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Neurology > USMLE and Neuroanatomy 3/16/14 > Flashcards

USMLE and Neuroanatomy 3/16/14 Flashcards

1
Q

What are characteristics of normal aging?

A

Occasional forgetfulness, difficulty word finding, difficulty falling asleep, low energy

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2
Q

Type of aphasia: word-finding difficulty

A

Expressive / non-fluent aphasia

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3
Q

In age-related expressive/non-fluent aphasia, what is the etiology?

A

Impairment of dominant frontal lobe function, age-related

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4
Q

Diagnosis of dementia requires:

A

impairment in daily functioning

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5
Q

Anterior circulation of the brain includes what vessels?

A

ICA and its branches (ACA, MCA)

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6
Q

Posterior circulation of the brain includes what vessels?

A

Paired vertebral arteries —> basilar artery —> paired PCAs

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7
Q

ACA stroke: characteristic features

A

Contralateral motor/sensory deficits leg>arm, urinary incontinence, gait apraxia, primitive reflexes, abulia, paratonic rigidity

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8
Q

Pronator Drift

A

sensitive test for UMN disease that pt may not otherwise notice; weakness in supination results in dominant pronation (pt with eyes closed)

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9
Q

Wernicke’s Encephalopathy: diagnostic triad

A

encephalopathy, oculomotor dysfunction, gait ataxia

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10
Q

Subarachnoid hemorrhage: clinical features

A

Worst headache of life; due to ruptured berry aneurysm; meningeal irritation (neck stiffness), uncommon focal deficits

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11
Q

Subarachnoid hemorrhage: complications

A

Rebleed (first 24h), vasospasm (after 3d), increased ICP; seizures; hyponatremia (from SIADH)

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12
Q

Subarachnoid hemorrhage: diagnosis

A

Noncontrast CT; LP; xanthochromia in CSF (usually 6h after onset), CTA-A to identify source

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13
Q

Subarachnoid hemorrhage: treatment

A

Coiling and/or stenting; nimodipine & hyperdynamic tx to reduce vasospasm

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14
Q

Myasthenia Crisis: definition

A

Life-threatening condition characterized by weakness of respiratory and pharyngeal muscles

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15
Q

Myasthenia Crisis: treatment

A

Endotracheal intubation, w/d of AChEis for a few days; treat concomitant infection; monitor PFTs

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16
Q

Treatment of acute exacerbations of MS

A

Corticosteroids (IV)

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17
Q

GBM: CT/MRI characteristic findings

A

butterfly appearance w/central necrosis

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18
Q

High-grade astrocytoma: CT/MRI characteristic findings

A

Heterogenous, serpiginous contrast enhancement

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19
Q

GBS: predisposing conditions

A

campylobacter infection, vaccination

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20
Q

Craniopharyngioma

A

benign tumors arising from Rathke’s pouch; bimodal age distribution (kids and 55-65yo); cysts filled w/oily material; located above sella turcica

21
Q

Craniopharyngioma: clinical feature

A

bitemporal hemianopia (compression of optic chiasm)

22
Q

Cauda Equina Syndrome: features

A

bilateral severe radicular pain; saddle anesthesia; asymmetric motor weakness; hyporeflexia/areflexia; late-onset bowel & bladder dysfunction

23
Q

Conus Medullaris Syndrome: features

A

sudden onset severe back pain; perianal hypo/anesthesia; symmetric motor weakness; early-onset bowel and bladder dysfunction

24
Q

CES v. CMS: LMN or UMN signs?

A

CES: LMN
CMS: UMN + LMN

25
Q

Conus Medullaris nerve roots

A

S1-S5

26
Q

Treatment for CES?

A

Emergent MRI, neurosurgical intervention, IV glucocorticoids

27
Q

Cavernous Sinus: contents

A

ICA, CN III, IV, V, VI

28
Q

Cavernous Sinus Thrombosis: pathophys

A

facial/ophthalmic venous system is valveless

29
Q

Cavernous Sinus Thrombosis: clinical features

A

headahce, binocular palsies, periorbital edema, hypoesthesia/hyperesthesia

30
Q

Cavernous Sinus Thrombosis: treatment

A

antibiotics, prevent herniation

31
Q

Cavernous Sinus Thrombosis: red flags

A

headache, bilateral periorbital edema, CN III, IV, V, VI deficits

32
Q

CNs that exit in the midbrain:

A

III, IV

33
Q

CNs that exit in the pons:

A

V, VI, VII, VIII

34
Q

CNs that exit in the medulla:

A

IX, X, XII

35
Q

CNs that exit medially:

A

MOTOR- III, IV, VI, XII

36
Q

CNs that exit laterally:

A

MIXED- V, VII, IX, X

37
Q

Most cranial nerves exit ventrally or dorsally?

A

Ventral/ventralateral

38
Q

Which CN exits dorsally?

A

IV, just posterior or below the inferior colliculi

39
Q

Superior Cerebellar Peduncle

A

Efferent route from cerebellum; projections from deep cerebellar nuclei —> red nucleus and thalamus (VL)

40
Q

Middle Cerebellar Peduncle

A

Largest CP, contains fibers from contralateral pontine nuclei —> mossy fibers in cerebellar cortex

41
Q

Inferior Cerebellar Peduncle

A

Input route to cerebellum, contains:

  • Crossed olivocerebellar fibers
  • Uncrossed posterior spinocerebellar and cuneocerebellar fibers, vestibulocerebellar fibers, and other cerebellar afferents
42
Q

Spinocerebellar tract

A

Clarke’s Nucleus (T1-L2) —> info about biomechanics state of muscle spindles and GTOs in Lower Extremity

43
Q

Cuneocerebellar tract

A

External cuneate nucleus (medulla) —> info about biomechanics state of muscle spindles and GTOs in upper extremity

44
Q

Corticospinal tract

A

precentral gyrus (motor cortex) —> post limb of internal capsule —> cross in pyramidal decussation (medulla) —> lateral corticospinal tract —> synapse in anterior horn of spinal cord

45
Q

Anterolateral (Spinothalamic) System

A

Pain, temp, crude touch; afferents cross 1-2 levels ABOVE their dorsal roots

46
Q

Anterolateral (Spinothalamic) System: path

A

Dorsal root ganglion —> cross 1-2 spinal levels above —> anterolateral pathway —> synapse in thalamus (VPL nucleus) —> primary somatosensory cortex

47
Q

Dorsolateral / Medial Lemniscus System

A

vibration, proprioception, light touch

48
Q

Dorsolateral / Medial Lemniscus System: path

A

Dorsal root ganglion —> dorsal columns —> gracilis/cuneate nucleus in medulla —> sensory decussation —> medial lemniscus —> synapse in thalamus (VPL) —> primary somatosensory cortex

Neurology (10 decks)

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