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Neuro Spring 2019 > TEST 2=THE SHIT > Flashcards

TEST 2=THE SHIT Flashcards

1
Q

Triventricular Hydrocephalus

A

1) major consequence of aqueduct blockage and enlargement of 3rd and both lateral ventricles
2) CAN BE CAUSED BY:
- MIDBRAIN TUMOR (Pineoblastoma or meningioma)
- MUMPS INFECTION (ependymal proliferation due to viral infection of CNS)
- INTRAVENTRICULAR HUMORRAGE
- bacterial or fungal infection
3) Common in elderly

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2
Q

Hydrocephalus Ex Vaco

A

1) not true hydrocephalus BUT GENERAL ATROPHY OF BRAIN W/O INCREASE ICP

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3
Q

Reserpine Inhibits transport of what parasympathetic NT?

A

1) DOPAMINE and Norepinephrine

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4
Q

Triventricular Hydrocephalus

A

1) CAUSED BY:
- MIDBRAIN TUMOR (pineoblastoma or meningioma)
- MUMPS INFECTIONS
- intraventricular hemorrhage
2) major consequence of aqueduct block enlargement of 3rd and both lateral ventricles

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5
Q

Hydrocephalus Ex Vaco

A

1) Not true hydrocephalus, but GENERALIZED ATROPHY OF BRAIN WITHOUT INCREASE OF ICP
2) no deficits other than related to brain atrophy

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6
Q

Choroid Plexus Tumors

A

1) Found MOSTLY IN 4th VENTRICLE
- some in lateral ventricles
2) RARE
3) Choroid Plexus papillomas
- benign and surgical removal
- more frequent
4) Choroid Plexus Carcinomas
- malignant and need chemo and surgery
- followed by combo chemo and radiation
5) BOTH ARE COMMON IN ADULTS

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7
Q

Lumbar Puncture

A

1) L3/4 or L4/5
2) 3 tube test-if blood in first tube:
- decide if subarachnoid hemorrhage or TRAUMATIC TAP (damage to vessel during procedure)
3) If 1st blood, little blood, no blood=TRAUMATIC TAP
4) if All 3 tubes have bloody CSF + XANthochromic=Subarachnoid hemorrhage

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8
Q

Viral Meningitis: Lumbar Puncture results

A

1) Clear CSF
2) Increased Lymph and Proteins
3) normal Glucose

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9
Q

Sulfalcine herniation

A

1) AKA cingulate herniation
2) INVOLVES CINGULATE GYRUS
3) supratentorial compartment
4) Lesionin one cerebral hemisphere expands midline
- forces cingulate gyrus under the Falx into opp hemisphere
5) Occlusion of adjacent anterior cerebral artery

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10
Q

Meningitis

A

Bacterial

1) Subarachnoid space and leptomeninges (arachnoid and Pia)
2) Can be caused by streptococcus pneumonia or Neisseria Meningitides
3) Both Acute and Subaccute have excellent prognosis with early diagnosis and proper tx
4) Acute:
- Signs and symptoms: Alternating chills and fever, headache, Acutely ill and depressed level of consciousness
- LUMBAR puncture: Increased CSF pressure, Cloudy CSF, Many WBC, Increased Protein, Bacteria present
5) Subacute:
- seen with pts w/tuberculosis (tuberculosis meningitis)
- slow onset
- Signs/symptoms: Headache, Fever, irritability, wakefulness at night

Viral:

1) caused by wide range of viral agents
- no antiviral meds
2) common in young patients (<25 y.o.)
3) Gradual onset
- becomes ill after a few days
- fever
- headache of increasing intensity
- confusion
4) Recover after 1 to 2 weeks w/no permanent deficits

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11
Q

Thalamostriate vein

A

1) Feeds internal cerebral vein

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12
Q

Carotid Cavernous Fistula

A

1) Shunting of blood fro internal carotid artery to cavernous sinus
2) typically occurs secondarily to trauma
- rarely from ruptured aneurysm

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13
Q

Kluver Brucy Syndrome

A

1) Bilateral loss of amygdala
- in temporal lobe
2) Symptoms: MOPS
- Metamorphosis
- Orality
- Phagia
- Sexuality
- Agnosia

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14
Q

Betz cells

A

1) only cells in layer 5 of cerebral cortex

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15
Q

Splanchic nerves are:

A

1) Preganglionic sympathetic
- below diaphragm
2) Preganglionic parasympathetic
- outside the CNS

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16
Q

Surgical Removal of Gray Ramus removes what type of fiber?

A

GVE fibers only

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17
Q

Dorsal Root Rhizotomy

A

1) cuts both GSA and GVA Fibers at dorsolateral sulcus

2) posterior roots sectioned to alleviate intractable pain

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18
Q

What fiber is not vagus?

A

GSE

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19
Q

SVE fibers of CN9 and CN10 innervate?

A

Nucleus Ambiguus

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20
Q

Anosognosia

A

1) inability to acknowledge disease in oneself

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21
Q

Radiculopathy

A

1) Result of damage to nerve root (disc problems)
2) most common cause:
- spondylolysis or intervertebral disc disease
- damage to one or more nerve roots
3) compression of single root may not cause significant sensory loss bc Overlap of dermatomes on body
4) Symptoms: perception of a:
- sharp, buring pain (shooting pains) in the dermatome for the damaged spinal nerve
5) Cervical Disc disease:
- result in pain in base of neck, over should or down UE
6) lumbar disc problems:
- low back pain or pain radiating down the LE

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22
Q

Mononeuropathy

A

1) Deficit of one nerve peripheral nerve
2) Caused by:
- Trauma (most common)
- entrapment
- compression syndromes (carpal tunnel syndrome)

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23
Q

Polyneuropathy

A

1) Deficit from multiple peripheral nerves
- sensory and motor
2) Common Cause: Diabetes Mellitus

24
Q

Syringomyelia

A

1) Damages Anterior Commissure

2) Bilateral Loss of ALS below level affected

25
Q

B12 deficiency

A 
1) + Lhermitte's sign (AKA barber chair phenomenon)
 paresthesia
 - Babinski
 Loss of sensory and reflex prop (deep tendon reflex)
Weakness
no coordination
Pain, numbness, and tingling hands/feet
2) Most common cause= Pernicious anemia
3) Common in US
-especially elderly
4) Results:
-seroious anemia
-nerve damage
-degeneration of spinal cord
26
Q

Cutting fibers in superior ganglion of vagus nerve causes what deficit:

A

1) sensory of posterior cranial nerve

27
Q

Cluster headaches

A

1) Brief, severe
2) Repeat Daily
3) Unilateral
4) non throbbing
5) Associated w/Horners Syndrome
- unilateral ptosis (drooping eyelid)
- Unilateral Miosis (small pupil)

28
Q

Lhermitte’s Sign

A

1) AKA barber chair phenomenon
2) electrical sensation that runs down the back into limbs
3) Lesion of dorsal columns of cervical cord or caudal medulla
4) Can be caused by:
- Multiple Sclerosis (Classic finding)
- transverse myelitis (nflammation of spinal cord)
- trauma
- vit B12 def
- disc herniation
- tumore
- ARNOLD chiari malformation (tonsilar herniation)

29
Q

Acute Headache

A

1) Subarachnoid Hemorrhage
- caused by ruptured berry aneursym
- Increased ICP
- RBC in CSF high
- CSF xanthrochromatic (YELLOW)
- PLEOCYTOSIS (increased WBC)
- SUDDEN ONSET

“WORST HEADACHE ever ever had in my life”

30
Q

What nerve egresses b/w posterior cerebral artery and superior cerebral artery?

A

Oculomotor

31
Q

What structure separates pons from medulla on posterior aspect?

A

Stria Medullaris

32
Q

Area Postrema

A

1) near obey at inferior border of rhomboid fossa
2) AKA vomit center
3) no BBB

33
Q

Reflex proprioception for UE ascends in:

A

Cutaneous Fasciculus

34
Q

CIPA

A

1) Congenital Insensitivity to pain w/ ANhydrosis
- rare genetic defect
- autosomal
- Child has no ability to feel pain
- anhydrosis-can’t sweat (sympathetic fxn)
2) Abnormal Development of Nociceptive receptors and some sympathetic neurons
3) Can’t diagnose in child until later in life
- die secondarily

35
Q

CINE flow study

A

1) Tool to observe Tonsil Herniation

36
Q

Non dominate Angular Gyrus

A

out of body experience

37
Q

Fiber found in Lam 7?

A

GVE

-parasympathetic

38
Q

Fiber type associated with hypoglossal

A

GSE

39
Q

Chandelier cells

A

Project to pyramidal cells within the column

40
Q

Astrocytomas

A

1) Most frequently encountered glial cell tumor
2) Grade 1:
- uncommmon
- grow slow
3) Grade 2:
- slow growing
- common in adults
- prominent processes filled w/glial filaments
- may take years to become symptomatic
4) Grade 3:
- Anaplastic Astrocytomas
- enlarged nuclei w/increased density of chromatin
- mitotic figures
- increased blood vessel density
- rapid growing malignant tumor
5) Grade 4: GBM-Glioblastoma Multiforme
- invade leptomeninges
- spread to contralateral hemisphere via corpus callous
- survival time-weeks
- TEMPORAL lobe

41
Q

Ependymomas

A

1) Arise from cells lining the ventricles
2) 5-6 % of all glial neoplasms -
3) Location
- Adults=Spinal Cord
- Children (<10y.o)= 4th ventricle
4) Supratentorial lesion
- hydrocephalus, seizures
5) Infratentorial lesion:
- nausea/vomitting
- headache
- hydrocephalus
- CN signs
6) TRUE ROSETTES

42
Q

Prosopagnosia

A

Inability to recognize faces

43
Q

Capgras Syndrome:

A

1) Recognize face, but think its imposter

44
Q

Medullary Arteries

A

1) No on every level

2) supply both ant and posterior spinal arteries

45
Q

Brown Sequard Syndrome

A

1) hemisection of spinal cord
-if T2 or lower=Horners also
2) Contra Loss of Pain and Temp & General Tactile
3) Ipsi loss of Fine touch and vibratory sense
4) Ipsi paralysis
contra LE ataxia (coordination)

46
Q

Dermatomes

A

1) T4=nipple
2) T10= umbilicus
3) L1= Groin

47
Q

Sympathetic vs Parasympathetic NT

A

Sympathetic NE

Parasympathetic Ach

48
Q

Spinal Nerves vs Cranial Nerves

-UMN vs LMN locations

A

Spinal nerves

  • UMN=cerebral corttex
  • LMN= ventral horn of spinal cord, exit via ventral roots-> dorsal or ventral rami

Cranial Nerves:

  • UMN= cerebral cortex
  • LMN=motor groups of CN nuclei in brainstem. Motor axons exit brainstem in motor components
49
Q

Spinal Nerves vs Cranial Nerves

-Primary Secondary, Tertiary

A

Spinal nerves

  • Primary-cell body located in spinal ganglion.
  • Central process synapses on secondary neuron in distal horn
  • secondary in cord–> Thalamus
  • Tertiary in thalamus–> cortex

Cranial Nerves

  • Primary- cell body located outside the CNS in sensory Ganglion
  • Central process conveys to sensory nuclei in brainsteem
  • Secondary->Thalamus
  • Tertiary Thalamus-> cortex
50
Q

Cranial Nerves involved in Parasympathetics

-Targets

A

CN 3: occulomotor
CN 7: facial
CN9: Glossopharyngeal
CN 10: Vagus

Targets:

  • Salivary Glands
  • Lacrimal Glands
  • Nasal and Pharyngeal Mucus glands
  • Sphincter muscles of pupill and culinary bodies
  • Visceral Organs
51
Q

3 Major Sympathetic Ganglia In neck:

A

1) Superior
- near common carotid a.
2) Middle
3) Inferior
- near T1 ganglia
- sometimes merge with T1 ganglia=Stellate ganglia

52
Q

Blow to head or fracture of skull: CN 1

A

1) Tearing of olfactory fibers across cribriform plate
2) Leads to:
- Anosmia (loss of olfaction)
- Rhinorhea (leakage of CSF from subarachnoid space to nasal cavity)
- passage of infectious agents to cranial cavity

53
Q

Facial Colliculus

A

Superior to Medullary Strria

-loops CN7 around CN6

54
Q

MLF

A

involved in eye movement

55
Q

Posterior longitudinal Fasciculus

A

1) Connects hypothalamus to other motor nuclei in brainstem

56
Q

Sulcus limitans

A

1) Alar and basal plates come together to form

57
Q

Vagus Nerve: 3 nuclei associated

A

1) Dorsal motor nucleus
- parasympathetic (GVE)
- give rise to preganglionic fibers
2) Nucleus Ambiguus
- Motor neurons
- LMN innervates skeletal muscles
- associated with some neck muscles
3) Nucleus Solitarius
- Sensory
- Secondary sensory neuron that receives input from visceral organs below level of consciousness

Neuro Spring 2019 (21 decks)

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