usmle- anatomy- neuro Flashcards
where are the preganglionic neuron cell bodies, the CNS or PNS
CNS
which three CNs send sensory information to the solitary nucleus
VII, IX, X
tast and general sensation for the tongue
vertebral artery or anterior spinal artery occlusion, resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
medial medullary syndrome
contralateral corticospinal and medial lemniscus tract deficits and an ipsilateral medial strabismus secondary to a lesion in CN VI
medial pontine syndrome
slow growing acoustic neuroma producing CN VII deficiencies
pontocerebellar angle syndrome
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
lateral medullary (Wallenberg’s) syndrome
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
lateral pontine syndrome
posterior cerebral art occlusion resulting in a contralateral corticospinal tract signs, contralateral corticobulbar signs to the lower face, and ipsi CN III palsy
medial midbrain (Weber’s) syndrome
CN affected if lesion in…
- midbrain
- upper medulla
- pontomedullary junction
- upper pons
- III and IV
- IX, X, XII
- VI, VII, VIII
- V
what is the only CN nucleus found in the cervical spinal cord
accessory nucleus
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
- motor nu
- spinal trigeminal nu
- mesencephalic nu
what deep cerebellar nuclei receive Purkinje cell projections in…
- floculonodular lobe
- vermis
- lateral cerebellar hemispheres
- intermediate hemispheres
- lateral vestibular nu
- fastigial nu
- interposed nu
- dentate nu
what is the only excitatory neuron in the cerebellar cortex, and what is its neurotransmitter
granule cell uses glutamate
all others use GABA
what three CNs are associated with conjugate eye movements
III
IV
VI
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
hypotonia (rag doll)
what bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex
vermis- pos Romberg with eyes open
dorsal column- pos Romberg with eyes closed
which one of the cerebellar peduncles is mainly responsible for outgoing (efferent) info
superior cerebellar peduncle
the inferior and middle are incoming tracts
what tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum, helping monitor and modulate muscle movements
lower extremity and lower trunk travels in the dorsal spinocerebellar tract
upper trunk and upper extremities travel in cuneocerebellar tract
what reflex seen in lesions of the corticospinal tract is an extension of the great toe with fanning of the remaining toes
Babinski in UMN lesions
Horner’s…
sympathetic fibers from __ - __ are obstructed
T1-T4
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
- semicircular canal
- semicircular duct
- utricle and saccule
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
subacute combined degeneration, which is bilateral below the level of the lesion
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
MGB
where are the postganglionic neuron cell bodies, the CNS or PNS
PNS
what disease is a coavitation of the spinal cord causing bilateral loss of pain and temp at level of lesion
syringomyelia
what nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm
suprachiasmatic
are white rami preganglionic or pstganglionic
preganglionic
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)
what CN transmits sensory info from cornea
V1
what preganglionic sympathetic fibers are responsible for innervating the smooth mm and glands of the pelvis and hindgut
lumbar splanchnics
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
what term describes the reflex that increases the curvature of the lens, allowing near vision
accommodation
what CN carries preganglionic parasympathetic fibers that innervate the viscera of the neck, thorax, foregut and midgut
X
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
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
what four CN carry preganglionic parasympathetics
III
VII
IX
X
name the form of spina bifida…
- meninges and spinal cord
- meninges
- open neural tube lying on surface of back
- defect in vertebral arch
- meningomyelocele
- meningocele
- myeloschisis
- occulta
all spina bifida’s except occulta cause elevated… levels
alpha fetoprotein
name the nucleus
input from optic tract
output to primary visual cortex
LGB
name the nucleus
input from trigeminal pathways
output to primary somatosensory cortex
ventral posteromedial
name the nucleus
input from globus pallidus and cerebellum
output to primary motor cortex
ventral lateral
name the nucleus
input from medial lemniscus and spinocerebellar tracts
output to primary somatosensory cortex
ventral posterolateral nu
name the nucleus
input from globus pallidus and substantia nigra
output to primary motor cortex
ventral anterior
name the nucleus
input from amygdala and prefrontal cortex and temporal lobe
output to prefrontal lobe and cingulate gyrus
medial nuclear group
limbic system
name the nucleus
input from inferior colliculus; output to primary auditory cortex
MGB
ears
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)
what is the name of a thin brown ring around the outer edge of the cornea, seen in Wilson’s disease
Kayser-Fleisher
what do UMNs innervate
LMNs
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
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)
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
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
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
what CNS arise from the
- midbrain
- pons
- medulla
- III and IV
- V, VI, VII, VIII
- IX, X, XII
XI arises from cervical spinal cord
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)
T or F
glucose readily diffuses across the blood-brain barrier
F
water readily diffuses across the bbb but glucose requires carrier-mediated transport
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
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
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
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
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
what branch supplies
- the ventrolateral 2/3 of the cervical spinal ord and the ventrolateral part of the medulla
- the cerebellum and the dorsolateral part of the medulla
- ant spinal art
2. PICA
what syndrome causes inability to conc, easy distractibility, apathy, and regression to an infantile suckling or grasping reflex
frontal lobe syndrome
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
what cells lining the ventricles have cilia on their luminal surface to move CSF
ependymal cells
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