Discs

257
Q

Reflex Spinal Root: Achilles Reflex

258
Q

Acute Closure (Glacuoma)

A

Ophthalmic emergency. Intraocular pressure pushes iris forward, angle closes abruptly.

Very painful, red eye, sudden vision loss, halos around lights, frontal headache, fixed and mid-dilated pupil, nausea, and vomiting. Mydriatic agents contraindicated.

259
Q

Noncommunicating Hydrocephalus

A

Caused by structural blockage of CSF circulation within ventricular system

260
Q

Embryological Germ Layers

A

Ectoderm, Mesoderm, Endoderm

261
Q

Myopia

A

Nearsightedness. Eye too long for refractive power of cornea and lens. Light focused in front of retina.

Correct with concave lenses.

262
Q

Production of Aqueous Humor

A

Produced by nonpigmented epithelium on ciliary body

263
Q

Closed-Angle Glaucoma

A

Primary: Enlargement/anterior movement of lens against iris -> obstruction of normal aqueous flow through pupil -> fluid builds up behind iris, pushing peripheral iris against cornea and impeding flow through trabecular network

Secondary: Hypoxia from retinal disease induces vasoproliferation in iris that contracts angle

264
Q

Innervation and Function: Genioglossus

A

Protrude tongue

CN XII

265
Q

Hyperopia

A

Farsightedness. Eyes too short for refractive power of cornea and lens. Light focused behind retina.

Correct with convex lenses

Misc Decks (7 decks)

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