Term
| the embryonic origin of CNS neurons, ependymal cells, ligodendroglia, astrocytes |
|
Definition
|
|
Term
| the embryonic origin of Schwann cells, PNS neurons |
|
Definition
|
|
Term
| the embryonic origin of microglia, like Macrophages in the nervous system |
|
Definition
|
|
Term
| Where can Nissl substance (RER) be found? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Physical support, repair, K+ metabolism, removal of excess neurotransmitter, maintenance of BBB. Reactive gliosis in response to injury |
|
|
Term
| What is microglia and what does it do? |
|
Definition
| CNS phagocytes says it all |
|
|
Term
| How many CNS axons does each oligodendrocyte myelinate? |
|
Definition
|
|
Term
| How many PNS axons does each Schwann cell myelinate? |
|
Definition
|
|
Term
| What do free nerve endings sense? |
|
Definition
|
|
Term
| What do Aδ (A delta) fibers type of free nerve endings sense? |
|
Definition
| they are slow and sense warm |
|
|
Term
| What do C group of free nerve ending fibers sense? |
|
Definition
| they are fast and sense cold |
|
|
Term
| what is Meissner's corpuscle and where is it located? |
|
Definition
| they are in the Glabrous (hairless) skin, very superficial. They sense position, dynamic fine touch, and they can adapt quickly |
|
|
Term
| What are Pacinian Corpuscles and where they are located? |
|
Definition
Deep skin layers, ligaments, and joints.
Vibration, pressure |
|
|
Term
|
Definition
| they are slow adapting and sense position and static touch |
|
|
Term
| What is the significance of perineurium in microsurgery for limb reattachment? |
|
Definition
|
|
Term
| what neurotransmitter is incr'd in anxiety and mania, and decr'd in depression? |
|
Definition
|
|
Term
| What neurotransmitter is incr'd in schizophernia and decr'd in Parkinson's and depression? |
|
Definition
|
|
Term
| what neurotransmitter is incr'd in mania, decr'd in anxiety and depression? |
|
Definition
|
|
Term
| what neurotransmitter is decr'd in Alzheimer's Huntington's and during REM sleep? |
|
Definition
|
|
Term
| what neurotransmitter is decr'd in anxiety and Huntington's? |
|
Definition
|
|
Term
| where is NE synthesized in the brain? |
|
Definition
Locus ceruleus
reticular formation in solitary tract |
|
|
Term
| where is Dopamine synthesized in the brain? |
|
Definition
| Ventral tegmentum and Substantia niagra |
|
|
Term
| Where is 5-HT made in the brain? |
|
Definition
|
|
Term
| Where is ACh made in the brain? |
|
Definition
|
|
Term
| where is GABA made in the brain? |
|
Definition
|
|
Term
| what physiological state is the Locus ceruleus ass'd with? |
|
Definition
|
|
Term
| What physiological states are nucleus accumbens and septal nucleus ass'd with? |
|
Definition
| reward center, pleasure, addition, fear. |
|
|
Term
| what physiological state is the reticular formation ass'd with? |
|
Definition
|
|
Term
| what is the main exciter in brain? |
|
Definition
|
|
Term
| What is vasogenic cerebral edema? |
|
Definition
| an infection that destroys endothelial cell tight junctions and thus destroys BBB |
|
|
Term
|
Definition
| the vomiting center of the brain that lacks BBB |
|
|
Term
Organum vasculosum of lamina terminalis
(OVLT) |
|
Definition
| osmotic sensing center in the brain |
|
|
Term
| What the functions of hypothalamus |
|
Definition
TAN HATS
thirst and water balance
Adenohypophysis release of hormones
Neurohypophysis release of hormones
Hunger
Autonomic regulation
Temperature
Sex |
|
|
Term
| What are the inputs for the hypothalamus? |
|
Definition
OVLT: changes in osmolarity
area postreme: responds to emetics (throwing up) |
|
|
Term
| where is ADH made in the brain? |
|
Definition
|
|
Term
| Where is oxytocin made in the brain? |
|
Definition
|
|
Term
| What is the lateral area of the hypothalamus? |
|
Definition
hunger
destruction->anorexia, failure to thrive. Inhibited by leptin |
|
|
Term
| what is the ventromedical area of the hypothalamus? |
|
Definition
satiety
destruction->hyperphagia
stimulated by leptin |
|
|
Term
| what does anterior hypothalamus do? |
|
Definition
|
|
Term
| what does the posterior hypothalamus do? |
|
Definition
|
|
Term
| what does septal nucleus do? |
|
Definition
|
|
Term
| what does suprachiasmatic nucleus do? |
|
Definition
|
|
Term
| what is the job of thalamus? |
|
Definition
| major relay for ascending sensory information that ultimately reaches the cortex |
|
|
Term
| what does the lateral geniculate nucleus do? |
|
Definition
|
|
Term
| what does the medical geniculate nucleus do? |
|
Definition
|
|
Term
|
Definition
body sensation
(proprioception, pressure, pain, touch, vibration via dorsal columns, spinothalamic tract) |
|
|
Term
|
Definition
facial sensation
you put Makeup on your face |
|
|
Term
|
Definition
|
|
Term
| what is the limbic system and what dose it do? |
|
Definition
cingulate gyrus, hippocampus, fornix, and mammillary bodies.
Feeding, fleeing, fighting, feeling, and fucking. 5 Fs |
|
|
Term
| what are climbing and mossy fibers? |
|
Definition
| input nerves for cerebellum |
|
|
Term
| what are output nerves for crebellum? |
|
Definition
|
|
Term
| What are Dentate, Emboliform Globose, and Fastigial? |
|
Definition
they are the deep nuclei of cerebellum
Don't Eat Greasy Foods |
|
|
Term
| what does the lateral cerebellum do? |
|
Definition
| voluntary movement of extremities |
|
|
Term
| what does medial cerebellum do? |
|
Definition
| balance, truncal coordination, atxia, propensity to fall toward injured side (ipsilateral) |
|
|
Term
| what is the function of basal ganglia? |
|
Definition
important in voluntary movements and making postural adjustments.
receives cortical input, provides negative feedback to cortex to modulate movement |
|
|
Term
|
Definition
| a contaminant in illicit street drugs that causes Parkinson's disease |
|
|
Term
| What is Parkinson's disease? |
|
Definition
| Degeneration disorder of CNS associated with lewy bodies and depigmentation of the substantia nigra pars compacta |
|
|
Term
| what are the clinical symptoms of Parkinson's disease? |
|
Definition
TRAP
Tremor
cogwheel Rigidity
Akinesia
Postural instability |
|
|
Term
|
Definition
sudden, wild flailing of one side of body, 1 arm +/-leg
contralateral subthalamic nucleus lesion. Loss of inhibition of thalamus through globus pallidus |
|
|
Term
|
Definition
The Cs
CAG repeats
Crazy (dementia)
Chorea
Caudate-nucleus atrophy(loses ACh and GABA)
Chromosome 4
treat with dopamine blockers |
|
|
Term
|
Definition
| sudden, jerky, purposeless movements. Characteristic of basal ganglia lesion |
|
|
Term
|
Definition
| slow, writhing movements, especially of fingers. Characteristic of basal ganglia lesions |
|
|
Term
|
Definition
| sudden, brief muscle contraction |
|
|
Term
|
Definition
| sustained, involuntary muscle contractions |
|
|
Term
| essential/postural tremor |
|
Definition
action tremor (worsens when holding posture), autosomal dominant.
treatment: self-meditate with alcohol, beta blockers |
|
|
Term
|
Definition
| most noticeable distally. Seen in Parkinson's |
|
|
Term
|
Definition
| slow, zigzag motion when pointing woard a target; ass'd with cerebellar dysfunction. |
|
|
Term
|
Definition
| Kluver-Bucy syndrome (hyperorality, hpersexuality, disinhibited bahavior) |
|
|
Term
|
Definition
| disinhibition and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes |
|
|
Term
| right parietal lobe lesion |
|
Definition
| spatial neglect syndrome(agnosia of the contralateral side of the world) |
|
|
Term
| Reticular activating system lesions (mid brain) |
|
Definition
| reduced levels of arousal and wakefulness |
|
|
Term
| Mammillary bodies lesions |
|
Definition
can be caused by alcohol
Wernicke-Korsakoff syndrome |
|
|
Term
|
Definition
| may result in tremor at rest, chorea, or athetosis |
|
|
Term
| Cerebellar hemisphere lesion |
|
Definition
| intention tremor, limb ataxia, damage to the crebellum results in ipsilateral deficits; fall toward side of lesion |
|
|
Term
|
Definition
| truncal ataxia, dysarthria (speech disorder) |
|
|
Term
| subthalamic nucleus lesion |
|
Definition
| contralateral hemiballismus |
|
|
Term
| paramedian pontine reticular formation (PPRF) lesion |
|
Definition
| eyes look away from side of lesion |
|
|
Term
| frontal eye fields lesion |
|
Definition
|
|
Term
| Central pontine myelinolysis |
|
Definition
| Acute paralysis, dysarthria, dysphagia, diplopia, and loss of consciousness. Commonly caused by very rapid correction of hyponetremia. |
|
|
Term
| recurrent laryngeal nerve injury |
|
Definition
| loss of all laryngeal muscles except circothyroid. Hoarseness. |
|
|
Term
|
Definition
| higher-order inability to speak |
|
|
Term
|
Definition
|
|
Term
|
Definition
| poor repetition but fluent speech, intact comprehension. lesion at Arcuate fasciculus |
|
|
Term
| Anterior spinal artery lesion |
|
Definition
| contralateral hemiparesis (lower extremities), medial lemniscus(decr contralateral proprioception), ipsilateral paralysis of hypoglossal nerve. |
|
|
Term
PICA lesion
Lateral medullary syndrome, aka Wallenberg's) |
|
Definition
| contralateral loss of pain and temperature, ipsilateral dysphagia, hoarseness, decr gag reflex, vertigo, diplopia, nystagmus, vomiting, ipsilateral Horner's, ipsilateral facial pain and temperature, trigeminal nucleus (spinal tract and nucleus), ipsilateral ataxia. |
|
|
Term
| AICA (lateral inferior pontine syndrome) |
|
Definition
| ipsilateral facial paralysis, ipsilateral cochlear nucleus, vestibular (nystagmus), ipsilateral facial pain and temperature, ipsilateral dystaxia (MCP, ICP) |
|
|
Term
| posterior cereberal artery |
|
Definition
| contralateral homonymous hemianopia with macular sparing; supplies occipital cortex. |
|
|
Term
| middle cereberal artery lesion |
|
Definition
| contralateral face and arm paralysis and sensory loss, aphasia (dominant sphere), left sided neglect. |
|
|
Term
| Anterior cerebral artery lesion |
|
Definition
| supplied medial surface of the brain, leg-foot area of motor and sensory cortices. |
|
|
Term
| Anterior communication artery common problem |
|
Definition
| most common site of circle of Willis aneurysm; lesions may cause visual field defects |
|
|
Term
| Posterior communicating artery |
|
Definition
| common area of aneurysm; causes CN III palsy. |
|
|
Term
| infarct of the posterior limb of the internal capsule |
|
Definition
| worse than anterior limb of the internal capsule, causes pure motor hemiparesis |
|
|
Term
|
Definition
| divisions of middle cerebral artery; supply internal capsule, caudate, putamen, globus pallidus. arteries of stroke" |
|
|
Term
|
Definition
| infarct causes "locked-in syndrome" (CN III is typically intact) |
|
|
Term
| in general, what does the stroke of anterior circle cause? |
|
Definition
| general sensory and motor dysfunction, aphasia |
|
|
Term
| in general, what dose stroke of posterior circle cause? |
|
Definition
| Cranial nerve deficits(vertigo, visual deficits), coma, cerebellar deficits (ataxia). dominant hemisphere (ataxia), non-dominant (neglect) |
|
|
Term
|
Definition
occur at bifurcations in the circle of Willis. most common at the anterior communicating artery. Rupture leads to hemorrhagic stroke/subarachnoid hemorrhage.
Ass'd with adult polycystic kidney disease, Ehler-Danlos syndrome, and Marfan's syndrome. |
|
|
Term
| Charcot-Bouchard microaneurysms |
|
Definition
| associated with chronic hypertension; affects small vessels |
|
|
Term
| epidural hematoma CT scan |
|
Definition
| biconvex disk, does not cross suture lines, can cross falx, tentorium |
|
|
Term
| subdural hematoma CT scan |
|
Definition
| crescent-shaped hemorrhage that crosses suture lines. Gyri are preserved, since pressure is distributed equally. Canot cross falx, tentorium. |
|
|
Term
| common cause of epidural hematoma |
|
Definition
| rupture of middle meningeal artery, often 2ndary to fracture of temporal bone |
|
|
Term
| common cause of subdural hematoma |
|
Definition
| rupture of bridging veins |
|
|
Term
| subarachnoid hemorrhage common cause and presentation |
|
Definition
| rupture of an aneurysm. Pt complain of "worst headache of my life" bloody or yellow spinal tap 2-3 days afterwards. |
|
|
Term
| how does the lateral ventricle connect to the 3rd ventricle? |
|
Definition
|
|
Term
| How does 3rd ventricle and 4th ventricle connect? |
|
Definition
|
|
Term
| what are the two places that connect 4th ventricle to subarachnoid space? |
|
Definition
Lateral=foramina of Luschka
Medial=foramen of Magendie |
|
|
Term
| Normal pressure hydrocephalus |
|
Definition
"wet, wobbly, and wacky"
clinical triad of dementia, ataxia, and urinary incontinence (a reversible cause of dementia in the elderly)
Does NOT result in incr of subarachnoid space volume. Expansion of ventricles distorts the fibers of the corona radiata. |
|
|
Term
| Communicating hydrocephalus |
|
Definition
Papilledema, and herniation (eg, arachnoid scarring post-meningitis)
decr CSF absorption by arachnoid villi, which can lead to incr intracranial pressure. |
|
|
Term
| Obstructive (noncommunicating) hydrocephalus |
|
Definition
| Caused by structrual blockage of CSF circulation with in the ventricular system (eg, stenosis of the aqueduct of Sylvus). |
|
|
Term
|
Definition
| Appearance of incr CSF in brain atrophy (eg, Alzheimer's, Advanced HIV, Pick's disease). Intracranial pressure is normal; |
|
|
Term
| Where is the most common site of vertebral disk herniation? |
|
Definition
|
|
Term
| Where do you put the needle in for lumbar puncture? |
|
Definition
| Between L3 and L5, at the level of cauda equina, using iliac crest as a guide |
|
|
Term
| Do you pierce the Pia matter during lumbar puncture? |
|
Definition
|
|
Term
| What are the functions of dorsal columns? |
|
Definition
| pressure, viberation, touch, and proprioception |
|
|
Term
| Which part of the body does fasciculus cuneatus receive input from? |
|
Definition
| It's lateral therefore upper extremities. |
|
|
Term
| which part of the body does fasciculus gracilis receive input from? |
|
Definition
| it's medial therefore lower body extremities. |
|
|
Term
| What is the function of the lateral corticospinal tract? |
|
Definition
|
|
Term
| what is the function of Spinothalamic tract? |
|
Definition
|
|
Term
|
Definition
| muscle twitching, happens after LMN lesion |
|
|
Term
what does UMN lesion do to the following?
Weakness, Atrophy, fasciculation, reflexes, tone, babinski, spastic paralysis,clasp knife spasticity |
|
Definition
Weakness +
Atrophy -
Fasciculation -
Reflexes incr'd
tone incr'd
Babinski +
Spastic paralysis +
Clasp knife spasticity + |
|
|
Term
What does LMN lesion do to the following?
Weakness, atrophy, fasciculation, reflexes, tone, babinski, spastic paralysis, clasp knife spasticity |
|
Definition
Weakness +
Atrophy +
fasciculation +
reflexes decr'd
tone decr'd
babinski -
spastic paralysis -
clasp knife spasticity - |
|
|
Term
| what is Poliomyelitis and Werdnig-Hoffman disease's damage to the spinal cord? |
|
Definition
| LMN lesions only, due to destruction of anterior horns; flaccid paralysis |
|
|
Term
| What multiple sclerosis's damage to spinal cord? |
|
Definition
| Mostly white matter of cervical region; random and asymmetric lesions. |
|
|
Term
| Where is the spinal cord damaged in ALS? |
|
Definition
|
|
Term
| what does the complete occlusion of anterior spinal artery damage? |
|
Definition
| it spares dorsal columns and tract of Lissauer |
|
|
Term
| What does Tabes dorsalis (tertiary syphills) do to the spinal cord? |
|
Definition
| degeneration of dorsal roots and dorsal columns; impaired proprioception, locomotor ataxia |
|
|
Term
| What does Syringomyelia damage? |
|
Definition
| anterior white commissure of spinothalamic tract->bilateral loss of pain and temperature sensation. Seen with Arnold-Chiari II; can expand and affect other tracts. |
|
|
Term
| What do Vitamin B12 neuropathy, vitamin E def, and Friedreich's ataxia all do to the spinal cord? |
|
Definition
| demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts. -> ataxic gait, hyperreflexia, impaired position and vibration sense |
|
|
Term
| How do you get Poliomyelitis? |
|
Definition
| Caused by poliovirus, fecal oral route. Replicates in the orophrynx and small intestine before spreading through the bloodstream to the CNS, leads to the destruction of cells in the anterior horn of the spinal cord. |
|
|
Term
| what are the lab findings of poliomyelitis? |
|
Definition
| CSF with lymphocytic pleocytosis with slight slight elevation of protein (with no change in CSF glucose). Virus recovered from stool or throat. |
|
|
Term
| What is Werdnig-Hoffman disease? |
|
Definition
| AKA infantile spinal muscular atrophy. Autosomal recessive; "floppy baby" with tongue fasciculation; median age of death 7 months. Ass'd with degeneration of anterior horns. LMN involvement only. |
|
|
Term
| What is Amyotrophic Lateral Sclerosis? |
|
Definition
AKA Lou Gehrig's disease
Both UMN and LMN signs. no sensory, cognitive, or oculomotor deficits. Can be caused by defect in superoxide dismutase 1 (SOD1), betel nut ingestion. presents with fasciculation. |
|
|
Term
| Tabes dorsalis's clinical presentations |
|
Definition
| impaired proprioception and locomotor ataxia. Ass'd with Charcot's joints, shooting light pain. Argyll Robertson pupils, absence of DTRs, positive Romberg, and sensory ataxia at night. |
|
|
Term
| What is Argyll Robertson pupil? |
|
Definition
AKA "prostitute's pupils"
they accommodate but do not react |
|
|
Term
|
Definition
| Autosomal recessive trinucleotide repeat disorder (GAA; frataxin gene). impairment in mito functions. Staggering gait, frequent failling, nystagmus, dysarthria, pes cavus, hammer toes, hypertrophic cardiomyopathy (cause of death). Presents in childhood with kyphoscoliosis. |
|
|
Term
|
Definition
Hemisection of spinal cord
1. ipsilateral UMN signs below lesion
2. ipsilateral loss of tactile vibration, and proprioception sense below lesion.
3. contralateral pain and temperature loss below lesion.
4. ipsilateral loss of all sensation at level of lesion.
5. LMN signs at level of lesion
If lesion occurs above T1, presents with Horner's syndrome |
|
|
Term
| What are the 3 symptoms of Horner's syndrome? |
|
Definition
Sympathectomy of face
1. Ptosis (slight drooping of eyelid: superior tarsal muscle)
2. anhidrosis (absence of sweating) and flushing (rubor) of affected side of face
3. Miosis (pupil constriction)
PAM is horny (horner's) |
|
|
Term
| What conditions can cause Horner's syndrome? |
|
Definition
| lesion of spinal cord above T1 (eg, Pancoast's tumor, Brown-Sequard syndrome, last stage syringomyelia). |
|
|
Term
| What is the function of muscle spindles? |
|
Definition
|
|
Term
| what is the function of Golgi tendon organs? |
|
Definition
| monitors muscle tension and prevent tendon tear. |
|
|
Term
|
Definition
|
|
Term
| Triceps reflex nerve root |
|
Definition
|
|
Term
| Patella reflex nerve root |
|
Definition
|
|
Term
| Achilles reflex nerve root |
|
Definition
|
|
Term
| erection and sensation of penile and anal zones |
|
Definition
|
|
Term
|
Definition
| "hang for life" reflex-abduct/extend limbs when startled, and then draw together |
|
|
Term
|
Definition
"nipple seeking"
movement of head toward one side of cheek or mouth is stroked |
|
|
Term
|
Definition
| sucking response when roof of mouth is touched |
|
|
Term
| palmar and plantar reflexes |
|
Definition
| curling of fingers/toes if palms of hands/feet are stroked |
|
|
Term
| what is parinaud syndrome? |
|
Definition
| paralysis of conjugate vertical gaze due to lesion in superior colliculi (eg, pinealoma) |
|
|
Term
| what are the functions of facial cranial nerve VII |
|
Definition
| famcial movement, taste from anterior 2/3 of tongue, lacrimation, salivation (submandibular and sublingual glands), eyelid closing (orbicularis oculi), stapedius muscle in ear |
|
|
Term
| what are the functions of glossopharyngeal (IX) nerve? |
|
Definition
| taste from posterior 1/3rd of the tongue, swallowing, salivation (partoid gland), monitoring carotid body and sinus chemo-and baroreceptors, and stylopharygeus (elevates pharynex, larynx) |
|
|
Term
| what are the functions of vagus nerve (X) |
|
Definition
| taste from epiglottic region, swallowing, palate elevation, midline uvula, talking, coughing, thoracoabdominal viscera, monitoring aortic arch chemo-and baroreceptors. |
|
|
Term
| what are the functions of accessory nerves (XI) |
|
Definition
| Head turning, shoulder shrugging (SCM, trapezius) |
|
|
Term
| what are the functions of hypoglossal nerve (XII)? |
|
Definition
|
|
Term
| What cranial nerve nuclei are located in the midbrain? |
|
Definition
|
|
Term
| what cranial nerves are located in the Pons? |
|
Definition
|
|
Term
| What cranial nerves are located in the medulla? |
|
Definition
|
|
Term
| What is the corneal reflex pathway? |
|
Definition
Afferent: V1 ophthalmic (nasociliary branch:levator palpebrae)
Efferent: VII temporal branch: orbicularis oculi) |
|
|
Term
| what is the lacrimation reflex pathway? |
|
Definition
Afferent: V1 (loss of reflex does not preclude emotional tears)
Efferent: VII |
|
|
Term
| what is the pathway for jaw jerk reflex |
|
Definition
Afferent: V3 (sensory-muscle spindle from masseter)
Efferent: V3 (motor-masseter) |
|
|
Term
| what is the pupillary reflex pathway? |
|
Definition
Afferent: II
Efferent: III |
|
|
Term
| what is the pathway of gag reflex |
|
Definition
Afferent: IX
Efferent: IX, X |
|
|
Term
| what nerves pass through Cavernous sinus? |
|
Definition
| CN III, IV, V1, V2, and VI |
|
|
Term
|
Definition
| due to mass effect->ophthalmoplegia, ophthalmic and maxillary sensory loss. |
|
|
Term
| what cranial nerve lesion causes tongue to deviate TOWARD the side of lesion? |
|
Definition
| CN XII, it decussates before medulla and synapse on contrallateral hypoglossal nucleus |
|
|
Term
| what CN lesion causes the jaw to deviate toward the side of lesion? |
|
Definition
| CN V motor lesion, it has bilateral cortical input to lateral pterygoid muscle. |
|
|
Term
| what CN lesion causes uvula deviates away from side of lesion? |
|
Definition
| CN X lesion. The weak side collapses and uvula points away. |
|
|
Term
| What CN lesion causes weakness turning head to contralateral side of lesion (SCM) and Shoulder droop on side of lesion (trapezius) |
|
Definition
|
|
Term
|
Definition
| contralateral paralysis of lower face only, since upper face receieves bilateral UMN innervation. |
|
|
Term
|
Definition
| ipsilateral paralysis of upper and lower face |
|
|
Term
| Bell's palsy mech and clinical prez |
|
Definition
complete destruction of the facial nucleus itself or its branchial efferent fibers (facial nerve proper).
Peripheral ipsilateral facial paralysis with inability to close eye on involved side |
|
|
Term
| What can cause Bell's palsy? |
|
Definition
| idiopathic, AIDS, lymes disease, Herpes zoster, Sarcoidosis, Tumors, Diabetes (ALexander graHam Bell with STD) |
|
|
Term
| What does Kuh-Kuh-Kuh test? |
|
Definition
| palate elevation (CN X-vagus) |
|
|
Term
|
Definition
| tongue (CN XII-hypoglossal) |
|
|
Term
|
Definition
|
|
Term
| what muscle opens your mouth? |
|
Definition
|
|
Term
|
Definition
| Masseter, teMporalis, and Medial pterygoid |
|
|
Term
| all muscles with root glossus in their names (except palatoglossus), are innervated by what? |
|
Definition
hypoglossal nerve
palatoglossus is innervated by vagus nerve |
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Term
| all muscle with root palat in their names (except tensor veli palatini) are innervated by what? |
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Definition
vagus nerve.
tensor veli palatini is innervated by mandibular branch of CN V |
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Term
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Definition
Normal results
COWS: cold opposite, warm same side
cold water irrigation of ear: nystagmus to opposite side
warm water irrigation, nystagmus to same side |
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Term
| In hearing loss, if BC>AC...then? |
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Definition
| there is conduction deafness in that ear (Weber lateralizes to that ear) |
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Term
| What's the Weber result if AC>BC but there is sensorineural loss? |
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Definition
| Weber lateralize to opposite ear |
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Term
| In normal hearing, which is better? AC or BC? |
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Definition
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Term
| what is endolymph in inner ear? |
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Definition
| made by stria vascularis, K+ rich. |
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Term
| what is perilymph in inner ear? |
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Definition
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Term
| what are the functions of utricle and saccule? |
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Definition
| detects linear acceleration |
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Term
| what is the function of semicircular canals? |
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Definition
| detects angular acceleration |
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Term
| What receptors does pupillary dilator/radial muscle have? what happens if you stimulate it? |
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Definition
| alpha 1. stimulation causes mydriasis. |
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Term
| what receptor does the pupillary sphincter/circular/constrictor muscle have? what happens if you stimulate it? |
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Definition
| M3, stimulation causes miosis |
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Term
| what receptor does the ciliary process have? what happens if you stimulate it |
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Definition
| beta receptors, stimulation causes it to produce aqueous humor. |
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Term
| what receptor does the ciliary muscle have? what happens if you stimulate it? |
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Definition
| M3. accommodation if stimulated. |
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Term
| what is open/wide angle glaucoma? |
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Definition
| obstructed outflow (eg., canal of Schlemm); associated with myopia, incr'd age, African-American race. More common, "silent" and painless. |
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Term
| what is closed/narrow angle glaucoma? |
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Definition
| obstruction of flow between iris and cornea->pressure buildup behind iris. Very painful, decr'd vision, rock-hard eye, frontal headache. An ophthalmogloic emergency. DO NOT GIVE EPINEPHRINE. |
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Term
| Eye looks down and out; ptosis, pupillary dilation, loss of accomodation. What CN is damaged? |
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Definition
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Term
| Diplopia with a downward gaze (adjust by tilting head toward lesion). What CN lesion? |
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Definition
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Term
| Medially directed eye, what CN lesion? |
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Definition
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Term
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Definition
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Term
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Definition
| fat deposition and causes gradual decr in vision |
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Term
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Definition
| rapid, due to neovascularization |
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Term
| what kind of eye problems do pt with MS frequently have? |
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Definition
| lesion in the medical longitudinal fasciculus (MLF)-> medical rectus palsy on attempted lateral gaze. Nystagmus in abducting eye. Convergence is normal |
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Term
| What genes are associated with Alzheimer's disease? |
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Definition
Down syndrome
Early onset: APP (21)
Late onset: ApE4 (19)
ApeE2 is protective |
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Term
| what are the histologic/gross findings of Alzheimer's? |
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Definition
1. Widespread cortical atrophy
2. decr ACh
3. Senile plagues
4. Neurofibrillary tangles |
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Term
| What is Pick's disease (frontotemporal dementia)? |
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Definition
Dementia, aphasia, parkinsonian aspects; CHANGE IN PERSONALITY. Spares parietal lobe and posterior 2/3 of superior temporal gyrus.
histological findings: Pick bodies (tau proteins). Frontotemporal atrophy. |
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Term
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Definition
Parkinsonism with dementia and hallucinations.
alpha-synucein defect. |
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Term
| Creutzfeldt-Jakob disease (CJD) |
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Definition
rapidly progressive (weeks to months) dementia with myoclonus.
findings: Spongiform cortex, prions (alpha helix->beta sheet,resistant to protease) |
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Term
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Definition
SIN
Scanning speech
Intention tremor
Incontinence, Internuclear ophthalmoplegia
Nystagmus |
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Term
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Definition
| incr protein (IgG) in CSF. Oligoclonal bands are diagnostic. MRI gold standard. Periventricular plagues (areas of oligodendrocyte loss and reactive gliosis) with preservation of axons |
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Term
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Definition
| beta interferon or immunosuppressant therapy |
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Term
| What is Guillain-Barre syndrome? |
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Definition
| inflammation and demyelination of peripheral nerves and motor fibers of ventral roots (sensory effect less severe than motor), causing symmetric ascending muscle weakness beginning in dstal lower extremities. Facial paralysis in 50% of cases. Autonomic function maybe severely affected (eg, cardiac irregularities, hypertension, or hypotension). Almost all pt survive; the majority recover completely after weeks to months. |
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Term
| Guillain-Barre lab findings |
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Definition
| elevated CSF protein. papilledema |
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Term
| Is Guillain-Barre associated with infection? |
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Definition
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Term
| How do you treat Guillain-Barre syndrome? |
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Definition
| all pt will completely recover after weeks to month. Respiratory support is critical until recover. Additional treatment: plasmapheresis, IV immune globulins. |
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Term
| Progressive multifocal leukoencephalopathy (PML) |
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Definition
| demylination of CNS due to destruction of oligodendrocytes. Associated with JC virus and seen in 2-4% of AIDS patients (reactivation of latent viral infection). Rapidly progressive, usually fatal. |
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Term
| Acute disseminated (postinfectious) encephalomyelitis |
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Definition
| mutlifocal perivenular inflammation and demyelination after infection (eg, chickenpox, measles) or certain vaccinations (eg, rabies, smallpox) |
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Term
| metachromatic leukodystrophy |
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Definition
| autosomal-recessive lysosomal storage disease, most commonly due to arylsulfatase A def. Buildup of sulfatides leads to impaired production of myelin sheath. |
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Term
| Charcot-Marine-Tooth disease (hereditary motor and sensory neuropathy (HMSN) |
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Definition
| group of progressive hereditary nerve disorders related to the defective production of proteins involved in the structure and function of peripheral nerves or myelin sheath. |
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Term
| What defines partial seizures? |
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Definition
| 1 area of the brain. Most commonly orginates in mesial temporal lobe. Often preceded by seizure aura; can secondarily generalize. |
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Term
| what is simple partial seizure? |
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Definition
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Term
| what happens to consciousness during a complex partial seizure? |
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Definition
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Term
| What does the pt look like during absence seizure? |
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Definition
| blank staire, no postictal confusion. |
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Term
| what is a myoclinic seizure? |
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Definition
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Term
| what is a tonic-clonic (grand mal) seizure? |
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Definition
| alternating stiffening and movement |
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Term
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Definition
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Term
| what is a atonic seizure? |
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Definition
| "drop" seizures...pt falls to floor. Commonly mistaken for fainting. |
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Term
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Definition
unilateral; 4-72 hours of pulsating pain with nausea, photophobia, or phonophobia. +/- "aura" of neurologic symptoms before headache, including visual, sensory, speech distrubances. Due to irritation of CN V and release of substance P, CGRP, vasoactive peptides.
Treatment: propranolol; NSAIDs; sumatriptan for acute migraines. |
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Term
| what is tension headache? |
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Definition
| bilateral; >30 minutes of steady pain. Not aggrevated by light or noise; no aura. |
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Term
| what is cluster headache? |
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Definition
| unilateral; repetitive brief headaches characterized by periorbital pain associated with ipsilateral lacrimation, rhinorrhea, Horner's syndrome. Much more common in males. Treatment; Sumtriptan |
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Term
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Definition
congenital disorder with prot-wine stains (aka nevus flammeus), typically in V1 ophtalmic distribution; ipsilateral leptomeningeal angiomas, pheochromocytomas.
Can cause gaucoma, seizures, hemiparesis, and mental retwardation. Occurs sporadically. |
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Term
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Definition
| Hamartomas in CNS, skin, organs, cardiac rhabdomyoma, renal angiomyolipoma, subependymal giant cell astrocytoma, mitral regurgitation, seizures, hypopigmented "ash leaf spots," sebaceous adenoma, shagree patch. Autosomal dominant. |
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Term
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Definition
| Cafe au lait spots, lisch nodules (pigmented iris hamartomas), neurofibroas in skin, optic gliomas, pheochromocytomas. Autosomal dominant. Mutated NF-1 Gene on chromosome 17. |
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Term
| Von Hippel-Lindau disease |
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Definition
| Cavernous hemangiomas in skin, mucoas, organs; bilateral renal cell carcinoma, hemangioblastoma in retina, brain stem, cerebellum; pheochromocytomas. Autosomal dominant; mutated tumor suppressor VHL on chromosome 3 |
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Term
| True or false, half of the th adult brain tumores are metastases |
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Definition
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Term
| what is the most common primary brain tumor in adults? |
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Definition
| Glioblastoma multiforme (grade IV astrocytoma). Grave prognosis. Can cross cropus callosum->"butterfly glioma" Stain astrocytes for GFAP |
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Term
| what is the second most common adult brain tumor? |
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Definition
| Meningioma. often occurs in convexities of hemispheres and parasagittal region. Arises from arachnoid cells external to brain. Resectable. has Psammoma bodies. |
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Term
| what's the 3rd most common adult brain tumor? |
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Definition
| Schwannoma. Often localize to CN VIII->acoustic schwannoma. Resectable. S-100 positive |
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Term
| what adult brain tumor has the "fried egg" cells? |
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Definition
| Oligodendroglioma. Rare and slow growing. |
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Term
| Pilocytic (low grade) astrocytoma |
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Definition
| well circumscribed childhood brain tumor. GFAF positive. Rosenthal fibers-eosinophilic, crokscrew fibers. Cystic and solid. Good prognosis. |
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Term
| what's the second most common childhood brain tumor? |
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Definition
| medullobastoma, a form of prmitive neuroectodermal tumor (PNET). Can compress 4th ventricle, causing hydrocephalus. has small blue cells and is radiosensitive. |
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Term
| what is the third most common brain tumor in children? |
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Definition
| Ependymoma. Found in 4th ventricle...can cause hydrocephalus. |
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Term
| what childhood brain tumor is associated with von Hipple-Lindau disease? |
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Definition
| Hemangioblastoma. Has foamy cells and high vascularity. |
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Term
| what's the mech of barbiturates? |
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Definition
| facilitate GABAa action by incr duration of Cl- channel opening, thus decr neuron firing. |
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Term
| what's the mech of benzodiazepines? |
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Definition
| Facilitate GABAa action by increasing frequency of Cl- channel opening |
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Term
| Can barbiturates cause coma even death? |
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Definition
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Term
| Can benzodiazepines cause coma even death? |
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Definition
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Term
| why are barbiturates contraindicated in prophyria? |
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Definition
| because barbiturates induce liver Cytochrome P-450 and thus induce heme production. |
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Term
| given lorazepam and diazepam, which one would you use? |
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Definition
| They are both long acting, but I would use lorazepam because diazepam has too many active metabolites that are benzodiazepines themselves. |
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Term
| what's the shortest acting benzodiazepine and would you use it for controlling seizure? |
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Definition
| it's midazolam and I would not use it for seizures because it's T1/2 is in minutes!! |
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Term
| which epilepsy drug has the unique toxicities of gingival hyperplasia and hirsutism? |
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Definition
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Term
| Which epilepsy drug that is also DOC for trigeminal neuralgia? |
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Definition
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Term
| which epilepsy drug is the 1st line for pregnant women and children? |
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Definition
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Term
| what's the first line epilepsy drug for absence seizure? |
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Definition
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Term
| what's the use of Succinylcholine? Mech? |
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Definition
Muscle paralysis in surgery or mechanical ventilation
it looks just like Ach!
noncompetitive depolarizing agent |
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Term
| what are the complications from using succinylcholine? |
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Definition
hypercalcemia
hyperkalemia
malignant hyperthermia |
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Term
| what's the antidote for succinylcholine and what kind of limitation does it have? |
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Definition
| we can use cholineesterase inhibitors such as neostigmine but it only works during phase II...when the muscle cells are repolarized but blocked. |
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Term
| What are curare like drugs used for and what's their mech? |
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Definition
they are used for muscle paralysis in surgery or mechanical ventilation.
they are competitive antagonists for the Ach receptors |
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Term
| which curare like drug is safe to use for pt with hepatic/renal impairment? |
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Definition
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Term
| what side effect does atracurium have? |
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Definition
seizures
atracurium is spontaneously inactivated to ladanosin...which causes seizure. |
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Term
| what's short acting curare like durg? |
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Definition
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Term
| what's the antidote for curare like drugs? |
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Definition
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Term
| what's dantrolene used for and what is it's mech? |
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Definition
| malignant hyperthermia caused by succinylcholine. it prevents the release of Ca++ from the sacroplasmic reticulum of skeletal muscle. |
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Term
| what's the active metabolite of morphine? is it more potent than morphine itself? |
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Definition
| Morphine-6-glucuronide is the active metabolite of morphine...its' more potent than morphine itself. |
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Term
| what's special about codeine as an opioid analgeic? |
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Definition
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Term
| why is methadone used for treating opioid addiction? |
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Definition
| because it's a long acting drug |
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Term
| what's about meperidine that sets it apart from the other opioid analgesics? |
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Definition
| AKA pethidine world wide, it is metabolized by P450 to normeperidine, an SSRI. It does not cause miosis. |
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Term
| what class of drugs work on opioid receptors to modulate synaptic transmission-through Gi coupling and open K+ channels, close Ca++ channels, decr synaptic transmission. Inhibit release of ACh, NE, 5HT, glutamate, and substance P? |
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Definition
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Term
| How does dextromethorphan work? |
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Definition
| it's an opioid related drug and suppresses cough...it dose not work on the mu receptor. |
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Term
| How does loperamide work? |
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Definition
| it's an opioid related drug so it used to treat diarrhea. |
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Term
| what's methylnaltrexone used for? |
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Definition
| it selectively antagonizes peripheral opioid receptors, treatment for opioid induced constipation. |
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Term
| what's the mech of opioid induced constipation? |
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Definition
| it relaxes the longitudinal smooth muscles and constricts circular smooth muscles |
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Term
| what's the mech of opioid induced constipation? |
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Definition
| it relaxes the longitudinal smooth muscles and constricts circular smooth muscles |
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Term
| what's the mech of opioid respiratory depression? |
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Definition
| it decreases CO2 response but O2 sensors are not affected. Do you give oxygen or you will cause the pt to really stop breathing! |
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Term
| Does tolerance develop for miosis and constipation for opioid analgesics? |
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Definition
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Term
| what are naloxone and naltrexone and what are they used for? |
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Definition
| they are opioid receptor antagonists |
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Term
| which opioid analgesics does not cause miosis? |
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Definition
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Term
| what drug is an partial agonist at opioid mu receptors, agonist at kappa receptors and thus causes dysphoria? |
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Definition
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Term
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Definition
| a very weak opioid agonist; also inhibits serotonin and NE reuptake (works on multiple neuortransmitters - "tram it all" in). |
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Term
| why is clonidine useful for treating opioid withdraw? |
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Definition
| It's a centrally acting alpha agonist, causes reduced central adrenergic outflow (NE). opioid withdraw symptoms are caused by sensitized alpha and beta receptors being overly stimulated. |
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Term
| what are the drugs used for Parkinson's? |
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Definition
BALSA
bromocriptine
Amantadine
Levodopa (with carbidopa)
Selegiline (and COMT inhibitors)
Antimuscarinics (Benztropine) |
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Term
| How does Bromocriptine work? |
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Definition
| it agonizes dopamine receptors |
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Term
| how does amantadine work? |
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Definition
| increases dopamine release |
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Term
| How does L-dopa/carbidopa work? |
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Definition
| converted to dopamine in CNS |
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Term
| how does selegiline work? |
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Definition
| prevent dopamine breakdown |
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Term
| How does Benztropine work for Parkinson's disease? |
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Definition
it curbs excess cholinergic activity
Park your Mercedes-Benz |
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