usmle- anatomy- neuro Flashcards
1
Q
where are the preganglionic neuron cell bodies, the CNS or PNS
A
CNS
2
Q
which three CNs send sensory information to the solitary nucleus
A
VII, IX, X
tast and general sensation for the tongue
3
Q
vertebral artery or anterior spinal artery occlusion, resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
A
medial medullary syndrome
4
Q
contralateral corticospinal and medial lemniscus tract deficits and an ipsilateral medial strabismus secondary to a lesion in CN VI
A
medial pontine syndrome
5
Q
slow growing acoustic neuroma producing CN VII deficiencies
A
pontocerebellar angle syndrome
6
Q
occlusion of the PICA, resulting in ipsilateral limb ataxia, ipsilateral facial pain and temperature loss, contralateral pain and body themp loss, ipsilateral Horner’s, ipsilateral paralysis of the vocal cords, palate droop, dysphagia, nystagmus, vomiting, and vertigo
A
lateral medullary (Wallenberg’s) syndrome
7
Q
AICA or superior cerebellar artery occlusion, resulting in ipsilateral limb ataxia, ipsilateral facial pain and temp loss, contralateral loss of pain and tem to the body, ipsi Horner’s syndrome, ipsi facial paralysis and hearing loss
A
lateral pontine syndrome
8
Q
posterior cerebral art occlusion resulting in a contralateral corticospinal tract signs, contralateral corticobulbar signs to the lower face, and ipsi CN III palsy
A
medial midbrain (Weber’s) syndrome
9
Q
CN affected if lesion in…
- midbrain
- upper medulla
- pontomedullary junction
- upper pons
A
- III and IV
- IX, X, XII
- VI, VII, VIII
- V
10
Q
what is the only CN nucleus found in the cervical spinal cord
A
accessory nucleus
11
Q
what component of the trigeminal nuclei…
- supplies mm of mastication
- receives sensory input (except pain and temp) from face, scalp, dura, and oral and nasal cavities
- forms the sensory comp of the jaw jerk complex
A
- motor nu
- spinal trigeminal nu
- mesencephalic nu
12
Q
what deep cerebellar nuclei receive Purkinje cell projections in…
- floculonodular lobe
- vermis
- lateral cerebellar hemispheres
- intermediate hemispheres
A
- lateral vestibular nu
- fastigial nu
- interposed nu
- dentate nu
13
Q
what is the only excitatory neuron in the cerebellar cortex, and what is its neurotransmitter
A
granule cell uses glutamate
all others use GABA
14
Q
what three CNs are associated with conjugate eye movements
A
III
IV
VI
15
Q
what is the term to describe the soft, flabby feel and diminished reflexes seen in patients with acute cerebellar injury to the deep cerebellar nuclei
A
hypotonia (rag doll)
16
Q
what bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex
A
vermis- pos Romberg with eyes open
dorsal column- pos Romberg with eyes closed
17
Q
which one of the cerebellar peduncles is mainly responsible for outgoing (efferent) info
A
superior cerebellar peduncle
the inferior and middle are incoming tracts
18
Q
what tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum, helping monitor and modulate muscle movements
A
lower extremity and lower trunk travels in the dorsal spinocerebellar tract
upper trunk and upper extremities travel in cuneocerebellar tract
19
Q
what reflex seen in lesions of the corticospinal tract is an extension of the great toe with fanning of the remaining toes
A
Babinski in UMN lesions
20
Q
Horner’s…
sympathetic fibers from __ - __ are obstructed
A
T1-T4
21
Q
what part of the inner ear has
- perilymph- and responds to angular acceleration and deceleration
- endolymph- responds to head turning
- endolymph- has gravity receptors monitoring linear acceleration and deceleration
A
- semicircular canal
- semicircular duct
- utricle and saccule
22
Q
what is the name of demyelination of the corticospinal tract and dorsal column in the spinal cord due most commonly to a vitamin B12 def
A
subacute combined degeneration, which is bilateral below the level of the lesion
23
Q
what encephalopathy causes ocular palsies, confusion, and gait abnormalities related to a lesion in the mammillary bodies and/or the dorsomedial nuclei of the thalamus
A
MGB
24
Q
where are the postganglionic neuron cell bodies, the CNS or PNS
A
PNS
25
what disease is a coavitation of the spinal cord causing bilateral loss of pain and temp at level of lesion
syringomyelia
26
what nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm
suprachiasmatic
27
are white rami preganglionic or pstganglionic
preganglionic
28
what area of the hypothalamus is responsible for recognizing a dec in body temp and mediates the rsponse to conserve heat
posterior hypothalamic zones; lesions result in poikilothermy (environmental control of heat)
29
what CN transmits sensory info from cornea
V1
30
what preganglionic sympathetic fibers are responsible for innervating the smooth mm and glands of the pelvis and hindgut
lumbar splanchnics
31
where are the cell bodies for the DCML and spinothalamic sensory systems
1st- dorsal root ganglia
carries ascending info in dorsal root of a spinal nerve, and synapses w/ ...
2nd- in brainstem (DCML) and spinal cord (spinothalamic), synapses w/ ...
3rd- thalamus and sends fibers to...
4th- primary somatosensory cortex
32
what term describes the reflex that increases the curvature of the lens, allowing near vision
accommodation
33
what CN carries preganglionic parasympathetic fibers that innervate the viscera of the neck, thorax, foregut and midgut
X
34
what area of the hypothalamus is responsible for recognizing an inc in body temp and mediates the response to dissipate heat
anterior hypothalamic zone;
| lesions here result in hyperthermia
35
what excitatory fibers arise from the inferior olivary nuclei in the contralateral side of the body
climbing fibers, they are monsynaptic input on Purkinje cells
Mossy fibers are also excitatory and are axons of all other sources and synapse on granule cells
36
what four CN carry preganglionic parasympathetics
III
VII
IX
X
37
name the form of spina bifida...
1. meninges and spinal cord
2. meninges
3. open neural tube lying on surface of back
4. defect in vertebral arch
1. meningomyelocele
2. meningocele
3. myeloschisis
4. occulta
38
all spina bifida's except occulta cause elevated... levels
alpha fetoprotein
39
name the nucleus
input from optic tract
output to primary visual cortex
LGB
40
name the nucleus
input from trigeminal pathways
output to primary somatosensory cortex
ventral posteromedial
41
name the nucleus
input from globus pallidus and cerebellum
output to primary motor cortex
ventral lateral
42
name the nucleus
input from medial lemniscus and spinocerebellar tracts
output to primary somatosensory cortex
ventral posterolateral nu
43
name the nucleus
input from globus pallidus and substantia nigra
output to primary motor cortex
ventral anterior
44
name the nucleus
input from amygdala and prefrontal cortex and temporal lobe
output to prefrontal lobe and cingulate gyrus
medial nuclear group
| limbic system
45
name the nucleus
| input from inferior colliculus; output to primary auditory cortex
MGB
| ears
46
name the nucleus
input from mammillary bodies via the mtt and the cingulated gyrus
output to cingulated gyrus via anterior limb of the internal capsule
anterior nuclear group (Papez circuit of limbic system)
47
what is the name of a thin brown ring around the outer edge of the cornea, seen in Wilson's disease
Kayser-Fleisher
48
what do UMNs innervate
LMNs
49
what area of the brian serves as the major sensory relay center for visual, asuditory, gustatory, and tactile information destined for the cerebral cortex, cerebellum, or basal ganglia
thalumus
50
which of the colliculi help direct the mov't of both eye in a gaze
superior colliculus
(Superior for Sight)
(inferior colliculus does both ears)
51
how do the corticobulbar fibers of CN VII differ from the rest of the CNs
normally corticobulbar fiber innervation of the CNs is bilateral (LMN receives info from both left and right cerebral cortex), but with CN VII, the LMN of the upper face receives bilateral input but hte lower facial LMNs only receive only contralateral input
52
what syndrome is described by a lesion in the angular gyrus (area 39) resulting in alexia, agraphia, acalculia, finger agnosia, and right-left disorientation
Gerstmann's syndrome
| spoken language understood
53
what are the three sites where CSF can leave the ventricles and enter the subarachnoid space (Name the lateral and medial foramina)
two Lateral foramina of Luschka
| one Medial foramina of Magendie
54
what CNS arise from the
1. midbrain
2. pons
3. medulla
1. III and IV
2. V, VI, VII, VIII
3. IX, X, XII
XI arises from cervical spinal cord
55
what disconnect syndrome results from a lesion in the corpus callosum secondary to an infarct in the anterior cerebral artery, so that the person can comprehen the command but not execute it
transcortical apraxia
(Wernicke's area of the left hemisphere can't communicate w/ the right primary motor cortex because of the lesion in the corpus callosum)
56
T or F
| glucose readily diffuses across the blood-brain barrier
F
| water readily diffuses across the bbb but glucose requires carrier-mediated transport
57
what encapsulated group of nerve endings seen at the muscle-tendon junction responds to an increase in tension generated in that muscle
(dropping a box that's too heavy)
GTOs are stimulated by Ib afferent neurons in response to inc in force or tension
the inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle
58
what chromosome 4, AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia
huntington's chorea, patient's have chorea, athetoid mov't, progressive dementia, and behavioral problems
59
what syndrome is described as bilateral lesions of the amygdala and the hippocampus resulting in placidity, anterograde amnesia, oral exploratory behavior, hypersexuality, and psychic blindness
Kluver-Bucy
60
by asking a patient to close the eyes while standing with feet together, what two pathways are you eliminating from proprioception
visual and cerebellar components are removed so you are testing the dorsal columns
61
what is the name of bilateral flaccid paralysis, hyporeflexia, and hypotonia due to a viral infection of the ventral horn of the spinal cord
poliomyelitis
| a bilateral LMN lesion
62
what branch supplies
1. the ventrolateral 2/3 of the cervical spinal ord and the ventrolateral part of the medulla
2. the cerebellum and the dorsolateral part of the medulla
1. ant spinal art
| 2. PICA
63
what syndrome causes inability to conc, easy distractibility, apathy, and regression to an infantile suckling or grasping reflex
frontal lobe syndrome
64
T or F
| the presence of PMNs in the CSF is always abnormal
T
| there may be up to 4 lymphocytes or monocytes but NEVER PMNs
65
what cells lining the ventricles have cilia on their luminal surface to move CSF
ependymal cells
66
what is the most common site for the aneurysm in cerebral circulation
the junction where the anterior comm and anterior cerebral arteries join
as the aneurysm expands, it compresses the fibers from the upper temporal fields of the optic chiasm, producing bitemporal inferior quadrantanopia
67
what fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the fronatal and parietal lobes
```
central sulcus
(sulcus of Rolando)
```
68
what is the name of violent projectile movements of a limb resulting from a lesion in the subthalamic nuceli of the basal ganglia
hemiballismus
69
what is the term for the type of pupil seen in neurosyphilis and what ocular reflexes are lost
Argyll Robertson
70
T or F
| intrafusal fibers form muscle spindles
T
| they are the sensory component of the stretch reflex
71
what Brodmann area is assoc w/
1. Broca's area
2. primary auditory cortex
3. primary somatosensory cortex
1. 44 and 45
2. 41 and 42
3. 1, 2, and 3
72
what Brodmann area is assoc w/
1. somatosensory assoc cortex
2. primary motor cortex
3. premotor cortex
1. 5 and 7
2. 4
3. 6
73
what Brodmann area is assoc w/
1. visual assoc cortex
2. frontal eye fields
3. primary visual cortex
4. Wernicke's
1. 18 and 19
2. 8
3. 17
4. 22
74
what is the fluid of the posterior compartment of the eye
vitreous humor
75
what aphasia produces a nonfluent pattern of speech with the ability to understand written and spoken langulate
expressive aphasia
76
in a topographical arrangement of the cerebellar homunculus map, what area or lobe...
1. controls the axial and proximal musclulature of limbs
2. involved in motor planning
3. controls balance and eye mov't
4. controls distal musculature
1. vermis
2. lateral part of hemispheres
3. flocculonodular lobe
4. intermediate part of the hemispheres
77
what glial cell is derived from mesoderm and acts as a scavenger, cleaning up cellular debris after injury
microglia
| Microglia and Mesoderm
78
what direct-pathway basal ganglia disease is described by masklike facies, stooped posture, cogwheel rigidity, pill-rolling tremor, shuffling gaint
Parkinson's
79
what artery supplies most of the lateral surfaces of the cerebral hemispheres
MCA
80
what hypothalamic nucleus is responsible for the production of ADH
supraoptic nuclei
| lesions here result in diabetes insipidus
81
T or F
| high frequency sound waves stimulate hair cells at the base of the cochlea
T
82
what nucleus of the hypothalamus is the statiety center
ventromedial
| lesion -> obesity
83
what cells of the retina sees in color and needs bright light to be activated
cones
84
what cells of axons are the only ones that leave the cerebellar cortex
Purkinje
85
what splanchnic carries preganglionic parasympathetics that innervate the hindgut and the pelvic viscera
Pelvic splanchnics
86
is nystagmus defined by the fast or slow component
fast
87
name the ocular lesion specified
1. left optic nerve
2. rt calcarin cortex
3. right LGB
4. optic chiasm
5. right lateral compression of optic chiasm
6. left meyer's loop of optic radiation
1. left eye anopsia
2. left homonymous hemianopsia
3. left homonumous hemianopsia
4. bitemporal heteronymous hemianopsia
5. right nasal hemianopsia
6. left homonymous hemianopsa
88
what is the function of the cerebellum
planning and fine-tuning of voluntary skeletal msucle contractions (coordination)
the function of the basal glanglia is to initiate gross voluntary skeletal muscle control
89
what is the name for inability to stop a mov't at the intended target
dysmetria (finger-to-nose)
90
if a lesion occurs before the onset of puberty and arrests sexual development, what area of hypothalamus occurs)
preoptic area of the hypothalamus; if the lesion occurs after puberty, amenorrhea or impotence will be seen
91
what sulcus divides the occipital lobe horizontally into a superior cuneus and inferior lingual gurys
calcarine sulcus
92
do alpha- or gamma- motor neurons innervate extrafusal mm fibers
alpha
| gamma do intrafusal
93
contracting both medial rectus mm simultanesous makes the images of near objects remain on the same part of the retinal. What term describes this...
convergence
94
will a unilateral lesion in the STT result in a contralateral or ipsi loss of pain and tem
contro
(it enters the spinal cord and immediately synapses in dorsal horn, crosses over and ascends contralateral in the spinal cord, brainstem, thalamus, and postcentral gyrus)
95
what ganglion supplies the postganglionic parasympathetics to the ciliary mm of the eye
ciliary ganglion
96
in what tract does pain, temp, and crude touc sensory info ascend to the postcentral gyrus
STT
97
what CN nu receives auditory info from both ears via the cochlear nu
superior olivary nucleus
98
what parasympathetic nu is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax, foregut and midgut
dorsal motor nu of X
99
what sensory system is affected in the late spinal cord manifestations of syphilis
bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis = tabes dorsalis
a high-step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet
100
what do LMNs innervate
innervate sk mm
101
what tract carries the ipsi dorsal column fibers from the lower limbs in the spinal cord
fasciculus gracilis (Graceful), which lies closest to the midline of the spinal cord
102
T or F
| CSF is a clear, isotonic solution w/ lower conc of K and HCO3 and higher conc of Cl and Mg
t
103
what type of fiber(s) are carried in...(motor, sensory, or both)
1. dorsal root
2. dorsal rami
3. ventral rami
4. ventral root
5. dorsal root ganglion
6. spinal nerve
1. sensory
2. both
3. both
4. motor
5. sensory
6. both
104
describe the loss for each of the following in a hemisection of the spinal cord (Brown-Sequard syndrome)
1. dorsal column tract
2. corticospinal tract
3. LMN
4. spinothalamic tract
1. ipsi loss at and below level of lesion
2. ipsi loss below level
3. ipsi flaccid paralysis
4. contra loss below and bilateral loss at level of lesion
105
what area of the brain acts as teh center for ipsi horizontal gaze
PPRF
106
what aphasia is seen as an inability to comprehend spoken language and speaking in a word salad
receptove aphasia
107
what is the function of the basal ganglia
initiate and manage gross sk mm mov't control
108
what art is formed by the union of the two vertebral arteries
the basilar artery is formed at the pontomedullary junction
109
what disease is described by bilateral flaccid weakness of the upper limbs (LMN) and bilateral spastic weakness of the lower limbs (UMN) beginning at the cervical level of the spinal cord and progressing up or down the cord
ALS
(LMN lesion AT the level of lesion
UMN lesion Below the level)
110
which DA receptor excites the direct pathway of the basal ganglia
D1
| inhibition of the direct pathway occurs through the D2 receptors
111
does the direct or indirect pathway result in a dec level of cortical excitation
although body pathways are associated with disinhibition
| the indirect basal ganglia pathway is associated with a dec level of cortical excitiation
112
what fissure of the cerebral cortex separates the frontal and temporal lobes rostrally and partially separates the parietal and temporal lobes
lateral fissure of Sylvius
113
what area of the brain acts as the center for contralateral horizontal gaze
frontal eye field
114
in an adult where does the spinal cord terminate and what is it called
conus medullaris terminates at L2
115
if a patient with a cerebellar lesion has nystagmus, which way is the fast component directed, toward or away
toward
116
what area of the limbic system is responsible for attaching emotional significance to a stimulus
amygdala
117
what is the name of the tremor that occurs during mov't and is absent while the person is at rest
intention tremor; a sign of cerebellar lesions
| a tremor at rest (pill rolling) is seen in basal ganglia lesions
118
what is the term for making up stories regarding past experiences because of an inability to retrieve them
confabulatino
| - Korsakoff's
119
what forntal lobe cortex is associated with organizing and planning the intellectual and emotional aspect of behavior
preforntal cortex
120
what is the largest nucleus in the midbrain
substantia nigra is the largest nucleus in the midbrain
| it contains melanin and uses GABA and DA as its neurotransmitters
121
where is the lesion that produces these sx when a petient is asked to loop left?
1. left eye cen't look left
2. right eye can't look left, left eye nystagmus, and convergence intact
3. neither eye can look left with a slow drift to the right
1. left abducens
2. right MLF
3. left abducens nucleus or right cerebral cortex
122
what area of the hypothalamus is the feeding center
lateral hypothalamic zone
| lesion results in Aphasia
123
in what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic, chorea, athetosis, tics, and dystonia
indirect pathway (Tourette's)
124
what happens to mm tone and stretch reflexes when there is a LMN lesion
hallmarks of LMN lesion injury are absent or dec reflexes, mm fasciculations, dec mm tone, and mm atrophy (flaccid paralysis)
don't forget, LMN lesions are ipsilateral AT the level of lesion)
125
in what pathway of the basal ganglia do lesions result in an underactive cortex with hypokinetic, slow, or absent spontaneous mov't
direct pathway
| ex. Parkinson's
126
what sided mm weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation
contralateral mm weakness when above the decussation,
| UMN injury below the pyramidal decussation results in ipsi mm weakness
127
what area of the retina consists of only cones and has the greates visual acuity
fovea
128
what tract carries the ipsi dorsal column fibers from the upper limbs in the spinal cord
fasciculus cuneatus
129
what CNS demyelinating disease is characterized by diplopia, ataxia, paresthesias, monocular blindness and weakness or spastic paresis
MS
130
what part of the ANS controls the constriction of the pupil in response to light
Parasymp
131
with which CN are preganglionic parasympathetics arising from the Edinger-Westphal nu
CN III
132
ophthalmic art is a branch of what artery
ICA
133
what thalamic relay nu do the mammillary bodies project to
anterior nu
134
what cells contribut to the bbb and proliferate in response to CNS injury
astrocytes
135
what causes slow writhing mov'ts (athetosis)
hypermyelination of corpus striatum and the thalamus (as in CP)
136
what area of the brain is responsible for emotion, feeding, mating, attention, and mating
limbic system
137
what is the name of the postganglionic parasympathetic ganglion that innervates...
1. papillary sphincter and ciliary mm of eye
2. parotid gland
3. submandibular gland and sublingual glands
4. lacrimal gland and oral and nasal mucosa
1. ciliary ganglion
2. otic ganglion
3. submandibular ganglion
4. pterygopalatine ganglion
138
what neuronal cell bodies are contained in the intermediate zone of the spinal cord (T1-L2)
preganglionic sympathetics
139
what limb of the internal capsule is not supplied by the MCA
anterior limb is supplied by ACA
140
what tract is responsible for voluntary refined mov'ts of distal extremities
CST
141
carniopharyngiomas are remnants of what
Rathke's puch
| can result in compression of the optic chiasm
142
Clarke's nu is the second ascending sensory neuron of which spinocerebellar tract
dorsal spinocerebellar tract
| the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract
143
name the three postganglionic sympathetic ganglia that receive input from thoracic splanchnics
celiac, aorticorenal, and superior mesenteric ganglias
| all Splanchnics are Symphathetic except for the Pelvic which are Preganglionic Parasympathetic
144
what is the only CN to arise from the dorsal surface oft he midbrain
IV
145
what basic reflex regulates mm tone by contracting mm in response to stretch of that mm
mytoatic reflex is responsible for the tension present in all resting mm
146
where are the LMN cell bodies of the corticospinal trat
in the ventral horn of the spinal cord.
| UMN cell bodies are in the precentral gyrus of the frontal lobe
147
what nu found in the intermediate zone of the spinal cord, sends unconscious proprioception to the cerebellum
Clarke's
148
the vertebral artery is a branch of...
subclavian artery
149
what mm of the middle ear is innervated by mandibular V
tensor tympani
150
the fibers of the nucleus gracilis and cuneatus cross that the medullary decussation and ascend conta to what thalamic relay nu
VPL sneds its fibers to synapse in the postcentral gyrus
151
what mm of the middle ear is innervated by CN VII
stapedius
152
what part of the inner ear contains the gravity receptors for changes in the position of the head
saccule and utricle
153
what nu supplies the preganglionic parasympathetics to ciliary ganglion
Edinger-Westphal of III
154
what reticular nu synthesize serotonin from L-tryptophan and plays a role in mood, aggression, and inducing sleep
raphi nuclei
155
will a patient with a unilateral lesion in the cerebellum fall toward or away from the affected side
unilateral cerebell lesions -> fall toward the side of the lesion
156
a unilateral lesion in what nucleus will produce ipsi paralysis of the soft palate
nu ambiguus, resulting in the uvula deviating away from the side of the lesion
157
T or F
| neurons in the dorsal horn participate in reflexes
T
158
what ganglion receives preganglionic sympathetic fibers from T1 to L1-L2 and innervates sm mm, cardiac mm, glands, head, thoracic viscera, and blood vessels of the body wall and limbs
symphathetic chain glanglion
159
what preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut
thoracic splanchnic fibers
160
does light or darkness regulate the pineal gland
light
| via the retina-suprachiasmatic-pineal pathway
161
name the three hormones produced by pinealocytes
melatonin
serotonin
CCK
162
is the pH of CSF acidotic, alkalotic, or neutral
acidotic- 7.33
163
what ascending sensory system carries joint position, vibratory and pressure sensation, and discriminative touch from the trunk and limbs
DCML system
164
what reflex enable the eyes to remain focused on a target while the head is turning
vestibulo-ocular reflex
165
what cells of the retina see back and white and are used for night vision
rods
