IVMS Neuroscience Flash Facts

Neuroscience Flash Facts
Q0001:Patient presents with decreased pain and temperature sensation over the lateral aspects of both arms;What is the lesion?
Syringomyelia`
Q0002:Penlight in patient's right eye produces bilateral pupillary constriction. When moved to the left eye there is paradoxical dilation;What is the defect
atrophy of left optic nerve
Q0003:patint describes decreased prick sensation on the lateral aspect of her leg and foot;deficit of what muscular action is expected?
dorsiflection and eversion of foot (common peroneal nerve)
Q0004:elderly woman presents with arthritis and tingling over the lateral digits of her right hand;what is the diagnosis?
carpal tunnel syndrome; median nerve compression
Q0005:decreased reports decreased plantar flexion and decreased sensation over the back of thigh; calf; and lateral half of foot;what spinal nerve is involved
tibial (L4-S3)
10
Q0006:patient cannot turn her head to the left and has right shoulder droop?;what structure is damaged?
11
Right CNXI (runs thru jugular foramen with IX and X) innervating sternocleidomastoid and trapezius muscles
12
Q0007:man presents with one wild; flailing arm;where is the lesion
13
contralateral subthalamic nucleus (hemiballismus)
14
Q0008:patient with cortical lesion does not know that he has a disease;where is the lesion
15
right parietal lobe
16
Q0009:patient cannot protruede tongue toward left side and has a right sided spastic paralysis;wehre is the lesion?
17
left medulla
18
Q0010:after fall that injures elbow; pt can't feel medial palm;which nerve and what injury?
19
ulnar nerve due to broken medial condyle
20
Q0011:midshaft break of the humerus;what nerve and artery likely to be damaged
21
radial nerve and deep brachial artery; which run together
22
Q0012:patient cannot blink right eye or seal lips and has mild ptosis on right side;what is diagnosis; what nerve affected?
23
Bell's palsy; cn vii
24
Q0013:patient complains of pain; numbness; and tingling. on exam; wasting of thenar eminence;what diagnosis; what nerve?
25
carpal tunnel; median nerve
26
Q0014:during a particular stage of sleep; man has variable blood pressure; penile tumescence; and variable eeg;what stage?
27
rem
28
Q0015:episodes of hypoglycemia; blood analysis reveals no elevation in c protein;what diagnosis?
29
factitious disorder; self scripted insulin
30
Q0016:headache; visual disturbance; galactorrhea; amenorrhea;what dx?
31
prolactinoma
32
Q0017:middle aged pt with dizziness and tinnitus. ct shows enlarged internal acoustic meatus;what dx?
33
schwannoma
34
Q0018:25 year old female with uniocular vision loss; slurred speech. history of weakness and paresthesias that have resolved;dx?
35
MS
36
Q0019:child "paces out". quivering lips during spells;dx?
37
absence seizure
38
Q0020:man on antidepressants has mydriasis and becomes constipated;what is cause of sx?
39
tricyclic antidepressants
40
Q0021:woman on MAO inhibitor has hypertensive crisis after a meal;what did she ingest?
41
tyramine (wine or cheese)
42
Q0022:patient has his right arm hanging by his side; medially rotated and his forearm is pronated. What is this condition called and what part of the brachial plexus is injured?
43
"Waiter's tip" Erb-Duchenne palsy; traction of upper trunk (C5; C6)
44
Q0023:injury to what part of the brachial plexus results in a hand that looks like a claw?
45
lower trunk (C8; T1)
46
Q0024:what are symptoms of an injury to the lower trunk of the brachial plexus?
47
1. atrophy of the thenar and hypothenar eminences;2. atrophy of the interosseous muscles;3. sensory deficits on the medial side of the forearm and hand;4. disappearance of the radial pulse upon moving the head toward the opposite side
48
Q0025:Which nerves arise from the posterior cord of the brachial plexus?
49
axillary nerve and radial nerve
50
Q0026:injury to the posterior cord of the brachial plexus results in what?
51
wrist drop and deltoid paralysis
52
Q0027:what nerve roots serve the long thoracic nerve?
53
C5; C6; C7
54
Q0028:What happens when the long thoracic nerve is damaged?
55
winged scapula
56
Q0029:What nerve supplies function to the deltoid muscle? From where on the brachial plexus does it derive?
57
Axillary nerve from the posterior cord
58
Q0030:A lesion in the radial nerve causes what?
59
wrist drop (extensor muscles of wrist) and sensory deficit on posterior arm and dorsal hand of first 3.5 digits
60
Q0031:what muscle protects the brachial plexus from injury during a clavicle fracture?
61
subclavius muscle
62
Q0032:injury to musculocutaneous nerve will cause what motor defect
63
difficulty in flexing elbow
64
Q0033:abduction and opposition of thumb and finger flexion is controlled by what nerve?
65
median nerve
66
Q0034:ulnar nerve supplies what motor and sensory function?
67
Motor: adduction of thumb; palmar and dorsal interosseus muscles. Sensory: palmar and dorsal aspect of little finger and half of ring finger
68
Q0035:Shoulder dislocation typically causes what brachial plexus injury?
69
Axillary nerve paralysis (cannot abduct arm past 90 degrees)
70
Q0036:a midshaft humerus fracture can affect which nerves?
71
either radial nerve causing a wrist drop and posterior arm and dorsal hand paresthesia or musculocutaneous nerve affecting flexion of arm at elbow and sensory loss of lateral arm
72
Q0037:a supracondylar humerus fracture or a palmar wrist injury will affect what nerve?
73
median nerve affecting flexion of fingers and abduction/opposition of thumb as well as sensation of majority of palmar aspect of hand
74
Q0038:a fracture of medial epicondyle of humerus or wrist fracture on medial aspect of wrist will affect what nerve?
75
ulnar nerve; resulting in an inability to adduct or abduct fingers or adduct thumb and sensation of last 1.5 digits
76
Q0039:What muscles are innervated by the radial nerve?
77
Brachioradialis; Extensors of wrist and fingers; Supinator; Triceps
78
Q0040:What motor and sensory functions does the obturator nerve serve?
79
adduction of thigh; and sensory on medial aspect of thigh
80
Q0041:anterior hip dislocation affects what nerve?
81
obturator nerve
82
Q0042:pelvic fracture affects what nerve?
83
femoral nerve
84
Q0043:what motor and sensory functions does the femoral nerve have?
85
flexion of thigh and extension of leg; sensory on anterior thigh and medial leg
86
Q0044:trauma to lateral aspect of leg or fibula neck fracture may damage what nerve?
87
common peroneal nerve
88
Q0045:what motor and sensory functions does the common peroneal nerve serve?
89
eversion and dorsiflexion of foot; extension of toes; sensory on anterolateral leg and dorsal foot
90
Q0046:knee trauma can affect what nerve?
91
tibial nerve
92
Q0047:tibial nerve serves what motor and sensory functions?
93
inversion and plantarflexion of foot and flexion of toes; sensory to sole of foot
94
Q0048:posterior hip dislocation and polio may affect what nerve?
95
superior gluteal nerve or inferior gluteal nerve
96
Q0049:the superior gluteal nerve serves what functions?
97
abduction of thigh (positive trendelenburg sign if damaged)
98
Q0050:damage to the inferior gluteal nerve causes what motor deficits?
99
inability to jump; climb stairs; or rise form seated position (gluteus maximus paralysis)
100
Q0051:Deep Fibular Nerve
101
FOOT DROP; paresthesia in webspace between big toe and second toe
102
Q0052:Femoral Nerve
103
(from posterior division of L2; L3; L4);longest branch is saphenous nerve - sensation over area of great saphenous vein; impaired ability to flex at hip and extend knee; decreased patellar reflex
104
Q0053:Superior Gluteal Nerve
105
(L4; L5; S1 - exits via greater sciatic foramen above piriformis) innervates gluteus medius; minimus and tensor fascia latae; impaired hip abduction ; in walking - "Trendlenburg" gait: pelvic tilt (sag) toward opposite side form lesion
106
Q0054:Inferior Gluteal Nerve
107
(L5-S2; gluteus maximus - exits greater sciatic foramen below piriformis w/ pudendal and sciatic);impaired lateral rotation and extension of thigh at hip; DIFFICULTY GETTING UP FROM A CHAIR; gluteus minimus gait = thrust torso posteriorly
108
Q0055:Superficial Fibular Nerve
109
impaired eversion and dorsal sensation; but extension is intact
110
Q0056:Tibial Nerve
111
"tarsal tunnel syndrome" = decreased flexion of big toe; difficulty standing on tiptoe
112
Q0057:Obdurator Nerve
113
(L2-4; anterior division; medial thigh-adductors- exits via obdurator canal);impaired adduction of thigh at hips
114
Q0058:Terrible triad
115
anterior cruciate ligament;medial collateral ligament;medial meniscus
116
Q0059:Anterior drawer sign
117
tibia displaced anteriorly to femur in flexed knee;indicated ACL tear
118
Q0060:Sx of torn Medial collateral ligament
119
pain when leg is rotated medially at the knee (abnl passive abduction)
120
Q0061:Foot drop (loss of dorsiflexion)
121
tibialis anterior;Comon peroneal nerve;(L4-S2);(PED: Peroneal Everts and Dorsiflexes)
122
Q0062:Loss of plantar flexion
123
gastroc and soleus;Tibial N;(L4-S3);TIP: Tibial Inverts and Plantarflexes (if injured; can't stand on TIPtoes)
124
Q0063:Loss of knee jerk
125
Femoral Nerve;L2;3;4
126
Q0064:Loss of hip adduction
127
Obdurator (L2;3;4)
128
Q0065:Vertebral disk herniation usu occurs between which vertebrae?
129
between L5 and S1;Sciatica!
130
Q0066:Lumbar puncture pierces which structures?
131
SLEDsA to CSF;Skin/superficial fascia;Ligaments (supraspinous; interspinous and ligmentum flavum if puncture is off midline);Epidural space and intralaminal space;Dura mater;subdural potential space;Arachnoid;CSF is in the subarachnoid space
132
Q0067:Which nerve extends the knee?
133
femoral
134
Q0068:Which nerve flexes the knee?
135
Tibial
136
Q0069:Nerves that contain fibers from the superior rami of the plexus (L2-L4) innervate muscles in the
137
anterior compartment (that act at the hip and knee joint).
138
Q0070:Nerves that contain fibers from the inferior rami of the plexus (S1-S3) innervate muscles of
139
the leg (that act on ankle and foot joints)
140
Q0071:Dermatome paresthesia at the anterior thigh
141
L3
142
Q0072:Dermatone paresthesia at the medial leg
143
L4
144
Q0073:Dermatome paresthesia at the anterior leg and dorsum of foot
145
L5
146
Q0074:Dermatome paresthesia at the lateral foot and sole
147
S1
148
Q0075:Patellar tendon reflex
149
L4
150
Q0076:Achilles tendon reflex
151
S1
152
Q0077:Obturator nerve comes from
153
L2-L4 (anterior division)
154
Q0078:Femoral
155
L2-L4 (posterior division)
156
Q0079:Common Fibular comes from roots
157
L4 L5 S1 S2 (posterior division)
158
Q0080:Tibial nerve comes from roots
159
L4 L5 S1-S3 (anterior division)
160
Q0081:Motor weakness with obturator lesion
161
adduction of thigh (affected hip flexors and hip adductors)
162
Q0082:motor weakness with femoral lesion
163
extension of knee
164
Q0083:motor weakness with common fibular lesion
165
foot drop (dorsiflexion; foot eversion)
166
Q0084:motor weakness with tibial lesion
167
no plantar flexion or toe flexion
168
Q0085:Pregnancy can cause compression of
169
L3/obturator
170
Q0086:Psoas abscess can cause a lesion of
171
Femoral
172
Q0087:Common (4) injuries to the Common Fibular nerve
173
1) compression at fibula neck;2) hip fracture or dislocation;3) misplaced gluteal injection;4) piriformis syndrome
174
Q0088:Penetrating trauma to buttock or hip fracture/dislocation can cause nerve damage to
175
Common fibular or tibial
176
Q0089:Recurrent Laryngeal nerve The recurrent laryngeal nerve is a branch of which cranial nerve?
177
CN X
178
Q0090:Recurrent Laryngeal nerve Which muscles does it supply?
179
intrinsic muscles of the larynx except the cricothyroid muscle
180
Q0091:Recurrent Laryngeal nerve What structure does the right recurrent laryngeal nerve wrap around?
181
right subclavian artery
182
Q0092:Recurrent Laryngeal nerve What structure does the left recurrent laryngeal nerve wrap around?
183
arch of the aorta and the ligamentum arteriosum
184
Q0093:Recurrent Laryngeal nerve In what kind of surgery can this nerve be damaged in?
185
thyroid surgery
186
Q0094:Recurrent Laryngeal nerve What happens when this nerve gets damaged?
187
hoarseness
188
Q0095:Name the layers of the scalp
189
skin; connective tissue; aponeurosis; loose connective tissue; pericranium (SCALP)
190
Q0096:Name the meninges.
191
Dura; arachnoid; and pia (DAP)
192
Q0097:Recurrent Laryngeal nerve What space is found between the dura and arachnoid?
193
subdural space
194
Q0098:Between what meninges is the subarachnoid space located?
195
between the arachnoid and the pia
196
Q0099:What is found in the subarachnoid space?
197
CSF
198
Q0100:In which scalp layer are the emissary veins found?
199
loose connective tissue
200
Q0101:Nerve Injury Injury to what nerve causes loss of dorsiflexion of foot
201
common peroneal (L4-S2) (PED = Peroneal Everts and Dorsiflexes)
202
Q0102:Nerve Injury Injury to what nerve causes loss of plantar flexion
203
tibial (L4-S3) (TIP = Tibial Inverts and Plantarflexes; if injured; can't stand on TIPtoes)
204
Q0103:Nerve Injury Loss of Knee Jerk?
205
Femoral (L2-L4)
206
Q0104:Nerve Injury Loss of hip adduction? Roots?
207
Obturator (L2-L4)
208
Q0105:Nerve Injury In adults; where does the spinal cord end?
209
L1-L2
210
Q0106:Nerve Injury Where does the subarachnoid space end?
211
S2
212
Q0107:Nerve Injury divide the 31 spinal nerves into their divisions
213
8Cs; 12Ts; 5Ls; 5Ss; 1 coccygeal
214
Q0108:What cell is responsible for physical support and repair; as well as K+ metabolism
215
astrocytes
216
Q0109:what are the phagocytic cells of the nervous system
217
microglia
218
Q0110:what cells produce myelin in the CNS
219
oligodendricytes
220
Q0111:what cells produce myelin in the PNS
221
Schawnn cells
222
Q0112:What three structures form the BBB
223
Choroid plexus epithelium; Intracerebral capillary endothelium; Arachnoid (remember CIA)
224
Q0113:Do nonpolar/lipid soluble substances or polar; watersoluble substances pass through the BBB more easily?
225
Nonpolar/lipid soluble
226
Q0114:Why is L-dopa; not dopamine; the treatment of choice in Parkinson's Disease
227
L-dopa crosses the BBB
228
Q0115:What are the functions of the hypothalamus (7)
229
Thirst; Adenohypophysis control; Neurohypophysis hormone synthesis; Hunger; Autonomic regulation (including circadian rhythms); Temperature regulation; Sexual urges (TAN HATS)
230
Q0116:anterior hyporthalamus control function?
231
Cools body when hot;Anterior Cooling = A/C
232
Q0117:Does the posterior hypothalamus control heat conservation?
233
Yes; think no Posterior hypothalamus = poikilotherm (cold blooded snake)
234
Q0118:Which nucleus is responsible for hunger?
235
Lateral nucleus
236
Q0119:Which nucleus is responsible for satiety?
237
ventromedial nucleus (without which you grow ventrally and medially
238
Q0120:Which nuclei of the hypothalamus project axons into the posterior pituitary?
239
supraoptic nuclei (ADH) and paraventricular nuclei (oxytocin)
240
Q0121:What is the function of the lateral geniculate nucleus?
241
Visual pathway (remember Lateral is needed to Look)
242
Q0122:What is the function of the medial geniculate nucleus?
243
Auditory pathway (remember Medial is to hear Music)
244
Q0123:Function of the ventral posterior nucleus; lateral part (VPL)?
245
receives body senses (proprioception; pressure; pain; touch; vibration)
246
Q0124:Function of the ventral posterior nucleus; medial part (VPM)?
247
receives facial sensations; including pain
248
Q0125:Ventral Nuclei (VA/VL) functions?
249
Motor
250
Q0126:What are the functions of the limbic system?
251
Feeding; Fighting; Feeling; Flight; and Sex (the five Fs)
252
Q0127:What two areas does the hippocampus project to?
253
the subiculum (mammillary nuclei) and the septal area
254
Q0128:Trace the pathway from Mammillary body to hippocampus.
255
Mammillary body; anterior nucleus of thalamus; cyngulate gyrus; entorhinal cortex; hippocampus
256
Q0129:Basal ganglia Describe the primary function fo the basal ganglia.
257
The basal ganglia mediates voluntary movements and postural adjustments
258
Q0130:Basal ganglia What are the roles of the direct and indirect pathways?
259
Indirect pathway inhibits movement; Direct pathway facilitates movement.
260
Q0131:Basal ganglia Delineate the flow of processing in the direct pathway.
261
Putamen (inhibitory) => Gpi (inhibitory) => Thalamus: inhibition of Gpi => activation of thalamus
262
Q0132:Basal ganglia Delineate the flow of processing in the indirect pathway.
263
Putamen (inhibitory) => GPe (inhibitory) => {STN (excitatory)=>GPi (inhibitory)} =>Thalamus; induces excitation of Gpi => inhibition of thalamus
264
Q0133:What is the anatomical defect in Parkinson's Dz?
265
Loss of substantia nigra pars compacta (SNc) dopamine output to putamen => activation of indirect pathway and inhibition of direct pathway
266
Q0134:What is the clinical presentation and cause of chorea?
267
sudden; jerky; purposeless movements; caused by basal ganglia lesionChorea= dancing; think choreography
268
Q0135:What is the clinical presentation and cause of athetosis?
269
slow; writhing movements; especially of fingers; caused by basal ganglia lesion
270
Q0136:What is the clinical presentation of hemiballismus?
271
sudden; wild flailing of 1 arm; half ballistic= as in throwing a baseball
272
Q0137:What is the anatomical defect in hemiballismus?
273
contralateral subthalamic nucleus lesion
274
Q0138:Where is the primary sensory cortex (S1) located?
275
anterior aspect of parietal lobe
276
Q0139:in smaller muscles; how many muscle fibers does an alpha motor neuron innervate?
277
just a few - results in finer control of movement
278
Q0140:cerebellum influences motor activity on which side?
279
ipsilateral - projects to contralateral motor cortex and red nuclei whose fibers cross back over
280
Q0141:what does the anterolateral system/spinothalamic tract carry?
281
pain; temperature; crude touch; and pressure
282
Q0142:what information do the dorsal columns carry?
283
fine touch; vibration; concious proprioception
284
Q0143:where does the corticospinal tract deccussate?
285
as it descends through the inferior aspect of the medulla through the medullary pyramids
286
Q0144:where do the dorsal columns cross over?
287
between their nuclei in the brainstem and the thalamus via the arcuate fibers of the medial lemniscus
288
Q0145:where do the axons of the spinothalamic tract cross over?
289
almost immediately after their first-order synapes in the dorsal horn
290
Q0146:what are the neurological deficits that occur in BrownSequard syndrome?
291
ipsilateral motor loss and loss of touch; vibration; propriceptive sense; contralateral pain and temperature loss
292
Q0147:where do the motor and sensory deficits manifes in patients with a lesion of the internal capsule?
293
corticospinal tract; dorsal columns; and spinothalamic tract travel to or from the cerebral cortex through the posterior limb - contralateral hemiplegia and contralateral sensory loss
294
Q0148:what is the primary mode of analgesic relief of opiods?
295
inhibition of the spinothalamic tract
296
Q0149:what disorder is characterized by loss of pyramidal cells in the cerebral motor cortex that leads to fibrosis of the lateral corticospinal tracts
297
ALS
298
Q0150:what is usually spared in ALS?
299
sensory tracts and cognitive function
300
Q0151:what are signs of UMN lesions?
301
spastic paralysis; hyperactive deep tendon reflexes; and clonus - UMNs are tonically inhibitory to LMNs
302
Q0152:what are signs of LMN lesions?
303
hporeflexia; fasciculations; flaccid paralysis
304
Q0153:familial forms of ALS have been associated with what?
305
mutations in the zinc/copper superoxide dismutase gene; which plays an important role in scavenging free radicals in metabolically active cells such as neurons
306
Q0154:periventricular plaques on MRI and oligoclonal bands in CSF are indicative of what?
307
MS
308
Q0155:what is destroyed in Parkinson's?
309
dopaminergic neurons in the substantia nigra
310
Q0156:what kind of drug is bromocriptine?
311
dopamine receptor agonist
312
Q0157:what is benztropine? why is it useful in PD?
313
anticholinergic - relative excess of Ach because of dopamine deficiency; anticholinergics can be useful in treating motor symptoms
314
Q0158:what compound that may be found in ilicit drugs can cause PD?
315
MPTP - selectively destroys neurons in the substantia nigra
316
Q0159:what is the difference between tremor in PD and tremor in cerebellar dysfunction?
317
PD - resting tremor;cerebellar dysfunction - tremor associated with volitional movements
318
Q0160:what is MG often associated with?
319
thymoma
320
Q0161:what is the pathophysiology of motor weakness in MG?
321
antibodies to the post-synaptic nicotinic ACh receptors on skeletal muscle fibers
322
Q0162:what type of receptors are nicotinic receptors?
323
ligand-gated sodium channels
324
Q0163:what kind of drug is edrophonium?
325
short-acting cholinesterase inhibitor - increases concentration of ACh in synaptic cleft
326
Q0164:what are the long-acting cholinesterase inhibitors?
327
pyridostigmine and neostigmine
328
Q0165:what are the side effects of cholinesterase inhibitors?
329
excessive PNS stimulation - diarrhea; miosis; bronchospasm; excessive urination; bradycardia; salivation; lacrimation; also sweating because SNS stimulates sweating via ACh
330
Q0166:how do you treat organophosphate poisoning?
331
treatment aimed at reducing total cholinergic activity palidoxine regenerates active cholinesterase; and anticholinergic atropine
332
Q0167:what is Lambert-Eaton syndrome?
333
AI disease with antibodies to voltage-gated calcium channels located in terminal bouton of presynaptic neurons result in impaired ACh release
334
Q0168:what is Lambert-Eaton syndrome often associated with?
335
paraneoplastic syndromes; particularly small cell CA of lung
336
Q0169:bilateral loss of pain and temperature sensation?
337
syringomyelia
338
Q0170:what is syringomyelia?
339
expanded fluid-filled cavity in spinal cord that affects the spinothalamic tract
340
Q0171:what produces atrophy of the muscles of hands and hypoactive reflexes of the upper extremities in syringomyelia?
341
expansion of the syrinx to compress the ventral horns produces LMN signs
342
Q0172:what should you examine for masses in a patient with trigeminal neuralgia?
343
posterior fossa
344
Q0173:what drug is used to treat trigeminal neuralgia?
345
carbamazapine - reduces rate of nerve transmission by inhibiting voltage-gated sodium channels of neurons
346
Q0174:what are CSF findings in MS?
347
oligoclonal immunoglobulin bands (absent in serum); elevated IgG; and myelin basic protein
348
Q0175:this is a disease that involves demyelination of various white matter areas of the CNS
349
MS
350
Q0176:what cell type is attacked and destroyed during an exacerbation of MS?
351
oligodendrocytes
352
Q0177:this syndrome is due to demyelination of peripheral nerves
353
Guillan-Barre
354
Q0178:this type of stroke primarily results from atherosclerosis and subsequent thrombus/embolism or from hypercoaguability in LA (e.g. atrial fibrillation) or LV (after MI)
355
ischemic stroke
356
Q0179:this type of stroke results predominantly from trauma; ruptured AV malformation; ruptured aneurysm; or vessel rupture due to hypertension
357
hemorrhagic
358
Q0180:how does atrial fibrillation predispose to stroke?
359
makes it easier for blood to pool and clot within the atria; and the clots can then embolize to brain
360
Q0181:what serves the motor and sensory cortex devoted to the contralateral leg?
361
anterior cerebral artery
362
Q0182:what does the MCA supply?
363
motor and sensory cortex for contralateral upper extremity; head; neck; and face
364
Q0183:what artery supplies Broca's and Wernicke's areas?
365
MCA (typically on left)
366
Q0184:occlusion of what can cause left homonymous hemianopsia?
367
right posterior cerebral artery - supplies visual cortex in occipital lobe
368
Q0185:worst headache of life; N&V; stiff neck; photophobia?
369
subarachnoid hemorrhage
370
Q0186:where do you do an LP?
371
L3-L4 or L4-L5 (SC terminates at L1-L2)
372
Q0187:what are the common causes of subarachnoid hemorrhage?
373
ruptured berry aneurysm; ruptured AVM; head trauma (most common)
374
Q0188:patients with PKD most often have berry aneurysms in what location?
375
bifurcation of anterior communicating artery
376
Q0189:almost one-half of cases of this are idiopathic; the rest develop after meningitis; subarachnoid hemorrhage; or intracranial surgery or develop as a result of a tumor
377
hydrocephalus
378
Q0190:CSF flows from the lateral ventricles into the third ventricle via what?
379
foramen of Monroe
380
Q0191:CSF flows from the third ventricle to the fourth ventricle via what?
381
cerebral aqueduct (aqueduct of Sylvius)
382
Q0192:how is CSF reabsorbed?
383
empties into dural venous sinuses via arachnoid granulations
384
Q0193:trauma that causes unconsciousness followed by lucid interval followed by confusion; lethargy; disorientation
385
epidural hematoma - intracranial bleeding that dissects periosteal dura away from skull
386
Q0194:this is composed of a periosteal layer adherent to bone and a meningeal layer continuous with the arachnoid layer
387
dura mater
388
Q0195:what artery is most commonly involved in an epidural hematoma?
389
middle meningeal artery - ruptures between dura and skull
390
Q0196:this layer attaches directly to brain parenchyma
391
pia
392
Q0197:does CSF show RBCs in an epidural bleed?
393
no - blood does not reach subarachnoid space where CSF is located
394
Q0198:what structures are typically involved in a subdural hematoma?
395
bridging veins that interconnect the subarachnoid space and the dural (venous) sinuses - more common in elderly people whose brains have atrophied
396
Q0199:what carries the efferent part of the corneal reflex?
397
facial nerve - causes contraction of the orbicularis oculi
398
Q0200:what carries the afferent part of the corneal reflex?
399
V1
400
Q0201:anticonvulsant with gingival hyperplasia; nystagmus; and ataxia as side effects?
401
phenytoin
402
Q0202:anticonvulsant with hepatotoxicity as potential side effect?
403
valproic acid
404
Q0203:anticonvulsants that can cause Stevens-Johnson syndrome?
405
lamotrigine; ethosuximide
406
Q0204:anticonvulsants that can cause respiratory depression?
407
phenobarbital; diazepam
408
Q0205:anticonvulsant that can cause agranulocytosis?
409
carbamazepine
410
Q0206:anticonvulsant that can cause tremor?
411
gabapentin
412
Q0207:what is the first line treatment for absence seizures?
413
ethosuximide
414
Q0208:what effects do most anticonvulsants have on neuronal discharge?
415
decrease the frequency of neuronal discharge by increasing the threshold for neuronal discharge - most do so by blocking sodium or calcium channels; but benzos activate chloride channels to hyperpolarize neurons
416
Q0209:how are AD and Pick's disease different?
417
AD: diffuse cerebral atrophy;Pick's: selecive atrophy of frontal and temporal lobes
418
Q0210:what class of drug is used to treat AD?
419
cholinesterase inhibitors - AD is associated with selective destruction of cholinergic neurons
420
Q0211:if a patient with AD has depression; what drugs should not be prescribed?
421
TCAs because they have powerful anticholinergic side effects that may exacerbate the cognitive decline due to AD
422
Q0212:what is the mechanism whereby short-term memory is consolidated into long-term memory?
423
long-term potentiation - occurs in hippocamus
424
Q0213:what is the second most common cause of dementia in the elderly?
425
multi-infarct dementia - focal neurologic defects
426
Q0214:what is the most common primary brain tumor?
427
astrocytoma
428
Q0215:what is the worst grade of astrocytoma?
429
glioblastoma multiforme
430
Q0216:what type of tumor has a characteristic pseudopaliasding arrangement of tumor cells?
431
glioblastoma multiforme
432
Q0217:why are lomustine and carmustine more suitable for treating brain tumors?
433
belong to a class of alkylating agents - nitrosureas - can effectively penetrate the BBB
434
Q0218:what is a meningioma?
435
benign tumor that arises from the arachnoid cells of the meninges - external to brain and so usually can be surgically resected
436
Q0219:Which cranial nerve opens eyelids?
437
III
438
Q0220:Which cranial nerve tastes from anterior 2/3 of tongue?
439
VII
440
Q0221:Which cranial nerve salivates from the submaxillary glands?
441
VII
442
Q0222:Which cranial nerve salivates from the submandibular glands?
443
VII
444
Q0223:Which cranial nerve closes eyelids?
445
VII
446
Q0224:Which cranial nerve tastes from posterior third of tongue?
447
IX
448
Q0225:Which cranial nerve salivates from parotid gland?
449
IX
450
Q0226:Which cranial nerve monitors carotid body and sinus chemo and baroreceptors?
451
IX
452
Q0227:Which cranial nerve tastes from epiglottic region?
453
454
Q0228:Which cranial nerve swallows?
455
456
Q0229:Which cranial nerve elevates palate?
457
458
Q0230:Where in the brain stem is the nucleus of the follow cranial nerve: 3
459
Midbrain
460
461
Midbrain
462
463
Pons
464
465
Pons
466
467
Pons
468
469
Pons
470
471
Medulla
472
473
Medulla
474
475
Medulla
476
477
Medulla
478
Q0240:Lateral or medial in brainstem: Sensory cranial nerve nuclei
479
Lateral (because Medial for Motor)
480
Q0241:Lateral or medial in brainstem: Motor cranial nerve nuclei
481
Medial for Motor
482
Q0242:What CNs are in the following nucleus and what kind of information does it carry: Nucleus Solitarius
483
8; 9; 10;Visceral sensory information (Solitarius is Sensory)
484
Q0243:What CNs are in the following nucleus and what kind of information does it carry: Nucleus Ambiguens
485
9; 10; 11;Motor innervation of pharynx larynx and upper esophagus (aMbiguens is Motor)
486
Q0244:What CNs are in the following nucleus and what kind of information does it carry: Dorsal motor nucleus
487
Sends parasympathetic fibers to heart; lungs; and upper GI
488
Q0245:What opening does the following structure pass through: Ophthalmic artery
489
Optic canal
490
Q0246:What opening does the following structure pass through: Central retinal vein
491
Optic canal
492
Q0247:What opening does the following structure pass through: CN III
493
Superior orbital fissure
494
Q0248:What opening does the following structure pass through: CN IV
495
496
Q0249:What opening does the following structure pass through: CN V1
497
Superior orbital fissure;Mnemonic for CN V: (Standing room only)
498
Q0250:What opening does the following structure pass through: CN VI
499
500
Q0251:What opening does the following structure pass through: Ophthalmic vein
501
502
503
Foramen rotundum;Mnemonic for CN V: (standing Room only)
504
505
Foramen ovale;Mnemonic for CN V: (standing Room only)
506
Q0254:What opening does the following structure pass through: Middle meningeal artery
507
Foramen spinosum
508
Q0255:What opening does the following structure pass through: Middle meningeal vein
509
Foramen spinosum
510
Q0256:What opening does the following structure pass through: Recurrent branch of V3
511
Foramen spinosum
512
Q0257:What opening does the following structure pass through: Accessory meningeal artery
513
Foramen ovale
514
Q0258:What opening does the following structure pass through: Lesser petrosal nerve
515
Foramen ovale
516
Q0259:What opening does the following structure pass through: Bridging veins
517
Foramen ovale
518
Q0260:What opening does the following structure pass through: CN VII
519
Internal auditory meatus
520
Q0261:What opening does the following structure pass through: CN VIII
521
Internal auditory meatus
522
Q0262:What opening does the following structure pass through: CN IX
523
Jugular foramen
524
Q0263:What opening does the following structure pass through: CN X
525
Jugular foramen
526
Q0264:What opening does the following structure pass through: cranial roots of CN XI
527
Jugular foramen
528
Q0265:What opening does the following structure pass through: Jugular vein
529
Jugular foramen
530
Q0266:What opening does the following structure pass through: Inferior petrosal nerve
531
Jugular foramen
532
Q0267:What opening does the following structure pass through: Posterior meningeal artery
533
Jugular foramen
534
Q0268:What opening does the following structure pass through: Sigmoid sinus
535
Jugular foramen
536
Q0269:What opening does the following structure pass through: spinal roots of XI
537
Foramen magnum
538
Q0270:What opening does the following structure pass through: brain stem
539
Foramen magnum
540
Q0271:What opening does the following structure pass through: vertebral artery
541
Foramen magnum
542
Q0272:What opening does the following structure pass through: CN XII
543
Hypoglossal canal
544
Q0273:Neural Crest Derivatives?;10
545
1) Adrenal Meduall;2) Ganglia (Sensory + Autonomic);3) Pigment Cells (Melanin);4) Schwann Cells;5) Meninges (Pia + Arachnoid);6) Pharyngeal Arches;7) Odontoblasts;8) Parafollicular (C) Cells;9) Aorticopulmonar Septum;10) Endocardial Cushions
546
Q0274:Asymptomatic defect in vertebtral arches
547
Spina Bifida Occulta
548
Q0275:Meninges project through the vertebral defect
549
Spina Bifida w/ Meningocele
550
Q0276:What Labx do you ask for in Spina Bifida?
551
Alfa-feto protein (increased)
552
Q0277:What happens in meningmyelocele?
553
Meninges and spinal cord project through vertebral defect
554
Q0278:What are the FOUR sympathetic ganglions?
555
1) Superior Cervical Ganglion;2) Middle Cervcial;3) Vertebral;4) Cervicothoracic
556
Q0279:What level does the Lateral Horn of the Sympathetic system comprises?
557
T1-L2
558
Q0280:What are the Four cranial ganglia of the Parasympathetic System?
559
1) Ciliary ganglion;2) Submandibular;3) Pterygopalatine;4) Otic
560
Q0281:What cranial nerves are Parasympathic?
561
1) III;2) VII;3) IX 3;7;9
562
Q0282:What controls the foregut and midgut in the parasympathetic?
563
Vagus X; at terminal ganglia
564
Q0283:What Parasympathetic controls the Hindgut?
565
Pelvic Splachnic Nerves S2-S4
566
Q0284:Ciliary Ganglion controls what CN and muscle?
567
Parasymp. CN III;Ciliary m.
568
Q0285:Submandibular galgion controlled by?
569
Parasymp. CN VI;Submandibular and sublingual glands
570
Q0286:Pterygopalatine ganglion is in control of?
571
Parasymp;Lacrimal glands;Nasal;Oral;CN VII
572
Q0287:Otic Ganglion controls what?
573
Parasymp. CV IX;Parotid Gland
574
Q0288:Decrease in Alfa-feto Protein in Pregnancy equals?
575
Down Syndrome
576
Q0289:Forebrain TEL;DI;Midbrain MES;Hindbrain MET;MI
577
Telencephalon;Diencephalon;Mesencephalon;Metencepahol; Myelencephalon
578
Q0290:Telecephalon? CNS Structure + what ventricle is formed?
579
Cerebral Hemis. Lat. Ventri
580
Q0291:Diecephalo? makes what structure in CNS and what Ventricles?
581
Thalamus; Pineal Third Vent;Gland; neurohypo;physis; hypotha-;lamus; retina
582
Q0292:Mesencephalon? CNS/Ventricle
583
Midbrain Cerebral Acued.
584
Q0293:Metencephalon
585
PONS Cerebellum 4th Ventri
586
Q0294:Myelencephalon
587
Medulla 4th Ventri
588
Q0295:Who makes the PONS Bridge?
589
Mesencephalon
590
Q0296:What makes Craniopharyngiomas?
591
Remannts of Rathke's Pouch that compress optich chiasm
592
Q0297:Anterograde movement by?
593
Kinesin
594
Q0298:Retograde movement in CNS?
595
Dyenin
596
Q0299:These viruses affect retrograde movement?
597
Herpes;Polio;Rabie;Tetanus
598
Q0300:Oligodendrocyte vs Schwan?
599
Oligo can myelinate more than 1 cell; sometimes up to 50 cells!
600
Q0301:Hair cells are derived from what layer?
601
Ectoderm
602
Q0302:Substantia Nigra derives from with plate? Alar or Basal?
603
Basal
604
Q0303:Polyhydramnios caused by?
605
Anencephaly
606
Q0304:Oligohydramnios?
607
Potter's Syndrome (Bilateral Renal Agenesis); Oligohydramnios causes limb deformities and pulmonary hipoplasia
608
Q0305:What connects the lateral ventricles?
609
Foramen of Monroe (Mon Roe)
610
Q0306:What connects the 3rd ventricle with the 4th?
611
Acueduct of Sylvius
612
Q0307:What connects the ventricles and the subarachnoid space? And where is this located?
613
Located in the 4th ventricle;Three openings;1) Two Lateral formaina of Luschka;2) Median foramina of Magendie
614
Q0308:Normal pH of CSF?
615
7.33
616
Q0309:CSF has higher concentrations of ____ than blood?
617
Cl-; Ca2+; HCO3- and glucose
618
Q0310:How are protein levels in CSF compared to blood?
619
Lower
620
Q0311:How are Sodium levesl in CSF compared to blood?
621
Same about 138 mEq/L
622
Q0312:Are PMN normal in CSF?
623
No!!! Bacterial Meningitis
624
Q0313:What does it mean when there is an increase in protein in CSF?
625
Possibly a CNS tumor
626
Q0314:Define Hydrocephalus?
627
Increase in volume (excess) or pressure of CSF producing ventricular dilation
628
Q0315:Communicating Hydrocephalus;What are the underlying causes?
629
It is due to oversecretion of CSF by;1) Choroid Plexus Papilloma;2) Tumor in Subarachnoid space;3) Meningitis (limits absorption into superior saggital sinus)
630
Q0316:Noncommunicating Hydrocephalus
631
undersecretion/ obstruction of CSF flow;1)tumor blocking foramen Monro; cerebral aqueduct; 4th ventricle or Fomanina Magendie or Lushka.
632
Q0317:Mechanism of Normal Pressure hydrocephalus?
633
- CSF not absorbed by arachnoid villi;- ventricles enlarged;ventricles press agains cortex and skull
634
Q0318:Symptoms of NPH (normal pressure hydrocephalus)?
635
1) confusion;2) gait apraxia;3) urinary incontinence;stiff legs; dementia ;confused with Alzheimer;like magnetic feet stuck to the ground
636
Q0319:Blood-brain barrier regulated by what type of cells? What type of junctions?
637
- Tight Junctions in the capillary endothelium;- Astrocytes
638
Q0320:Where is CSF produced?
639
Choroid Plexus
640
Q0321:What part of hypothalamus is controlled by sympathetic?
641
Posterior Hypothalamus;remember to use your posterior to be sympathetic w/ someone
642
Q0322:Sympathetic Response? Think of the tiger chasing you
643
- Eyes open wide + pupil dilation (to see better);- Perspire (to slip from it);- Hair Sticks up (to look ferocious);- Sphincters close (don't wanna go to the bathroom in the middle of the chase);- Increase HR;- Epinephrine increase adrenalin;- liver incre
644
Q0323:Horner Sx is an attack to sympathetic. What are the symptoms?
645
- Miosis enophthalmos;- pseudotosis ;- Anhydrosis (can't sweat);- lack of piloerection
646
Q0324:What kind of neurons does the ventral horn contains?
647
Motorneurons
648
Q0325:What kind of neurons does the dorsal horn control?
649
Sensory neurons
650
Q0326:What 2 motorneurons does the ventral horn have?
651
Alpha and Gamma
652
Q0327:What do alpha motorneurons control?
653
skeletal muscle (extrafusal fibers)
654
Q0328:What do gamma motorneurons control?
655
muscle spindle contractile intrafusal fibers
656
Q0329:Neural Systems
657
3 Major Neural Systems
658
Q0330:Motor Systems composed of?
659
1) Upper Motorneuron;2) Lower Motorneuron
660
Q0331:Where are the bodies of the upper motor neurons found?
661
1) Red nucleus;2) Reticular Formation;3) Lateral Vestibular Nuclei of the brain stem;4) Cerebral Cortex (Most Important)
662
Q0332:What tract are the upper motor neurons run in?
663
Corticospinal Tract
664
Q0333:Where is the motor cortex located in the brain? What lobe of the brain?
665
1) Precentral Gyrus of the Frontal Lobe;2) Premotor Area both 60%;3) 1ry + 2ry somatosensory cortical areas of parietal lobe 40% of fibers
666
Q0334:Where do corticospinal tract fibers exit the cerebral cortex?
667
In the Internal Capsule
668
Q0335:Dorsal Horns transmit what type of stimulus?
669
Sensory
670
Q0336:Ventral Horns transmit which type of stimulus?
671
Motor (Remember S&M)
672
Q0337:What happens to the corticospianl tract at the lower medulla?
673
They cross the decussation of the pyramids continue contralaterally
674
Q0338:Decorticate rigiditiy is caused by?
675
Lesions above the midbrain
676
Q0339:A lesion below the midbrain causes what type of rigidity?
677
Decerebrate Rigidity
678
Q0340:What reflexes are lost in an Upper Motorneuron Lesion?;Reversal of Reflexes
679
1) Babinski Reflex (extension instead of flexion);2) Abdominal Reflex Lost;3) Cremasteric Reflex Lost
680
Q0341:What are the two sensory systems?
681
1) Dorsal Column-Medial Meniscal System;2) Anterolateral (Spinothalamic) System
682
Q0342:Where is the 1st order neuron for the Sensory Systems?
683
Dorsal Root Ganglion (Pseudounipolar neuron)
684
Q0343:Where is the 2nd order neuron?
685
- Starts in Brain stem or Spinal Cord before crossing ;- it then crosses;Second Order Always crosses
686
Q0344:Where is the 3rd order neuron?
687
Thalamus (T for Third);It already has crossed to the other side
688
Q0345:What does the Dorsal Column-medial leminiscal system convey? (DC-ML)
689
Propioception and Stereoception;- sensory info. for discriminatory touch;- joint position;- vibratory;- pressure sensation from trunk and limbs
690
Q0346:What type/class of fibers does the Dorsal Column (DC-ML) system have?
691
Class II or A-beta
692
Q0347:Which part of the Dorsal Column is located medially? (Which Fasciculus)
693
Fasciculus Gracilis
694
Q0348:What does the fasciculus gracilis control? (Closest to the midline)
695
Lower Extremities;- Remember that you are graceful when you walk;- Also; gracilis muscle is on the medial aspect of the leg/thigh
696
Q0349:What part of the brainstem is the 2nd order neuron located?
697
Medulla
698
Q0350:Does the second order neuron for sensory pathway cross the midline?
699
YES! It crosses; axon doesn't cross but dendrite and body crosses
700
Q0351:Where do 2nd order Dorsal Column cells synapse?
701
Medulla ;Nucleus Gracilis;Nucleaus Cuneatus
702
Q0352:Where do 3rd order of the Dorsal Column-Medial Leminiscus System (DC-MLS) cells synapse?
703
Medial Leminiscus like its name;Part of the Thalamus;in the Ventroposterolateral Nucleus (VPL)
704
Q0353:What does the fasciculus gracilis control? (Closest to the midline)
705
Lower Extremities;- Remember that you are graceful when you walk;- Also; gracilis muscle is on the medial aspect of the leg/thigh
706
Q0354:What part of the brainstem is the 2nd order neuron located?
707
Medulla
708
Q0355:Does the second order neuron for sensory pathway cross the midline?
709
NO! It crosses at the 3rd order neuron in the Thalamus
710
Q0356:Where do 2nd order Dorsal Column cells synapse?
711
Medulla ;Nucleus Gracilis;Nucleaus Cuneatus
712
Q0357:Where do 3rd order of the Dorsal Column-Medial Leminiscus System (DC-MLS) cells synapse?
713
Medial Leminiscus like its name;Part of the Thalamus;in the Ventroposterolateral Nucleus (VPL)
714
Q0358:Where is the 2nd order neuron?
715
Brain stem or Spinal Cord before crossing
716
Q0359:Where is the 3rd order neuron?
717
Thalamus (T for Third);It already has crossed to the other side
718
Q0360:What does the Dorsal Column-medial leminiscal system convey? (DC-ML)
719
Propioception and Stereoception;- sensory info. for discriminatory touch;- joint position;- vibratory;- pressure sensation from trunk and limbs
720
Q0361:What type/class of fibers does the Dorsal Column (DC-ML) system have?
721
Class II or A-beta
722
Q0362:Which part of the Dorsal Column is located medially? (Which Fasciculus)
723
Fasciculus Gracilis
724
Q0363:Decorticate rigiditiy is caused by?
725
Lesions above the midbrain
726
Q0364:A lesion below the midbrain causes what type of rigidity?
727
Decerebrate Rigidity
728
Q0365:What reflexes are lost in an Upper Motorneuron Lesion?;Reversal of Reflexes
729
1) Babinski Reflex (extension instead of flexion);2) Abdominal Reflex Lost;3) Cremasteric Reflex Lost
730
Q0366:What are the two sensory systems?
731
1) Dorsal Column-Medial Meniscal System;2) Anterolateral (Spinothalamic) System
732
Q0367:Where is the 1st order neuron for the Sensory Systems?
733
Dorsal Root Ganglion (Pseudounipolar neuron)
734
Q0368:Where can you find 2nd order neuron in the Dorsal Column pathway? What Nuclei?
735
Brainstem;- Medulla;Nucleus Gracilis;Nucelus Cuneatus
736
Q0369:What pathway crosses the midline in the sensory pathways?
737
The 2nd order neuron always crosses; need two lines to make a cross
738
Q0370:Where is the 3rd order neuron located in the Dorsal Column Medial Leminiscus (DC-MLS) Pathway? Which nucleus?
739
Brainstem;- Thalamus;- At the medial lemniscus like its name;- It is found in the Ventroposterolateral Nucleus
740
Q0371:Where do the 3rd order Neurons project in the Dorsal Column Pathway?
741
To the ANTERIOR portion of the PARIETAL Lobe;Primary somethetic (somatosensory) area;- located in the Postcentral gyrus
742
Q0372:How do you determine a lesion to the Dorsal Column?
743
Loss of Joint sensation;- vibratory ;- pressure sensation;two-point discrimination;- loss of the ability to identify characteristics of an object
744
Q0373:What is asterognosis?
745
Identify;- shape;- size;- consistency;- form;of an object using the sense of TOUCH
746
Q0374:How do you diagnose Dorsal Column Pathway lesion?
747
ask patient to close his eyes and place feet together;- positive if patient sways;- if patient sways with eyes open then the lesion/damage is at the cerebellum and not dorsal column
748
Q0375:What is another name for the Anterolateral System?
749
Spinothalamic Tract System
750
Q0376:What does the Anterolateral System sense?
751
- pain;- temperature;- crude touch sensations
752
Q0377:Via what fibers do the dorsal root ganglia enter the spinal cord?
753
Dorsal Root Fibers;- via A-Delta ;- Class III;- Class IV
754
Q0378:What is the backup of the Corticospinal Tract Lesions?
755
The backup is that 20% of the fibers do not cross;- the conscious crosses;unconscious doesn't cross
756
Q0379:What do direct fibers that do NOT cross controll?
757
They control proximal pathways giving function to the proximal extremities
758
Q0380:What is a picture of a Monkey's Bottom w/ flowers?
759
Medulla Oblongata IX; X; XII
760
Q0381:What is the function of a bipolar neuron?
761
They are responsible for special senses;- vision;- smell;- taste
762
Q0382:Function of a pseudounipolar neuron?
763
It is a scanning neuron
764
Q0383:Where are 3ry (Tertiary) neurons of the Dorsal Column Systems located?
765
Thalamus (Remember T is for Third/Tertiary and Thalamus);They cross
766
Q0384:What happens to all the lesions that are unilateral in the Spinal Cord or the Brain Stem?
767
They result in a contralateral loss of pain and temperature
768
Q0385:Where is the 2nd Neuron located for the Anterolateral (Spinothalamic) System?
769
Dorsal HORN Gray Matter
770
Q0386:What order neuron crosses in the Anterolateral ALSpT tract?
771
2nd order neuron
772
Q0387:Where do the axons of the 2nd order neuron enter?
773
Ventral White Commissure
774
Q0388:Where does the analgesia begin after a lesion of the anterolateral/spinothalamic tract?
775
1 or 2 segments below the contralateral side of the lesion.
776
Q0389:What information does the spinocerebellar pathways carry?
777
Unconscious propioceptive input from muscle spindles and GTOs to cerebellum
778
Q0390:What two major spinocerebellar pathways are there?
779
Dorsal and Cuneocerebellar;(Dorsal and Ventral)
780
Q0391:Where are the 2nd order neuron from the Dorsal Spinocerebellar tract found?;(What nucleus);At what level?
781
- Clarke Nucleus;- Spinal Cord level (T1-L2)
782
Q0392:Where are the bodies of the cuneocerebellar tact found? (What nucleus);At what level?
783
- External Cuneate Nucleus;- Medulla
784
Q0393:What information is gathered from the dorsal spinocerebellar pathway?
785
Input from lower extremities and lower trunk
786
Q0394:What information is gathered by the Cuneocerebellar tracts?
787
Propioceptive input to the cerebellum from upper extremities and upper trunk
788
Q0395:What disease atacks the Spinocerebellar tract?
789
Friederich's Ataxia
790
Q0396:What form of inheritance is Friederich's Ataxia?
791
Autosomal Recessive
792
Q0397:What are the symptoms in a hemisection of the spinal cord?
793
1) ipsilateral spastic paresis below injury;2) ipsilateral loss of joint position sense; tactile discrimination and vibratory sensations below lesion;3) contralateral loss of pain and temperature starting 1 or 2 segments below lesion
794
Q0398:What is another name for hemisection of the spinal cord?
795
Brown-Sequard Sx
796
Q0399:What pathways are interrupted by a hemisection?
797
1) corticospinal;2) dorsal columns;3) spinothalamic (anterolateral)
798
Q0400:What spinal cord lesion is caused by Vitamin B12 Deficiency?
799
Subacute Combined Degeneration
800
Q0401:What other Diseases cause Subacute Combined Degeneration (SCD)?
801
- Vitamin B12;- Pernicious Anemia;- AIDS
802
Q0402:What pathway is damaged in Polio?
803
LMN
804
Q0403:What pathway is damaged in Tabes Dorsalis?
805
Dorsal Column
806
Q0404:What Pathway is damaged in Amyotrophic Lateral Sclerosis?
807
- Corticospinal Tract ;- LMN
808
Q0405:What pathways are damaged in Anterior Spinal Artery occulsion (ASA)?
809
- LMN;- Spinothalamic tract (SpTh);- Corticospinal tract (CST);- LMN;Except Dorsal Column (DC) is spared
810
Q0406:What pathways are damaged in Subacute combined degeneration?
811
- Corticospinal Tract (CT);- Dorsal Column;- Spinocerebellar Tract
812
Q0407:What sign do we find on Dorsal Column lesion?
813
Romberg's Sign (+)
814
Q0408:What tract is damaged in Syringomyelia?
815
- Spinothalamic (SpTh);- LMN
816
Q0409:What is a late complication of Syringomyelia?
817
Horner Syndrome (ptosis; miosis; anhydrosis)
818
Q0410:What tracts are damaged in Hemisection: BrownSequard Sx?
819
- DC;- CST;- SpTh;- LMN;All of them!;If lesion is above T1 then Horner Sx. (Ipsilateral)
820
Q0411:Which side is affected in Horner Sx lesion at T1T4?;Above T1?
821
Contralateral side;Above T1 is ipsilateral side
822
Q0412:What happens in Vitamin B12 Def?
823
Demyelination of Spinal Cord Tracts
824
Q0413:What tracts are affected by Vitamin B12 deficiency?
825
- Dorsal Columns (DC);- Spinocerebellar Tracts ;Corticospinal Tracts (CTS)
826
Q0414:Patient with paresthesias; bilateral spastic weakness; Babinksi sign and antibodies to intrinsic factor? Diagnosis Dx:?
827
Dx: Subacute combined degeneration;Intrinsic Factor is deficient and wont let the ileum absorb Vitamin B12
828
Q0415:How are Multiple Sclerosis; Vitamin B 12 deficiency and Subacute Combined Degeneration similar?
829
They are all conditions where CNS is demyelinated
830
Q0416:What cells are within the white matter of spinal cord?
831
Oligodendrocytes;- they create the myelin for all axons inside the CNS and tracts of white matter
832
Q0417:What tract is injured in a patients with signs of UMN and LMN?
833
Amyotrophic Lateral Sclerosis (ALS)
834
Q0418:Which cells regenerate in the PNS? Why?
835
Cells in the Ventral Root;- they contain myelin from Schwann Cells which promote regeneration of cut axons.
836
Q0419:What are the three Ps of Tabes Dorsalis?
837
1) Pain;2) Paresthesia;3) polyuria;Argyll Robertson Pupils;Last P is Pupil Defect!
838
Q0420:What structures degenerates in MS?
839
Myelin containing nerves;i.e. Optic Nerves; formed by oligodendrocytes not schwann(PNS)
840
Q0421:What test do you find positive in MS?
841
Heterogeneous Immunoglobulin G Staining w/ oligoclonal banding
842
Q0422:Charactestic of Syringomyelia?
843
Bilateral loss of pain and temperature
844
Q0423:What level does the fasciculus cuneatus begins?
845
T5 segment
846
Q0424:What cells are affected in LMN lesions?
847
Alpha motor neurons in the ventral horns
848
Q0425:What cells manage the reflex contraction of muscle and extension of oposite muscles?
849
Muscle Spindles
850
Q0426:What are does the anterior spinal artery supply?
851
Ventrolateral 2/3's of the spinal cord;- DC are spared;- NO problems in pain and temp.
852
Q0427:What is affected if the spinothalamic tract on the left side is affected?
853
Pain and temperature sensations on the right leg
854
Q0428:Where do axons of fasciculus cuneatus have their bodies in?
855
Dorsal Root Ganglia
856
Q0429:The Brain Stem
857
pg. 363
858
Q0430:What three parts make the Brainstem?
859
1) midbrain;2) pons;3) medulla
860
Q0431:What cranial nerves arise from the midbrain?
861
1) oculomotor III;2) trochlear IV;3 and 4
862
Q0432:What cranial nerves enter or exit the pons?
863
V; VI; VII; VIII;5-8
864
Q0433:What three cranial nerves enter or exit from the medulla?
865
IX; X; XII
866
Q0434:Are Motor Nuclei located medially or lateral?
867
Medial M=Medial M=Motor
868
Q0435:What are some of the symptoms for a pineal tumor?
869
Parinaud Sx;1) paralisis of upward gaze;2) noncummunicating hydrocephalus
870
Q0436:What cranial nerve is affected in Neurofibromatosis II?
871
VIII; associated with Schwannomas
872
Q0437:What happens to a lesion of the nucleus ambiguus?
873
Ipsilateral paralysis of the soft palate;- uvula deviates away from the lesion;- nasal regurgitation of liquids;- hoarseness;difficulty swallowing
874
Q0438:What does the solitary nucleus control?
875
solitary sounds like salivary and taste;- it controls the taste and visceral sensory neurons
876
Q0439:What cranial nerve does the spinal nucleus control?
877
Trigeminal nerve V
878
Q0440:What is the major parasympathetic nucleus in the brain stem? Where is it located?
879
Dorsal motor nucleus in the 4th ventricle
880
Q0441:What cranial nerves does the nucleus solitarius control?
881
VII; IX; X;7;9;10
882
Q0442:What nerve is NOT affected when there is an intramedullary lesion?
883
Spinal Accesory Nerve (XI)
884
Q0443:What muscles does the spinal accesory nerve innervate?
885
1) sternocleidomastoid ;2) trapezius
886
Q0444:Where is the abducens nucleus found?
887
Floor of the 4th ventricle;- lateral to the MLF
888
Q0445:What happens when the abducens nucleus has a lesion?
889
- ipsilateral facial paralisis of the VII nerve;- inability to look to the side of the lesion
890
Q0446:Where does the facil nerve exit the brain?
891
pontomedullary junction
892
Q0447:What is the superior olivary nucleus responsible for?
893
It receives auditory impulses from both ears by cochclear nuclei;- cochclear nuclei at pontomedullary junction
894
Q0448:Where are vestibular nuclei found?
895
posterior surface of pons
896
Q0449:What three structures are found in the pontomedullary junction?
897
- Facial motor nucleus exits fibers;- cochlear nuclei
898
Q0450:What four nerves emerge from the pons?
899
V-VIII;5;6;7;8;at the pontomedullary junction
900
Q0451:What is another name for midbrain?
901
Mesencephalon
902
Q0452:What structures pass through the midbrain?
903
- cerebral acueduct;- superior colliculi;- inferior colliculi
904
Q0453:What is the function of the inferior colliculi?
905
processes auditory information received bilaterally from cochlear nuclei
906
Q0454:What is the function of superior colliculi?
907
help direct movement of both eyes in gaze
908
Q0455:What two nerve emerge from midbrain?
909
oculomotor III;trochlear IV;3;4
910
Q0456:What do the cerebral peduncles contain?
911
Corticospinal fibers;corticobulbar fibers
912
Q0457:How do oculomotor nucleus exists the midbrain?
913
ventrally in the interpenducular fossa
914
Q0458:How do trochlear nerves exit?
915
posterior midline inferior to the inferior colliculi
916
Q0459:How does the ear protect itself against damage to the inner ear from loud sounds?
917
It contracts the stapedius and tensor tympani muscles
918
Q0460:What happens to the Upper Face and Lower Face in a corticobulbar lesion?
919
The Upper Face has normal function since it has a bilateral innervation;The Lower Face is affected contralaterally since there is only one set of fibers going there.
920
Q0461:What are the components of the ear?
921
1) external ear;2) middle ear;3) inner ear
922
Q0462:What structures make up the external ear?
923
Pinna;External Auditory Meatus
924
Q0463:What makes up the middle ear?
925
- Temporal Bone;- tympanic membrane;- connecting it to the oval window
926
Q0464:What bones are included in the middle ear?
927
malleus;stapes;incus
928
Q0465:What makes up the inner ear?
929
- labyrinth;- channels (semicircular ducts and cochlear duct)
930
Q0466:What is the characteristic of endolymph?
931
It contains the same characteristics as intracellular fluid
932
Q0467:What is the characteristic of perilymph?
933
It is ionically extracellular fluid
934
Q0468:How does sound travel from the ear to the brain?
935
hair cells in the organ of Corti are conected to the spiral ganglion;- to cochlear part of CN VIII;- ventral cochlear nuclei --> Superior Olivary N. --> Inferior Colliculus --> Midbrain
936
Q0469:What is stimulated in low-frequency sounds?
937
Apex of of the cochlea
938
Q0470:What is stimulated in high-frequency sounds?
939
Base of the cochlea
940
Q0471:Does perilymph move towards or away the direction of movement?
941
Toward
942
Q0472:How does endolymph move?
943
Against the direction of movement
944
Q0473:Static Laberynth is made up of?
945
Striola;Otoconia;Kinocillium
946
Q0474:How can you tell if there is excitation from the kinocillium?
947
They are pointing toward the striola
948
Q0475:What are the components of the dynamic laberynth?
949
Ampulla; endolymph; hair cells; crystals
950
Q0476:What consists in a Pinealoma Sydrome?
951
Insomnia; headache and can't look up
952
Q0477:What is the mechanism of damage in a pinealoma?
953
- Damage to the superior colliculus center for upward gaze;pupillary constriction for accomodation;- decrease in melatonin;- decrease in sleep patterns;- headache from tumor compression
954
Q0478:- Can't follow Upward gaze;- Hydrocephalus;Headache;- Pupils Accomodate but not react;Diagnostic?
955
Pinnealoma/Parinaud Sx
956
Q0479:What nerve is intact when you have good convergence?
957
III adducts well
958
Q0480:Patient difficulty swallowing and palata droopped; what center is affected?
959
Nucleus Ambiguus
960
Q0481:Cranial Nerve nuclei in Midbrain
961
CN-3 and CN-4
962
Q0482:Cranial nerve nuclei in Pons
963
CN-5 to CN-8
964
Q0483:Cranial nerve nuclei in Medulla
965
CN-9 to CN-12
966
Q0484:CN's which pass thru sphenoid (middle cranial fossa)
967
CN II-VI
968
Q0485:pathway of CNI
969
cribiform plate
970
Q0486:CN's which pass through bones of posterior cranial fossa (temporal or occipital)
971
CNVII-XII
972
Q0487:CNII exit from skull
973
Optic canal
974
Q0488:CN that exit skull via Superior Orbital Fissure
975
CN-III; CN-IV; CN-V1; CN-VI
976
Q0489:CNV2: exit from skull
977
Foramen rotundum
978
Q0490:CNV3: exit from skull
979
Foramen Ovale
980
Q0491:middle meningeal artery: entrance into skull
981
Foramen spinosum
982
Q0492:CNVII: exit from skull
983
internal auditory meatus
984
Q0493:CNIX exit from skull
985
jugular foramen
986
Q0494:CNXII: exit from skull
987
hypoglossal canal
988
Q0495:spinal root CNXI: entrance into skull
989
foramen magnum
990
Q0496:decreased pain and temp sensation over lat. aspects of both arms. where is the lesion
991
syringomyelia
992
Q0497:penlight in pts right eye produces bilateral pupillary constriction. when moved to the left eye; there is paradoxical dilation;what is the defect?
993
atrophy of L optic nn
994
Q0498:decresassed prick sensation on lateral aspect of leg and foot;deficit in what mm action can also be expected
995
dorsiflexion & eversion of foot (common peronial nn)
996
Q0499:pt presents w/ tingling over lateral digits of her R hand;What is the dx
997
carpal tunnel syndrome;median nn compression
998
Q0500:decreased plantar flexion and decreased sensation over back fo thigh; calf; and latereal half of foot;what spinal nn
999
tibial (L4-S3)
1000
Q0501:pt in MVA can't turn head to L & has rightt shoulder droop;What sx is damaged.
1001
R CN XI (inn SCL & trap mm)
1002
Q0502:pt presents w/ one wild flailing arm. where is the lesion?
1003
contralateral subthalamic nuccleus (hemiballismus)
1004
Q0503:pt w/ cortical lesion does not know he has a dz. where is the lesion?
1005
right paraietal lobe
1006
Q0504:pt cannot protrude tongue toward L side and has a Rsided spastic paralysis. Where is the lesion?
1007
L medulla; CN XII
1008
Q0505:teen falls while rollarblading and hurts his elbow. He can't feel the medial part of his palm;What is the nn & what is the injury.
1009
ulnar nn due to broken medial condyle
1010
Q0506:pt presents to ER after falling on arm. X-ray shows midshaft break of the humerus? Which nn & aa are most lkely damaged?
1011
radial nn & deep brachial aa (run together
1012
Q0507:pt cannot blink his R eye or seal his lips and has mild ptosis on R side. What is the dx and which nn is affected.
1013
bell's palsy; CN VII
1014
Q0508:pt c/o numbness; & tingling sensation. She has wasting of thenar eminence. What is the dx/ What nn is affected?
1015
carpel tunnel syndrome (medial nn)
1016
Q0509:stage of sleep where there is variable BP; penile tumescence & variable EEG.
1017
REM
1018
Q0510:person demands only the best & most famous doctor in town;what personality d/o
1019
narcissistic personality d/o
1020
Q0511:nurse has episodes of hypoglycemia; blood analysis shows no elevation in C protien. What is the dx.
1021
factitious d/o. self scripted insulin
1022
Q0512:woman presents w/ headache; visual disturbance; galactorrhea and amenorrhea;what is the dx
1023
prolactinoma
1024
Q0513:pt experiences dizziness & tinnitis. ct shows enlarged internal acoustic meatus. What is the dx
1025
schannoma
1026
Q0514:25 y/o female presents w/ sudden uniocular vision loss & slightly slurred speech. She has hx of weekness & parasthesias that have resoved. what is the dx
1027
MS
1028
Q0515:10 y/o child "spaces out" in class (e.g; stops talking midsentance & then continues as if nothing happened. During spells there is slight quivering of lips. Dx?
1029
absence seizures
1030
Q0516:man on several meds including antidepressants and antihypertensives; has mydriasis and becomes constipated. What is the cause of his symptoms
1031
TCA
1032
Q0517:woman on MAO inhibitor has hypertensive crisis after a meal. What did she ingest?
1033
tyramine (wine or cheese)
1034
Q0518:This CNS support cell helps maintain the blood-brain barrier. It's cell marker is GFAP
1035
astrocyte
1036
Q0519:this CNS support cell makes up the inner lining of the ventricles
1037
ependymal cells
1038
Q0520:this CNS support cell is the macrophage of the brain phagocytosing in areas of inflammation or neural damage. Like the macrophage; this cell is mesodermal in origen.
1039
microglia.
1040
Q0521:This CNS support cell is responsible for myelin production
1041
oligodendroglia
1042
Q0522:This pns support cell is responsible for peripheral myelin production
1043
schwann cell
1044
Q0523:All CNS/ PNS support cells (except the microglia which originates from mesoderm)originate from this primary germ cell layer.
1045
ectoderm
1046
Q0524:autopsy done on pt w/ HIV shows these support cells transformed into virus filled multinucleated giant cells in CNS
1047
microglia
1048
Q0525:these CNS support cells are destroyed in MS
1049
oligodendroglia
1050
Q0526:Acoustic neuroma is a neoplasm of this PNS support cell commonly associated with the internal acoustic meatus (CN VII; VIII)
1051
schwann cell
1052
Q0527:Give following peripheral nn layers from inner most to outermost ;nn fibers;endoneurium;epineurium;perineurium
1053
endoneurium-perineurium-epineurium-nn fibers
1054
Q0528:this peripheral nn layer must be rejoined in microsurgery for limb reattachment
1055
perineurium
1056
Q0529:this sensory corpuscle is a small; encapsulated nn ending found in the dermis of palms; soles; and digits of skin. It is involved in light discriminatory touch of glabrous (hairless) skin.
1057
meissner's corpuscle
1058
Q0530:this sensory corpuscle is a large; encapsulated nn ending found in deeper layers of skin at ligaments; joint capsules; serous membranes; and mesenteries. It is involved in pressure; coarse touch; vibration; and tension.
1059
pacinian corpuscle
1060
Q0531:this sensory corpuscle is a cup-shaped nn ending in dermis of fingertips; hair follicles; hard palate. It is involved in light; crude touch
1061
merkel's corpuscle
1062
Q0532:when you hear high frequency sound; this part of the cochlea is responding (narrow & stiff)
1063
base
1064
Q0533:when you hear low frequency sound; this part of the cochlea is responding (wide and flexible)
1065
apex
1066
Q0534:perilymph in the inner ear is similar to (ECF or ICF)
1067
ECF (high Na+)
1068
Q0535:when you hear high frequency sound; this part of the cochlea is responding (narrow & stiff)
1069
base
1070
Q0536:endolymph in the inner ear is similar to (ECF or ICF)
1071
ICF (K+)
1072
Q0537:Utricle and saccule of the inner ear contain maculae which detect which type of acceleration?
1073
linear
1074
Q0538:Semicircular canals of the inner ear contain ampullae which detect which type of acceleration?
1075
angular
1076
Q0539:hearing loss in the elderly usually begins with which type of frequency
1077
high frequencies
1078
Q0540:blood brain barrier is formed by which 3 structures:
1079
1)astrocyte processes;2) basement membrane;3)tight jx b/n nonfenestrated capillary endothelial cells
1080
Q0541:glucose and amino acids cross the blood-brain barrier by which method.
1081
carrier mediated transport mechanism
1082
Q0542:what crosses blood brain barrier more redily. water soluble substances or lipid soluble substances?
1083
lipid soluble
1084
Q0543:the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus? ;What does the T stand for (2 chances to get it right.
1085
either;1)Thirst;or;2)Temperature
1086
Q0544:the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus? ;What does the A stand for (2 chances to get it right.
1087
Either;1) Adenohypophysis control;or;2)Autonomic regulation
1088
Q0545:the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus? ;What does the A stand for (2 chances to get it right.
1089
Either;1) Adenohypophysis control;or;2)Autonomic regulation
1090
Q0546:the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus? ;What does the N stand for
1091
Neurohypophysis hormones (synthesized in hypothalamic nucleii)
1092
Q0547:the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus? ;What does the H stand for
1093
Hunger
1094
Q0548:the hypothalamus wears TAN HATS is a mneumonic for the fxns of the hypothalamus? ;What does the S stand for?
1095
Sexual urges
1096
Q0549:destruction of the lateral nucleus of the hypothalamus results in what type of food intake?
1097
anerexia & starvation
1098
Q0550:destruction of the ventromedial nucleus of the hypothalamus results in what type of food intake?
1099
hyperphagia and obesity
1100
Q0551:Anterior hypothalamus regulates what division of the ANS.
1101
parasympathetic
1102
Q0552:Posterior hypothalamus regulates what division of the ANS.
1103
Sypathetic
1104
Q0553:This nucleus controls circadian rhythms.
1105
suprachiasmatic nucleus
1106
Q0554:This nucleus controls thirst and water balance
1107
supraoptic nucleus
1108
Q0555:This part of the hypothalamus (anterior or posterior) kicks in and regulates heat concervation when cold.
1109
posterior hypothalamus
1110
Q0556:This part of the hypothalamus (anterior or posterior) coordinates cooling when hot.
1111
anterior hypothalamus
1112
Q0557:When this nucleus of the hypothalmus is destroyed-rage results?
1113
septal nucleus
1114
Q0558:The posterior pituitary (neurohypophysis) recieves hypothalamic axonal projections from the supraoptic nucleii and releases what hormone?
1115
ADH
1116
Q0559:The posterior pituitary (neurohypophysis) recieves hypothalamic axonal projections from the paraventricular nucleii and releases what hormone?
1117
oxytocin
1118
Q0560:this part of the brain is the major relay for ascending sensory informationthat ultimately reaches the cortex?
1119
thalamus
1120
Q0561:This geniculate nucleus of the thalamus (lateral or medial) is involved in relaying visual sensory information to the cortex.
1121
lateral
1122
Q0562:This geniculate nucleus of the thalamus (lateral or medial) is involved in relaying auditory sensory information to the cortex.
1123
medial geniculate nucleus (MGN)
1124
Q0563:This nucleus of the thalamus is involved in relaying BODY sensation information (proprioception; pressure; pain; touch; vibriation) to the cortex via the dorsal columns & the spinothalamic tract.
1125
Ventral Posterior Nucleus; Lateral part (VPL)
1126
Q0564:This nucleus of the thalamus is involved in relaying FACIAL sensation information to the cortex via CN V
1127
Ventral Posterior nucleus; medial part (VPM)
1128
Q0565:This nucleus of the thalamus is involved in relaying motor information to the cortex.
1129
Ventral Anterior/Lateral nucleus (VL)
1130
Q0566:This "system" of the brain is responsible for the 5 Fs. Feeding; Fighting; Feeling; Flight; and Fucking.
1131
limbic system
1132
Q0567:This part of the brain is important in voluntary movements and making postural adjustments.
1133
basal ganglia
1134
Q0568:Parkinson's dz symptoms are do to decreased imput from this part of the basal gangia.
1135
substantia nigra.
1136
Q0569:In Parkinson's dz the symptoms are due to decreased input from the substantia nigra of the basal ganglia. This leads to _______ (increased or decreased) stimulation of the direct pathway and _______ (increased or decreased) inhibition of the indirect pathway
1137
decreased ;decreased
1138
Q0570:In the basal ganglia; _________ (D1)facilitates movement
1139
direct pathway
1140
Q0571:In the basal ganglia; _________ (D2)inhibits movement
1141
indirect pathway
1142
Q0572:In the cerebral cortex associative auditoritory fx is associated with which area?
1143
Wernicke's area (22)
1144
Q0573:In the cerebral cortex speech motor fx is associated with which area?
1145
broca's area
1146
Q0574:Your pt has become recently more and more disorganized. He reports problems concentrating and poor social judgement. What lobe of the brain could be involved.
1147
frontal lobe
1148
Q0575:anterior cerebral artery hemarrage could result in sensory motor problems in which location of the body?
1149
lower extremity
1150
Q0576:anterior cerebral aa supplies what part of the brain
1151
medial surface
1152
Q0577:hemhorrage of the middle cerebral aa would involve what part of the brain.
1153
lateral
1154
Q0578:hemhorrage of the middle cerebral aa could involve what pathologies?
1155
motor & sensory deficits of teh trunk-arm-face; Broca's and Wernicke's speech areas
1156
Q0579:Anterior communicating artery lesion is the most common circle of Willis aneurism. It may cause this deficit.
1157
visual field defect
1158
Q0580:Posterior communicating artery is also a common area of aneurism. It can result in this cranial nn palsy.
1159
CN III
1160
Q0581:A stroke in this general part of the circule of wilis can cause general sensory and motor dysfunction and aphasia
1161
anterior circle
1162
Q0582:A stroke in this general part of the circle of wilis can cause cranial n deficits (vertigo; visual deficits); coma; cerebellar deficits (ataxia)
1163
posterior circle
1164
Q0583:this division of the middle cerebral aa is a common site of stroke. It feeds the internal capsule; caudate; putamen; & globus pallidus
1165
lateral striate
1166
Q0584:Cerebral veins drain into the venous sinuses which drain into what?
1167
internal jugular vv
1168
Q0585:lateral ventricle drains into the 3rd ventricle via the foramen of _______.
1169
monro
1170
Q0586:3rd ventricle drains into the 4th ventricle via the aquaduct of ________
1171
sylvius
1172
Q0587:4th ventricle drains into the subarachnoid space via the foramina of ________ (laterally) and the foramina of ________ (medially
1173
Luschka;Magendie
1174
Q0588:How many spinal nn are there total?
1175
31;8-C;12-T;5-L;5-S;1-coccygeal
1176
Q0589:Vertibral disk herniation usually occurs between what levels_______
1177
L5-S1
1178
Q0590:At what levels do you want do a LP
1179
L3-L5 ;(spinal cord extends to lower border of L2; Subarachnoid space extends to lwer border of S2)
1180
Q0591:You perform an LP at the level of L4/L5 (iliac crest levels). List the following sx in the order that you will pierce them?;Ligaments ;Arachnoid;Epidural space;Subdural space;skin/superficial fascia;Dural matter;Subarachnoid space CSF
1181
skin/superficial fascia;Ligaments ;Epidural space;Dural matter;Subdural space;Arachnoid;Subarachnoid space CSF
1182
Q0592:Should you pierce the Pia matter in a lubar puncture?
1183
No
1184
Q0593:These columns relay sensation of pressure; vibration; touch; and proprioception to the cerebral cortex.
1185
dorsal columns
1186
Q0594:This fasciculus within the dorsal column relays the sensation of pressure; vibration; touch; and proprioception from the upperbody and extremities to the cerebral cortex.
1187
fascciculus cuneatus
1188
Q0595:This fasciculus within the dorsal column relays the sensation of pressure; vibration; touch; and proprioception from the lower body and extremities to the cerebral cortex.
1189
fasciculus gracilis
1190
Q0596:These tracts relay sensation of pain and temperature up the spinal cord to the cerebral cortex
1191
spinothalamic tract
1192
Q0597:These tracts relay motor signals from the brain down teh spinal cord.
1193
lateral corticospinal tract
1194
Q0598:what is more lateral in the dorsal columns the fasciculus cuneatus or fasciculs gracilis
1195
fasciculus cuneatus
1196
Q0599:Describe the path of a vibratory (or pressure; touch; proproceptive) sensation as after it signals a sensory nn up until its first synapse (must get 3 key points)
1197
Sensation enters the DORSAL ROOT GANGLION to ascent the spinal cord IPSILATERALLY in the DORSAL COLUMN.
1198
Q0600:Describe the location of the first synapse of that vibratory (or pressure; touch; proproceptive) sensation (must give nucleus and brain location)
1199
NUCLEUS CUNEATUS or GRACILIS in the MEDULLA
1200
Q0601:Describe the 2nd order neuron of that vibratory (or pressure; touch; proproceptive) sensation. (decussation & ascention)
1201
decussates in the MEDULLA and ascends CONTRALATERALLY in the MEDIAL LEMNISCUS
1202
Q0602:Describe the 2nd synapse of that vibratory (or pressure; touch; proproceptive) sensation. (Nucleus and brain location)
1203
VPL of the THALAMUS
1204
Q0603:Describe the final destination of the 3rd order neuron of that vibratory (or pressure; touch; proproceptive)sensation
1205
SENSORY CORTEX
1206
Q0604:Describe the path of an ascending pain (or temperature) sensation after it signals a sensory nn up until its first synapse
1207
travels from sensory nn endigns (A-delta and C-fibers)and enters spinal cord ipsilaterally.
1208
Q0605:Describe the first synapse of ascending pain and temperature sensation
1209
IPSILATERAL synapse with gray matter in spinal cord.
1210
Q0606:Describe the 2nd order neuron transmission of the ascending pain and temperature sensation. (decussation & ascention)
1211
Decussates at the ANTERIOR WHITE COMMISSURE and ascends CONTRALATERAL in the SPINOTHALAMIC TRACT
1212
Q0607:Describe the 2nd synapse of the ascending pain and temp sensation?
1213
VPL of thalamus
1214
Q0608:Describe the 3rd order neuron final destination of the ascending pain and temperature sensation.
1215
sensory cortex
1216
Q0609:You want to move you're right arm? Describe the 1st order neuron pathway.
1217
begin in the LEFT HEMISPHERE PRIMARY MOTOR CORTEX. The UPPER MOTOR NEURONS descends IPSILATERALLY until decussating at CAUDAL MEDULLA (PYRAMIDAL DECUSSATION) and then descend CONTRILATERALLY.
1218
Q0610:You want to move you're right arm? Describe where the 1st synapse occurs.
1219
CELL BODY OF THE ANTERIOR HORN (SPINAL CORD)
1220
Q0611:You want to move you're right arm? Describe the 2nd order neuron.
1221
LOWER MOTOR NEURON leaves the spinal cord.
1222
Q0612:You want to move you're right arm? Describe where the 2nd synapse occurs.
1223
neuromuscular jx
1224
Q0613:Give the brachial plexus dx from the BP damage;Upper trunk (C5; C6)
1225
waiters tip
1226
Q0614:Give the diagnosis from the location of Brachial Plexus damage;Lower trunk (T1;C8)
1227
claw hand
1228
Q0615:Give the diagnosis from the location of Brachial Plexus damage;Posterior chord (C5-T1)
1229
Wrist drop
1230
Q0616:Give the diagnosis from the location of Brachial Plexus damage;Long Thoracic Nerve
1231
Winged scapula
1232
Q0617:Give the diagnosis from the location of Brachial Plexus damage;Axillary nn
1233
Deltoid paralysis
1234
Q0618:Give the diagnosis from the location of Brachial Plexus damage;Radial nn
1235
Sadurday night palsy
1236
Q0619:Give the diagnosis from the location of Brachial Plexus damage;musculocutaneous nn
1237
difficulty flexing elbow; variable sensory loss
1238
Q0620:Give the diagnosis from the location of Brachial Plexus damage;Median nn
1239
decreased thumb fx-Pope's blessing
1240
Q0621:Give the diagnosis from the location of Brachial Plexus damage;Ulnar branch
1241
Intrinsic mm of hand; claw hand
1242
Q0622:What mm protects brachial plexus from injury in the case of the relatively common clavicle fracture
1243
subclavius
1244
Q0623:This nn is known as the "great extensor nn" it provides innervation of the Brachioradialis; Extensors or the wrist and fingers; Supinator; and Triceps.
1245
Radial nn;mneu:RAD=BEST;Brachioradialis; Extensors or the wrist and fingers; Supinator; and Triceps.
1246
Q0624:Thenar mm (3);Hypothenar mm (3)
1247
Opponens pollicis; Abuctor pollicis brevis; Flexor pollicis brevis;Opponens digiti minimi; Abductor digiti minimi; Flexor digiti minimi;Both groups perform the same fx: Oppose; Abduct; and Flex (OAF)
1248
Q0625:Clinically important Landmarks;-Ischial spine?;-2/3 of the way from the umbilicus to the anterior superior Iliiac Spine;-Iliac Crest
1249
Pudendal nn block;McBurney's Pt-Appendix;Lumbar puncture
1250
Q0626:Landmark Dermatomes;Posterior half of the scull "cap"
1251
C2
1252
Q0627:Landmark Dermatomes: high turtle neck shirt
1253
C3
1254
Q0628:Landmark Dermatomes: low collar shirt
1255
C4
1256
Q0629:Landmark Dermatomes: T4
1257
nipple;T4 at the "teat pore"
1258
Q0630:Landmark Dermatomes: xyphoid process
1259
T7
1260
Q0631:Landmark Dermatomes: Umbilicus
1261
T10;T10 at the belly butTEN
1262
Q0632:Landmark Dermatomes: Inguinal ligament
1263
L1 ;L1 is IL
1264
Q0633:Landmark Dermatomes: includes the kneecaps
1265
L4;down on L4s (all 4s)
1266
Q0634:Landmark Dermatomes;erection; and sensation of penile and anal zones
1267
S2;3;4;S2;3;4 keeps the penis off the floor
1268
Q0635:Gallbladder pain is referred to the right shoulder via this nn
1269
phrenic nn
1270
Q0636:This work in prallel w/ mm fibers. When a mm is stretched it causes the intrafusal to stretch which stimulates the Ia afferent which in turn stimulates the alpha motor neuron which causes a reflex muscle (extrafusal ) contraction
1271
muscle spindle
1272
Q0637:these monitor mm lenth. For example help you pick up a heavy suitcase when you didn't know how heavy it was.
1273
muscle spindles
1274
Q0638:This senses tension and provides inhibitory feedbach to alpha motor neurons
1275
golgi tendon organs
1276
Q0639:These monitor mm tension. For example make you drop a heavy suitcase you've been holding for too long
1277
golgi tendon organs
1278
Q0640:CNS stimulates the gamma motor neuron which contracts intrafusal fiber and causees an increased sensitivity of the reflex arc
1279
gamma loop
1280
Q0641:Clinical reflexes;-Achillies;-Patella;-Biceps;-Triceps:
1281
S1;2;L3;4;C5;6;C7;8
1282
Q0642:Dorsiflexion of the big toe and fanning of other toes; sign of UMN lesion; but normal reflex in 1st year of life
1283
Babinski
1284
Q0643:Primitive Reflexes;extension of limbs when startled;(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)
1285
moro reflex
1286
Q0644:Primitive Reflexes;nipple seeking;(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)
1287
rooting reflex
1288
Q0645:Primitive Reflexes;grasps objects in palm;(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)
1289
palmar reflex
1290
Q0646:Primitive Reflexes;large toe dorsiflexes w/ plantar stimulation;(normally disappear w/in 1st year. May reemerge following a frontal lobe lesion)
1291
babinski reflex
1292
Q0647:CNs that lie medially at brainstem
1293
III; VI; XII;mneu: 3(x2)=6(x2)=12
1294
Q0648:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;smell
1295
CNI-olfactory(S)
1296
Q0649:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Sight
1297
CN II: Optic (S)
1298
Q0650:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Eye movement (up(lateral & medial) down (lateral); pupil constriction; accommodation; eyelid opening
1299
CN III: Oculomotor (M)
1300
Q0651:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Eye movement (down & medial)
1301
CN IV: Trochlear (M)
1302
Q0652:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Mastication; Facial sensiation
1303
CN V: Trigeminal (B)
1304
Q0653:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Eye movement (lateral)
1305
CN VI: Abducens (M)
1306
Q0654:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Facial mvmt; taste from anterior 2/3 of tongue; lacrimation; salivation (submaxillary and sublingual glands; eyelid closing.
1307
CN VII: Facial (B)
1308
Q0655:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Hearing; balance
1309
CN VIII: Vestibulocochlear (S)
1310
Q0656:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Taste from post 1/3 of tongue; swallowing; salivation (parotid gland); monitoring carotid body and sinus chemo-and baroreceptors
1311
CN IX: Glossopharyngeal (B)
1312
Q0657:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Tastte from epiglottic region; swallowing; palate elevaton; talking; throacoabdominal viscera; monitoring aortic arch chemo-and baroreceptors
1313
CN X: Vagus (B)
1314
Q0658:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;Head turning; shoulder shrugging
1315
CN XI: Accessory (M)
1316
Q0659:Give Cranial nn by Fx: Is it Motor or sensory or Both?;Fx;tongue mvmt
1317
CN XII: Hypoglossal (M)
1318
Q0660:Cranial nn nucleii located in the Midbrain
1319
CN III; IV
1320
Q0661:Cranial nn nucleii located in the Pons
1321
CN V-VIII
1322
Q0662:Cranial nn nucleii located in the Medulla
1323
IX-XII
1324
Q0663:Cranial nn nucleii located in the Midbrain
1325
CN III; IV
1326
Q0664:Cranial nn more lateral in the brainstem tend to be ______; those more medially tend to be _______
1327
sensory;motor
1328
Q0665:This vagal nucleii recieves visceral sensory information (e.g; taste baroreceptors; and gut distension) from cranial nn VII; IX; & X
1329
Nucleus Solitarius
1330
Q0666:This vagal nucleii is responsible for Motor inervation of the pharynx; larynx and upper esophagus (e.g; swallowing; palate elevation)via CN IX;X;XI.
1331
Nucleus aMbiguous
1332
Q0667:This vagal nucleii sends autonomic (parasympathetic) fibers to heart; lungs; and upper GI
1333
Dorsal motor nucleus
1334
Q0668:Crandial nn and vessel pathways;Cribiform plate
1335
CN I
1336
Q0669:Crandial nn and vessel pathways;optic canal
1337
CN II; opthalmic artery; central retinal vein
1338
Q0670:Crandial nn and vessel pathways;Superior orbital fissure
1339
(CN III; IV; V1;VI; opthalmic vv)
1340
Q0671:Crandial nn and vessel pathways;Foramen Rotundum
1341
CN V2
1342
Q0672:Crandial nn and vessel pathways;Foramen Ovale
1343
CN V3
1344
Q0673:Crandial nn and vessel pathways;Foramen spinosum
1345
middle meningeal aa
1346
Q0674:Crandial nn and vessel pathways;Internal auditory meatus
1347
CN VII; VIII
1348
Q0675:Crandial nn and vessel pathways;Jugular foramen
1349
CN IX;X;XI; jugular vv
1350
Q0676:Crandial nn and vessel pathways;Hypoglossal canal
1351
CN XII
1352
Q0677:Crandial nn and vessel pathways;Foramen magnum
1353
Spinal roots of CN XI; brainstem; vertebral arteries
1354
Q0678:a collectionof venous sinuses on either side of the pituitary
1355
cavernous sinus
1356
Q0679:nn that pass through cavernous sinuses
1357
nn that control extaocular mm (CN III; IV; VI) plus V1 & V2
1358
Q0680:pt presents w/ opthalmoplegia; & opthalmic and mandibular sensory loss;what is a possible dx?
1359
Cavernous sinus syndrome (e.g; due to mass effect
1360
Q0681:Muscles of mastication;3 mm that close the jaw;innervated by?
1361
Masseter; teMporalis; Medial pterygoid;inn: V3;mneu: Ms Munch
1362
Q0682:Muscles of mastication;1 mm opens the jaw;innervated by:
1363
Lateral pterygoid;inn: V3;mneu: Lateral Lowers
1364
Q0683:All mm with the root glossus in their names are innervated by?;Except one exception. What is it and what is the innervation.
1365
hypoglossal;palatoglossus (inn by vagus)
1366
Q0684:All mm with the root palat in their names are innervated by this;One exception what is it innervated by?
1367
vagus;;exception: tensor veli palatine (inn by Mandibular branch of CN V)
1368
Q0685:CN IV innervates what mm? What direction would you look?
1369
SO--towards your nose
1370
Q0686:CN VI innervates what mm. What direction would you look
1371
LR-laterally
1372
Q0687:What reflex? Light in either retina sends a signal via CN III to PRETECTAL nucleii in midbrain that activate bilateral EDINGER-WESTPHAL nucleii;pupls contract bilaterally (consensual reflex)
1373
Pupillary light reflex
1374
Q0688:Saying KLM outloud tests what three CNs?
1375
K (vagus) palate elevation;L (hypoglossal) tongue;M (facial) lips
1376
Q0689:What waveform?;awake (eyes open); alert; active mental concentration
1377
Beta (highest frequency; lowest amplitude)
1378
Q0690:What waveform?;awake (eyes closed)
1379
alpha
1380
Q0691:What waveform?;light sleep;What stage of sleep is this? What percentage of total sleep time is this in young adults?
1381
Theta;1;5%
1382
Q0692:What waveform?;deeper sleep;What stage of sleep is this? What percentage of total sleep time is this in young adults?
1383
Sleep spindles and K complexes;2;45%
1384
Q0693:What waveform?;Deepest sleep; sleepwalking; night terrors; bed wetting;What stage of sleep is this? What percentage of total sleep time is this in young adults?
1385
Delta (lowest frequency; hightest amplitude);3-4;25%
1386
Q0694:What waveform?;dreaming; loss of motor tone; possibly memory procesing fx; erections; increase brain oxygen use;What stage of sleep is this? What percentage of total sleep time is this in young adults?
1387
Beta;REM ;25%;mneu: At night; BATS Drink Blood
1388
Q0695:What type of sleep is this?;increase variable pulse; rapid eye movements; inceased and variable blood pressure; penile/clitoral tumenescence. Occurs every 90 min; duration increases throughout the night.
1389
REM
1390
Q0696:principle neurotransmitter involved in REM sleep
1391
Ach
1392
Q0697:REM sleep _______ (increases or decreases) with age
1393
decreases
1394
Q0698:neural tube defects are associated with lack of this vitamen intake during pregnancy
1395
folic acid
1396
Q0699:neural tube defects are associated with elevated levels of this in amniotic fluid and maternal serum
1397
alpha fetoprotein levels
1398
Q0700:This describes failure of bony spinal canal to close; but no structural herniation. Usually seen at lower vertebral levels
1399
spinal bifida occulta
1400
Q0701:This describes when the meninges herniate throgh a spinal canal defect
1401
meningocele
1402
Q0702:This describes when meninges and spinal cord herniate through spinal canal defects
1403
meningiomyelocele
1404
Q0703:Give the area of the brain lesion?;motor (nonfluent/expressive) aphasia with good comprehension
1405
broca's area
1406
Q0704:Give the area of the brain lesion?;sensory (fluent/receptive) aphagia with poor comprehension
1407
Wernicke's area
1408
Q0705:Give the area of the brain lesion?;conduction aphagia; poor repitition with good comprehension; fluent speech
1409
Arcuate fasciculus ;(connects Wernicke's to Broca's area
1410
Q0706:Give the area of the brain lesion?;Kluver-Bucy Syndrome (hyperorality; hypersexuality; disinhibited behavior)
1411
Amygdala (bilateral)
1412
Q0707:Give the area of the brain lesion?;Personality changes and deficits in concentration; orientation; and judgement; may have reemergence of primitive reflexes
1413
frontal lobe
1414
Q0708:Give the area of the brain lesion?;Spacial neglect syndrome (agnosia of the contralateral side of the world)
1415
Right parietal lobe
1416
Q0709:Give the area of the brain lesion?;coma
1417
reticular activating system
1418
Q0710:Give the area of the brain lesion?;wernicke-korsakoff syndrome
1419
mamillary bodies (bilateral)
1420
Q0711:Give the area of the brain lesion?;tremor at rest; chorea; or athetosis
1421
basal ganglia
1422
Q0712:Give the area of the brain lesion?;Intention tremor; limb ataxia
1423
cerebellar hemisphere;mneu: cerebellar hemispheres are LATERALLY located--affect LATERAL limbs. Vermis is CENTRALLY located-affects CENTRAL body
1424
Q0713:Give the area of the brain lesion?;truncal taxia; dysarthria
1425
cerebellar Vermis ;mneu: cerebellar hemispheres are LATERALLY located--affect LATERAL limbs. Vermis is CENTRALLY located-affects CENTRAL body
1426
Q0714:Give the area of the brain lesion?;contralateral hemiballismus
1427
subthalamic nucleus
1428
Q0715:Chorea--sudden; jerky; purposeless movements are characteristic of a lesion in this part of the brain. Give the classic dz example.
1429
Basal ganglia;Huntington's dz
1430
Q0716:Athetosis are slow; writhing movements; especially of the fingers. This is characteristic of a lesion in this part of the brain
1431
basal ganglia
1432
Q0717:hemiballismus involves the sudden wild flailing of 1 arm. What kind of lesion does this indicate (& on what side)
1433
contralateral subthalamic nucleus;(results in loss of inhibition of thalamus through globus pallidus)
1434
Q0718:Broca's lesion is nonfluent aphagia with intact comprehension it involves this gyrus
1435
inferior frontal gyrus
1436
Q0719:Wernicke's aphagia is fluent aphagia with impared comprehension it involves this gyrus
1437
superior temporal gyrus
1438
Q0720:most common cause of dementia in the elderly. Associated w/ senile plaques (extracellular; Beta amyloid core) and neuro fibrillary tangles (intracellular; abnormally phosphorylated tau protiein)
1439
Alzheimers dz
1440
Q0721:Familial form of alziemers is associeted w/ genes on chromosomes 1; 14; 19 (APOE4 allele); and 21 (p-App gene) is thought to be responsible for this percent of alzheimers cases
1441
10%
1442
Q0722:What is the 2nd most common cause of dementia in the elderly
1443
multi-infarct dementia ;(may cause amyloid angiopathy)
1444
Q0723:pt presents with dementia; aphasia; parkinsonian aspects; associated with intracellular aggregated tau protien and is specific for frontal and temporal lobes.
1445
Pick's dz
1446
Q0724:pt presents with chorea and dementia. Autopsy shows atrophy of caudate nucleus (loss of GABAergic neurons).
1447
Huntinton's dz
1448
Q0725:Dz associated with chromasome 4--expansion of CAG repeats.
1449
Huntinton's dz;mneu: CAG-Caudate loses ACh & GABA.
1450
Q0726:dz associated w/ Lewy bodies and depigmentation of the substantia nigra pars compacta (loss of dopaminergic neurons) Rare cases have been linked to exposure to MPTP; a contaminant in illicit sreet drugs.
1451
Parkinson's dz;mneu: TRAP=Tremor (at rest); Rigidity; Akinesia; and Postural instability (you are TRAPped in your body.
1452
Q0727:Dz associated with BOTH LMN & UMN signs; no sensory defect. Also known as Lou Gehrig's dz
1453
Amyotrophic lateral Sclerosis (ALS)
1454
Q0728:presents as birth as a "floppy baby"; tongue fasciculations; median age of death is 7 months. Associated w/ degeneration of anterior horns. Autosomal-recessive inheritance.
1455
Werdnig-Hoffmann dz
1456
Q0729:dz follws infection with poliovirus; LMN signs. Associated with degeneration of anterior horns.
1457
Polio
1458
Q0730:Pt presents w malaise; headache; fever; nausea abdominal pain; sore throught. Progreses to signs of LMN lesions--mm weakness & atrophy; fasciculations; fibrillation; & hyporeflexia;LP of CSF shows lymphocytic pleocytosis w/ slight elevation of protein;What do you suspect?
1459
Poliomyelits
1460
Q0731:this dz is causesd by the poliovirus; which is transmitted by the fecal-oral route. It replicates in the oropharynx and small intestine before spreading through the bloodstream to the CNS where it leads to the destruction of cells in the anterior horn of the spinal cord; leading in turn to LMN destruction.
1461
poliomyelitis
1462
Q0732:This dz shows increased prevalence with increased distance from the equator.
1463
MS
1464
Q0733:This dz shows periventricular plaques (areas of oligodendrocyte loss and reactive gliosis)with preservation of actions. There is an increase in protein (IgG) in CSF.
1465
MS
1466
Q0734:dz associated with a relapsing-remitting course.
1467
MS
1468
Q0735:With this dz pts often present w/ optic neuritis (sudden loss of vision) MLF syndrome (internuclear ophtalmoplegia); hemiperesis; hemisensory symptoms; or bladder/bowel incontinence.
1469
MS
1470
Q0736:This dz classically presents with scanning speech; intension tremor; and nystagmus. It most often affects women in their 20s and 30s. And is more common in whites. Tx is Beta interferon or immunosuppressant therapy.
1471
MS
1472
Q0737:This demyelinating dz is associated with the JC virus and is seen in 2-4% of AIDS pts.
1473
Progressive multifocal leukoencephalopathy (PML)
1474
Q0738:This dz is associated with inflammationand demyelination of peripheral nn and motor fibers of the ventral roots (sensory effects are less severe than motor). This results in symmetric ASCENDING mm weakness begining in distal and lower extremities;LP of CSF shows elevated protein with normal cell count (albuminocytologic dissociation). Elevated protien levels may lead to papilledema;Pts usually recover completely.
1475
Guillian-Barre Syndrome (acute idiopathic polyneuritis)
1476
Q0739:Guillian-Barr has been associated with certain infections including (2)
1477
herpesvirus or Campylobacter jejuni
1478
Q0740:seizures involving only one area of the brain
1479
partial seizures
1480
Q0741:simple partial seizures
1481
1 area of the brain;conciousness intact
1482
Q0742:complex partial seizures
1483
1 area of the brain;impaired consciousness
1484
Q0743:generalized seizures
1485
diffuse areas of brain
1486
Q0744:generalized siezures involving a blank stare
1487
absence (petit mal)
1488
Q0745:generalized siezures involving quick repetitive jerks
1489
myoclonic
1490
Q0746:Generalized siezure involving alternating stiffening and movement
1491
tonic-clonic
1492
Q0747:Pt hit in the side of the head with a baseball and fracturs his temperal bone. Rupture of the middle meningeal aa results. CT shows a "bioconvex disk" that does not cross suture lines. What is your dz of the Intracranial hemorrhage?
1493
epidural hematoma
1494
Q0748:Alcoholic presents to the ER. He fell and hit his head the previous night but thought he was fine until neurological symptoms appeared the next morning. MRI shows a crescent-shaped hemorrhage that crosses suture lines. You suspect a venous bleed. What is your dx of this intracranial hemorrhage?
1495
Subdural hematoma
1496
Q0749:Pt complains of "worst headache of their life." You worry it may be a rubture of a berry aneurism. Spinal tap is bloody. What is the d of this intracranial hemorrhage?
1497
Subarachnoid hemorrhage
1498
Q0750:This type of aneurism often occurs at the bifurcation in the circule of Willis. The most common site is the bifurcation of the anterior communicating artery. Risk factors include adult polycystic kidney dz; Ehlers-Danlos syndrome; & Marphan's syndrome.
1499
Berry aneurysms
1500
Q0751:most _______ (childhood v. adult) tumors are supratentorial; while most ________childhood v. adult) tumors are infratentorial.
1501
adult;childhood;Note: 50% of brain tumors are metastases
1502
Q0752:This tumor has an adult peak incidence. It is the most common primary brain tumor and it has a grave prognosis (<1 yr life expectancy). It is found in the cerebral hemisphere and can cross the corpus callosum;"Pseudopalisading" tumor cells border central areas of necrosis and hemorrhage. Stain astrocytes with GFAP.
1503
Glioblastoma multiforme (grade IV astrocytoma)
1504
Q0753:This tumor has an adult peak incidence. It is the second most common primary brain tumor. It most often occurs in the convexities of hemispheres and parasagital region. It arises from arachnoid cells external to the brain. It is usually resectable.
1505
Meningioma
1506
Q0754:On pathology this primary brain tumor shows spindle cells concentrically arranged in a whorled pattern and psammoma bodies (laminated calcification) What is it?
1507
Meningioma
1508
Q0755:This brain tumor has an adult peak incidence. It is the 3rd most common primary brain tumor. It is of Schwann cell origin and is often localized to the 8th nerve. It is resectable. What is it?
1509
Schwannoma
1510
Q0756:Bilateral schwannoma is often found in what condition?
1511
neurofibromatosis type 2
1512
Q0757:This primary brain tumor with an adult peak incidence is relatively rare. It is slow growing and most often occurs in the frontal lobes.
1513
Oligodendroma
1514
Q0758:On pathology this tumor has "fried egg" cells-round nucleii with clear cytoplasm. They are often calcified.
1515
Oligodendroma
1516
Q0759:This priary brain tumor that has an adult peak incidence most commonly comes in a prolactin secreting form. Often it occurs with bilateral hemianopia (due to pressure on optic chiasm)
1517
pituitary adenoma
1518
Q0760:This primary brain tumor has a peak incidence in childhood. It is a diffusely infiltrating glioma. It is most often found in the posterior fossa. It is benign and carries a good prognosis.
1519
Pilocytic (low grade) astrocytoma)
1520
Q0761:On pathology this primary brain tumor shows Rosenthal fibers (eosinophilic; corkscrew fibers)
1521
Pilocytic (low grade )astrocytoma
1522
Q0762:This primary brain tumor that occurs with a peak incidence in children is a highly malignant cerabellar tumor. It is a form of primitive neuroectodermal tumor (PneT). It can compress the 4th ventricle causing hydrocephalus. It is highly radiosensitive.
1523
Medulloblastoma
1524
Q0763:On pathology this tumor shows Rosettes or perivascular pseudorosette pattern of cells
1525
medulloblastoma
1526
Q0764:This primary brain tumor that occurs with a peak incidence in children is an ependymal cell tumor most commonly found in the 4th ventricle. It can cause hydrocephalus and carries a poor prognosis.
1527
ependymoma
1528
Q0765:On pathology this tumor has characteristic perivascular pseudorosettes. Rod shaped blepharoplasts (basal ciliary bodies) found near the nucleus
1529
ependymoma
1530
Q0766:This primary brain tumor that occurs with a peak incidence in children is most often cerebeller. It is associated with Von Hippel-Lindau syndrome when found with retinal angiomas. Can produce EPO and lead to secondary polycythemia;On pathology: Foamy cells and high vascularity are characteristic.
1531
Hemangioblastoma
1532
Q0767:This primary brain tumor that occurs with a peak incidence in children is a benign tumor which can be confused with pituitary adenoma (can also cause bitemporal hemianopia). This is the most common childhood supratentorial tumor. It is derived from remnants of Rathke's pouch and calcification is common.
1533
Craniopharyngioma
1534
Q0768:Sign of UMN or LMN lesion or both?;Weakness
1535
Both;mneu: LOWER MN= everything is LOWERED (less mm mass; less mm tone; less reflexes; downgoing toes. UPPER MN= everything UP (tone; DTRs; toes)
1536
Q0769:Sign of UMN or LMN lesion or both?;Atrophy
1537
LMN;mneu: LOWER MN= everything is LOWERED (less mm mass; less mm tone; less reflexes; downgoing toes. UPPER MN= everything UP (tone; DTRs; toes)
1538
Q0770:Sign of UMN or LMN lesion or both?;Fasciculation
1539
LMN;mneu: LOWER MN= everything is LOWERED (less mm mass; less mm tone; less reflexes; downgoing toes. UPPER MN= everything UP (tone; DTRs; toes)
1540
Q0771:Sign of UMN or LMN lesion or both?;Increased Reflexes?;Decreased Reflexes?
1541
UMN;LMN;mneu: LOWER MN= everything is LOWERED (less mm mass; less mm tone; less reflexes; downgoing toes. UPPER MN= everything UP (tone; DTRs; toes)
1542
Q0772:Sign of UMN or LMN lesion or both?;Increased tone?;Decreased tone?
1543
UMN;LMN;mneu: LOWER MN= everything is LOWERED (less mm mass; less mm tone; less reflexes; downgoing toes. UPPER MN= everything UP (tone; DTRs; toes)
1544
Q0773:Sign of UMN or LMN lesion or both?;Babinski?
1545
UMN;mneu: LOWER MN= everything is LOWERED (less mm mass; less mm tone; less reflexes; downgoing toes. UPPER MN= everything UP (tone; DTRs; toes)
1546
Q0774:These diseases result in lower motor neuron lesions only. They are due to destruction of the anterior horns and result in flacid paralysis. [pic]
1547
Poliomyelitis & Werdinig Hoffman dz
1548
Q0775:This dz effects mostly the white matter of the cervical region. Random and asymmetrical demyelinating lesions are seen. Often pt presents with scanning speech; intention tremor; and nystagmus [pic]
1549
MS
1550
Q0776:These diseases result in lower motor neuron lesions only. They are due to destruction of the anterior horns and result in flacid paralysis. [pic]
1551
Poliomyelitis & Werdinig Hoffman dz
1552
Q0777:This dz involves combined UMN and LMN deficits with no sensory deficit. Pt often presents with both UMN & LMN neuron signs [pic]
1553
ALS
1554
Q0778:When this happpens the only thing spared are the dorsal columns and tract of Lissauer[pic]
1555
complete occlusion of ventral artery
1556
Q0779:This results in degeneration of the dorsal roots and dorsal columns. Pt presents with impared proprioception and locomotor ataxia.
1557
Tabes dorsalis (tertiary syphilis)
1558
Q0780:This resultswhen the crossing fibers of the corticospinal tract are damaged. Pt presents with bilateral loss of pain and temperature sensation
1559
syringomyelia
1560
Q0781:This results in demyelination of dorsal columns; lateral corticospinal tracts; and spinocerebellar tracts. Pt often presents with ataxic gait; hyperreflexia; impared position and vibration sense
1561
vit B neuropathy and Friedreich's ataxia
1562
Q0782:This results when the central canal of the spinal cord is enlarged for some reason. The crossing fibers of spinothalamic tract are thus damaged. Pt shows bilateral loss of pain and temperature sensation in upper extremities with preservation of touch sensation.
1563
Syringomyelia
1564
Q0783:Syringomyelia often presents with this congenital malformation.
1565
Arnold-Chiari malformation
1566
Q0784:Syringomyelia is most common at this spinal level
1567
C8-T1
1568
Q0785:This disorder is due to degeneration of the dorsal columns and dorsal roots due to tertiary syphilis. It results in impared proprioception and locomotor ataxia. Pt often presents with Charccot's joints (neuropathy of the joint); Argyll Robertson pupils (reactive to accommidation but not to light); and absensce of DTRs
1569
Tabes dorsalis
1570
Q0786:Brown Sequard syndrome is a complete hemisection of the spinal cord. Give the findings.
1571
1. Ipsilateral UMN signs(corticospinal tract) below lesion;2) Ipsilateral loss of tactile; vibration; proprioception sense (dorsal column) below lesion;3) Contralateral pain and temperature loss (spinothalamic tract) below the lesion;4) Ipsilateral loss of all sensation at the level of lesion;5) LMN signs at the level of the lesion;*note: if the lesion occurs above T1 the pt will present with Horner's syndrome
1572
Q0787:What are the symptoms of Horner's syndrome?;What spinal levels is it associated with?;What is a common cancer that may result in it?
1573
1)Ptosis (droopy eyelid);2)Anhydrosis (no sweating or flushing of effected side of face;3)Miosis (pupil constriction);HS is associated with lesion of spinal cord above T1;Pancoast tumor
1574
Q0788:The 3 neuron OCULOSYMPATHETIC PATHWAY projects from 1)hypothalamus to the 2)intermediolateral column of the spinal cord; then to the 3) superior cervical (sympathetic) ganglion; and finally to the 4) pupil; the smooth mm of the eyelids; and the sweat glands of the forehead and face. Interruption of these pathways results in _________
1575
Horner's syndrome
1576
Q0789:What nerve was injured?;Pt fractures the shaft of humerus. He presents with "wrist drop" ( extensor carpi radialis longus damage); loss of triceps and brachioradialis reflexes;Loss of sensation on posterior surface of arm and forearm (posterior brachial cutaneous and posterior antebrachial cutaneous)
1577
Radial nn
1578
Q0790:The 3 neuron OCULOSYMPATHETIC PATHWAY projects from 1)hypothalamus to the 2)intermediolateral column of the spinal cord; then to the 3) superior cervical (sympathetic) ganglion; and finally to the 4) pupil; the smooth mm of the eyelids; and the sweat glands of the forehead and face. Interruption of these pathways results in _________
1579
Horner's syndrome
1580
Q0791:What nerve was injured?;Pt reports hitting his "funny bone" (medial epicondyle) hard! He now has impared wrist flexion and adduction. He can't adduct his thumb or the 4th and 5th digits resulting in a "claw hand";He has a loss of sensation over the medial palm and his pinky finger.
1581
ulnar
1582
Q0792:What nerve was injured? ;pt experiences a break through the surgical neck of the humerus or has an anterior shoulder dislocation. He now has trouble abducting his arm above 30 degrees.
1583
Axillary
1584
Q0793:What nerve was injured?;Pt presents with a loss of function of biceps; coracobrachialis; and brachialis muscle. He has no biceps reflex?
1585
musculocutaneous
1586
Q0794:This nerve passes through the supinator
1587
radial
1588
Q0795:this nerve passes through the pronator teres
1589
median
1590
Q0796:this nerve passes through the flexor carpi ulnaris
1591
ulnar
1592
Q0797:Child presents with "waiter's tip" appearance: arm hanging to one side (paralysis of abductors); medially rotated (paralysis of lateral rotators); and forarm is pronator (loss of biceps;What is the dx? What are the nerve roots and what are you concerned about?
1593
Erb-Duchenne palsy;traction tear of the upper trunk of the brachial plexis (C5 & C6 roots) often follows blow to shoulder;could be due to trauma during delivery or child abuse.
1594
Q0798:What nerve was injured?;Pt presents with loss of dorsiflexion resulting in "foot drop"
1595
Common peroneal nerve (L4-S2);PED= Peroneal Everts & Dorsiflexes; if injured; foot is dropPED
1596
Q0799:Deep peroneal nn innervates _______ compartment;Superficial peroneal nn innervates _______ compartment
1597
anterior;lateral
1598
Q0800:What nn is injured?;pt presents with loss of plantar flexion.
1599
Tibial (L4-S3);TIP=Tibial Inverts & Plantarflexes; if injured; cant stand on TIPtoes.
1600
Q0801:What nn is damaged?;Pt presents with loss of knee extension and deminished pateller reflex.
1601
Femoral (L2-L4)
1602
Q0802:What nn is injured?;Pt presents with a loss of hip adduction?
1603
Obturator
1604
Q0803:Pt presents with;1) atrophy of the thenar and hypothenar eminences;2) atrophy of the interosseous mm;3) sensory deficits on the medial side of the forearmand hand;4) disappearance of the radial pulse upon moving the head towards the opposite side;What do you suspect? Discribe this disorder?
1605
Thoraci outlet syndrome (Klumpke's palsy);Compression of subclavian aa and inferior trunk of brachial plexus (C8;T1)
1606
Q0804:In a LMN lesion of CN XII the tongue will deviate _____ (away or towards) the side of the lesion?
1607
towards;mneu: lick your wounds
1608
Q0805:In a CN V motor lesion the jaw deviates ______ (towards or away) the side of the lesion
1609
towards
1610
Q0806:in a CN X lesion the uvula will deviate _______ (towards or away) of the side of the lesion.
1611
away
1612
Q0807:In a unilateral lesion of the cerebellum the pt tends to fall _______ (towards or away) the side of the lesion.
1613
towards
1614
Q0808:In a CN XI lesion there is weakness turning head to the side _________ (ipsi or contralateral) to the lesion. There is also a shoulder droop (ipsi or contralateral) to the lesion
1615
contralateral;ipsilateral
1616
Q0809:pt presents with paralysis of the lower half his face only. What do you suspect.
1617
contralateral UMN lesion ;(either of motor cortex or connection between cortex and facial nucleus)
1618
Q0810:pt presents with paralysis of one side of his entire face (upper and lower). What do you suspect?
1619
ipsilater LMN lesion of CN VII
1620
Q0811:This disorder is due to a destruction of the facial nucleus itself or it's brancchial efferent fibers (facial nn). It results in ipsilateral facial paralysis with an inability to close the eye of the involved side. It is often idiopathic and there is gradual recovery in most cases
1621
Bell's palsy
1622
Q0812:Give some diseases in which Bell's palsy is often seen as a complicaion.
1623
Aids; Lyme dz; Sarcoidosis; Tumors; Diabetes;mneu: ALexander BELL with STD: AIDS; Lyme; Sarcoid; Tumors; Diabetes
1624
Q0813:This herniation syndrome can compress the anterior cerebral aa
1625
Cingulate herniation under falx cerebri
1626
Q0814:These 3 herniation syndrome can result in coma and death if brain stem is compressed.
1627
1)downward transtentoral (central herniation;2) Uncal herniation (Uncus=medial temporal lobe);3)Cerebellar tonsillar herniation into the foramen magnum
1628
Q0815:In the case of an uncal herniation you may see ipsilateral dilated pupil/ptosis. This is due to what?
1629
Stretching of CN III
1630
Q0816:In the case of an uncal herniation you may see contralateral homonymous hemianopia. This is due to what?
1631
compression of ipsilateral posterior cerebral aa
1632
Q0817:In the case of an uncal herniation you may see ipsilateral paresis. This is due to what?
1633
compression of contralateral crus cerebri (Kernohan's notch)
1634
Q0818:In the case of an uncal herniation you may see Duret hemorrhages (paramedian artery rupture). This is due to
1635
caudal displacement of the brain stem
1636
Q0819:Pt can't see at all out of his right eye (right anopia) Where is the lesion?
1637
Right optic nn
1638
Q0820:Pts has bilateral temporal visual field defects (bitemporal hemianopia) Where is the lesion?
1639
Optic chiasm
1640
Q0821:Pt can't see the left visual field in either eye (Left homonymous hemianopia) Where is the lesion?
1641
Right Optic Tract
1642
Q0822:Pt has Left upper quadratic anopsia (cant see up and to the right on both sides) Where is the lesion?
1643
Right Temporal Lesion (Meyer's loop)
1644
Q0823:Pt has left lower quandrantic anopia (can't see down and to the left in either eye) Where is the lesion?
1645
Right Parietal lesion ;(Dorsal optic radiation)
1646
Q0824:Pt has left hemianopia with macular sparing??
1647
???visual cortex??
1648
Q0825:this syndrome is seen in many patients with multiple sclerosis. It results in medial rectus palsy on attempted lateral gaze & nystagmus in the abducting eye. Convergence is normal.
1649
Internuclear opthalmoplegia (MLF syndrome);mneu: MLF=MS
1650
Q0826:explain the pathology of Internuclear opthalmoplegia (Medial longitudinal fasciculus [MLF] syndrome)[pic]
1651
When looking left; the left nucleus of CN VI fires; which contracts the left lateral rectus and stimulates the contralateral (right) nucleus of CN III via the right MLF to contract the right medial rectus. Lesion in the MLF interrupts this process.
1652
Q0827:give the dz indicated by the following neurotransmitter changes;increased NE;decreased GABA;decreased 5HT
1653
Anxiety
1654
Q0828:give the dz indicated by the following neurotransmitter changes;decreased NE & decreased 5HT
1655
depression
1656
Q0829:give the dz indicated by the following neurotransmitter changes;decreased ACh
1657
Alzheimer's dementia
1658
Q0830:give the dz indicated by the following neurotransmitter changes;decreased GABA;decreased ACh
1659
Huntington's dz
1660
Q0831:give the dz indicated by the following neurotransmitter changes;increased Dopamine
1661
Schizophrenia
1662
Q0832:give the dz indicated by the following neurotransmitter changes;decreased Dopamine
1663
Parkinson's dz
1664
Q0833:When a person becomes disoriented they generally lose concept of person(their name; who they are); place (where they are); and time. In what order does this loss usually occur?
1665
1st-time;2nd-place;last-person
1666
Q0834:what is anosognosia?
1667
unawareness that one is ill
1668
Q0835:what is autotopagnosia
1669
inability to locate one's own body parts
1670
Q0836:what is depersonalization
1671
body seems unreal or dissociated
1672
Q0837:what is ANTEROgrade amnesia?
1673
inability to remember things that occurred afte a CNS insult;mneu: antero=after
1674
Q0838:what is RETROgrade amnesia?
1675
inability to remember things that occurred before a CNS insult;mneu: retro=before
1676
Q0839:what is substance dependance?
1677
maladaptive pattern of substance use defined as 3 or more of the follwing signs in 1 yr;1)tolerance;2)withrawal;3)substance taken in larger amounts or over longer period of time than desired;4) persistant desire or attempts to cut down;5) significant energy spent obtaining; using; or recovering from substance;6 Important social; occupational; or recreational activities reduced because of substance use;7) continued use in spite of knowing the problems it causes
1678
Q0840:What is substance abuse
1679
maladaptive pattern leading to clinically significant imparment or distress. Symptoms have not met criteria for substance dependance. 1 or more of the follwing in 1 yr;1) recurrent use resulting in failure to fulfill major obligations at work; school; or home;2) recurrent use in physically hazardous situations;3) recurrent substance-related legal problems;4)Continued use in spite of problems caused by use
1680
Q0841:intoxication of this drug results in disinhibition; emotional lability; slurred speech; ataxia; coma; blackouts.
1681
alcohol
1682
Q0842:gamma glutamyltransferase (GGT) is a sensitive indicator of this drugs use
1683
alcohol
1684
Q0843:withdrawal from this drug results in tremor tachycardia; hypertension; malaise; nausea; seizures; delerium tremens (DTs); tremulousness; agitation; hallucinations
1685
alcohol
1686
Q0844:intoxication of this substance results in CNS depression; nausea and vomiting; constipation; pupillary constriction (pinpoint pupils); seizures;*overdose is life threatening
1687
opiods
1688
Q0845:withdrawal from this substance results in anxiety; insomnia; anorexia; sweating; dilated pupils; piloerection (goose pimples); fever; rhinorrhea; nausea; stomach cramps; diarrhea ("flulike" symptoms); yawning
1689
opiods
1690
Q0846:intoxication of this substance results in psychomotor agitation; impared judgement; pupillary dilation; hypertension; tachycardia; euphoria; prolonged wakefulness and attention; cardiac arrhythmias; delusions; hallucinations; fever
1691
amphetamines
1692
Q0847:withdrawal from this substance results in post use "crash"; including depression; lethargy; headache; stomach cramps; hunger; hypersomnolence
1693
amphetamines
1694
Q0848:intoxication of with this substance results in euphoria; psychomotor agitation; impared judgement; tachycardia; pupillary dilation; hypertension; hallucinations (including tactile); paranoid ideations; angina; sudden cardiac death
1695
cocaine
1696
Q0849:withdrawal from this substance results in a post-use "crash"; including severe depression and suicidality; hypersomnolence; fatigue; malaise; and severe psychological craving
1697
cocaine
1698
Q0850:intoxication with this substance results in belligerence; impulsiveness; fever; psychomotor agitation; vertical and horizontal nystagmus; tachycardia; ataxia; homicidality; psychosis; delirium
1699
PCP
1700
Q0851:with this drug recurrence of intoxication symptoms can occur due to reabsorption in the GI tract; resulting in a sudden onset of severe; random; homicidal violence
1701
PCP
1702
Q0852:intoxication with this substance can result in marked anxiety or depression; delusions; visual hallucinations; flashbacks; and pupil dilation
1703
LSD
1704
Q0853:Intoxication with this substance can result in euphoria; anxiety; paranoid delusions; perception of slowed time; impared judgement; social withdrawal; increased appetite; dry moth; hallucinations
1705
Marijuana
1706
Q0854:Intoxication with this drug is dangerous because of its low safety margin. higher doses result in respiratory depression
1707
barbituates
1708
Q0855:withdrawal from this substance results in anxiety; seizures; delerium; and life-threatening cardiovascular collapse
1709
barbiturates
1710
Q0856:These medications have a greater safety margin than barbituates. Intoxication can result in amnesia; ataxia; somnolence; minor respiratory depression.
1711
benzodiazepines
1712
Q0857:these drugs have an additive effect with alcohol
1713
benzodiazepines
1714
Q0858:withdrawal from these drugs results in rebound anxiety; seizures; tremor; and insomnia
1715
benzodiazepines
1716
Q0859:excessive use of this drug results in restlessness; insomnia; increased diuresis; muscle twitching; and cardiac arrhythmias
1717
caffeine
1718
Q0860:withdrawal from this drug results in headache; lethargy; depression; and weight gain
1719
caffiene
1720
Q0861:use of this drug results in restlessness; insomnia; anxiety; and arrhythmias-no increased diuresis
1721
nicotine
1722
Q0862:withdrawal from this drug results in irritability; headache; anxiety; weight gain; and extreme cravings
1723
nicotine
1724
Q0863:use of this drug results in restlessness; insomnia; anxiety; and arrhythmias-no increased diuresis
1725
nicotine
1726
Q0864:This dz is charachterized by physiologic tolerance and alcohol dependence with symptoms of withdrawal (tremor; tachycardia; hypertension; malaise; nausea; DTs when intake is interrupted. Pts will show continued drinking despite medical and social contradictions and life disruptions.
1727
Alcoholism
1728
Q0865:What is a drug used in treatment of alcoholism
1729
disulfiram
1730
Q0866:describe the metabolism and effects of ethenaol
1731
image p. 360
1732
Q0867:When do DTs usually appear in alcoholics?
1733
2-5D after last drink.
1734
Q0868:In alcoholics in withdrawal what occurs 1st-autonomic system hyperactivity (tachycardia; tremors; anxiety) or psychotic symptoms (hallucinations; delusions)
1735
1st-autonomic hyperactivity;2nd-psychotic symptoms
1736
Q0869:How do you treat DTs in alcholics going through withdrawal?
1737
benzodiazpenes
1738
Q0870:Long-term alcohol use leads to this involving micronodular cirrhosis with accompaning symptoms of jaundice; hypoalbuminemia; coagulation factor deficiencies; and portal hypertension.
1739
alcoholic cirrhosis
1740
Q0871:This syndrome caused by vitamin B1 (thiamine) deficiency; is common in malnourished alcoholics. They classically present with a triad of confusion; opthallmoplegia; and ataxia. This may progress to memory loss; confabulation; and personality change. It is associated with periventricular hemorrhage/necrosis; especially in mamillary bodies.
1741
Wernicke-Korsakoff syndrome
1742
Q0872:What is the tx of Wernicke-Korsakoff syndrome
1743
IV vitamine B1 (thiamine)
1744
Q0873:this complication of alcoholism consists of longitudinal lacerations at the gastroesophageal junction caused by excessive vomiting. In contrast to esophageal varices it is associated with pain.
1745
Mallory-Weiss syndrome
1746
Q0874:Heroine is a schedule __ drug
1747
schedule I (not perscribable)
1748
Q0875:addicts of this drug are at increase risk of hepatitis; abscesses; overdose; hemorrhoids; AIDS; and right sided endocarditis.
1749
heroine
1750
Q0876:These drugs can competatively inhibit opiods
1751
Naloxone (narcan) and naltrexone
1752
Q0877:This long acting oral opiate is used for heroine detoxification or long term maitenance
1753
methadone
1754
Q0878:this psychiatric illnesss involves rapid decrease in attention span and level of arousal. Pts show disorganized thinking; have hallucinations; illusions; misperceptions; disturbance in sleep wake cycle; and cognitive disfunction;The key to diagnosis is its rapid onset and the waxing and waning of level of conciousness.
1755
delerium;mneu: deliRIUM=changes in sensoRIUM
1756
Q0879:this is the most common psychiatric illness on medical and surgical floors.
1757
delerium
1758
Q0880:delerium is often iatrogenic and reversable. Look at pts meds for ones with this effect.
1759
anticholenergic
1760
Q0881:This psychiatric illness ivolves a gradual decrease in cognition--memory deficits; aphasia; apraxia; agnosia; loss of abstract thought; behavior/ personality changes; and impared judgement;Be sure to differentiate this from delerium. The key to diognosis is the more gradual onset and the fact that pt is alert with no change in his/her level of conciousness.
1761
Dementia;mneu: DeMEMtia is characterized by MEMory loss. Commonly irreversable.
1762
Q0882:In elderly pts this disease can often present like dementia.
1763
depression
1764
Q0883:DSM Criteria of Major depressive episode
1765
characterized by at least 5 of the following for 2 weeks; including either depressed mood or anhedionia;1) Sleep disturbance;2)decreased Interest ;3)Guilt or feelings of worthlessness;4)decreased Energy;5)decreased Concentration;6)?Appetite;7)Psychomotor retardation/agitation;8)Suicidal ideations;mneu: SIG E CAPS
1766
Q0884:Lifetime prevalence of a major depressive episode is _____ for males and _____ for females
1767
5-12% - males;10-25% - females
1768
Q0885:This variation on Major depressive disorders invoves 2 or more major depressive episodes with a symptom free interval of 2 months
1769
RRECURRENT Major Depressive Disorder
1770
Q0886:This disorder is a milder form of depression that lasts at least 2 years
1771
dysthymia
1772
Q0887:Pts with depression typically have the follwing 3 changes in their sleep stages.
1773
1)decreased slow wave sleep;2)decreased REM latency;3) Early-morning awakening (important screening question
1774
Q0888:Risk factors for suicide completion
1775
Sex (male);Age (teenager or elderly);Depression;Previous attempt;Etoh (or drug use);Rational thinking (loss of);Sickness (3 perscriptions) ;Organized plan;No spouce (esp if childless);Social support lacking;mneu: SAD PERSONS
1776
Q0889:ECT is a treatment option when?
1777
MDD refractory to other treatment
1778
Q0890:Major adverse effects of ECT
1779
anterograde and retrograde amnesia; and confusion
1780
Q0891:T or F: ECT is painful.
1781
1782
Q0892:This psychiatric disorder is characterized by a period of abnormally and persistantly elevated; expansive; or irritable mood lasting at least one week.
1783
Manic episode
1784
Q0893:Describe the DSM criteria for a manic episode.
1785
During a manic episode; 3 or more of the follwing are present;1) Distractibility;2) Irresponsibility;3) Grandiosity;4) Flight of ideas;5)increased Activity;6)decreased Sleep;7)Talkativeness;mneu: DIG FAST
1786
Q0894:this psychiatric disturbance is like a manic episode except mood disturbance is not severe enough to cause marked imparement in social and/or occupational functioning or to necessitate hospitalization. There are no psychotic features
1787
Hypomanic episode
1788
Q0895:In this disorder pt consciosly fakes or claims to have a disorder in order to attain a specific gain (e.g; avoiding work; obtaining drugs)
1789
malingering
1790
Q0896:Drug of choice for bipolar disorder
1791
lithium
1792
Q0897:what is cyclothymic disorder?
1793
a milder form of bipolar disorder lasting at least 2 years
1794
Q0898:In this disorder the pt conciously creates symptoms in order to assume the "sick role" and to get medical attention.
1795
factitious disorder
1796
Q0899:This form of factitious disorder is manifested by a chronic history of multiple hospital admissions and willingness to receive invasive procedures.
1797
Munchausen's syndrome
1798
Q0900:This factitious disorder is seen when an illness in the child is caused by the parent. The motivation is unconscious. It is a form of child abuse and must be reported.
1799
Muchausen's syndrome by proxy
1800
Q0901:In this psychiatric disorder both illness production and motivation are unconcious drives. These are more common in women and manifest themselves in a variety of ways.
1801
Somatoform disorders
1802
Q0902:Type of somatoform disorder in which pt presents with motor or sensory symptoms (e.g; paralysis; pseudoseizure) that suggest neurologic of physical disorder; but tests and physical exam are negative. Onset of symptoms often follow an acute stressor. Pt may seem strangely unconcerned about symptoms
1803
Conversion disorder
1804
Q0903:Type of somatoform disorder in which pt presents with prolonged pain that is not explained completely by an illness.
1805
Somatoform pain disorder
1806
Q0904:Type of somatoform disorder in which pt presents with preoccupation with and fear of having a serious illness in spite of medical reassurance
1807
hypochondriasis
1808
Q0905:Type of somatoform disorder in which pt presents with a variety of complaints in multiple organ sytems with no identifiable underlying physical findings
1809
Somatization disorder
1810
Q0906:Type of somatoform disorder in which pt presents with preoccupation with minor or imagined physical flaws. Pts often seek cosmetic surgery
1811
Body dysmorhic disorder
1812
Q0907:Type of somatoform disorder in which pt presents with false belief of being pregnant associated with objective physical signs of pregnancy
1813
pseudocyesis
1814
Q0908:What type of gain: primary; secondary; tertiary?;What the symmptom does for the patients internal psychic economy
1815
primary gain
1816
Q0909:What type of gain: primary; secondary; tertiary?;What the symptom gets the patient (sympathy; attention)
1817
secondary gain
1818
Q0910:What type of gain: primary; secondary; tertiary?;What the caretaker gets (like an doctor on an interesting case)
1819
tertiary
1820
Q0911:Describe DSM characterization of panic disorder
1821
recurrent periods of intense fear and discomfort peaking in 10 minutes with 4 of the following;Palpitations;Paresthesias;Abdominal distress;Nausa;Intense fear of dying or losing control;lIght headedness;Chest pain;Chills;Choking;disConnectedness;Sweating ;Shaking;Shortness of breath;mneu: PPANIICCCCSSS;note: panic disorder is descrribed in context of occurrence (e.g; panic d/o w/ agoraphobia)
1822
Q0912:This psychiatric disorder involves a specific fear that is excessive or unreasonable. It is cued by presence or anticipation of a specific object or situation. Exposue to this object or situation provokes an anxiety response. Person recognizes the fear is excessive (insight). This fear interfears with normal routine.
1823
specific phobia
1824
Q0913:what form of psychotherapy works well for specific phobias
1825
systematic desensitation
1826
Q0914:gamophobia
1827
fear of marrage
1828
Q0915:algophobia
1829
fear of pain
1830
Q0916:acrophobia
1831
fear of heights
1832
Q0917:agoraphobia
1833
fear of open spaces
1834
Q0918:In this disorder person experiences or witnesses an event that involved actual or threatened death or serious injury. response involves intense fear; helplessness; or horror. The traumatic event is persistently reexperienced as nightmares or flashbacks. The person persistantly avoids stimuli associated with the trauma and experiences persistant symptoms of increased arousal. Disturbance lasts > 1mo and cuases distress or socia/occupation imparent. This disorder often follwos acute stress disorder which lasts up to 2-4 weeks.
1835
Post-traumatic stress disorder
1836
Q0919:In this disorder emotional symptoms (anxiety; depression) causing impairment follw an identifiable psychosocial stressor (e.g; divorse; moving). This lasts less than 6 months
1837
Adjustment disorder
1838
Q0920:This psychiatric disorder is characterized by uncontrollable anxiety for at least 6 months that is unrelated to a specific person; situation; or event. Sleep disturbance; fatigue; and difficulty concentrating are common.
1839
generalized anxiety disorder
1840
Q0921:children with this disorder have severe communication problems and difficulty forming relationships. This disorder is characterized by repetitive behavior; unusual abilities (savants); and usually below-normal intelligence.
1841
Autistic disorder
1842
Q0922:This disorder is a milder form of autism involving problems with social relationships and repetitive behavior. These children are of normal intellegence and lack social or cognitive deficits.
1843
Asperger disorder
1844
Q0923:This is an X-linked disorder seen only in girls (affected males die in utero). It is characterized by a loss of development and mental reatardation appearing at approximately age 4. There is steriotyped hand-wringing.
1845
Rett disorder
1846
Q0924:this disorder is characterized by limited attention span and hyperactivity. Children are emotionally labile; impulsive; and prone to accidents. These children typically have normal intellegence.
1847
Attention Deficit Hyperactivity Disorder (ADHD)
1848
Q0925:What is the treatment of ADHD
1849
methylphenidate
1850
Q0926:This psychiatric disorder of childhood is characterized by behavior that continually violates social norms. At >18 y/o this disorder is recategorized as antisocial personality disorder.
1851
Conduct disorder
1852
Q0927:This psychiatric disorder of childhood is characterized by noncompliance in the absence of criminality.
1853
Oppositional defiant disorder.
1854
Q0928:This psychiatric disorder of childhood is characterized by motor/vocal tics and involuntary profanity. Onset is <18 y/o.
1855
Tourette's syndrome
1856
Q0929:What is the treatment for Tourette's syndrome
1857
haloperidol
1858
Q0930:This psychiatric disorder of childhood is characterized by fear of loss of attachment figure leading to factitious physical complaints to avoid going to school. The common onset is age 7-8.
1859
Seperation anxiety disorder.
1860
Q0931:This eating disorder is commonly seen in adolescent girls and coexists with depression. It is characterized by excessive dieting; body image distortion; and increased exercise. Pts often experience severe weight loss; amenorrhea; anemia and eventually electrolyte disturbance.
1861
Anerexia nervosa
1862
Q0932:This eating disorder is characterized by binge eating followed by self-induced vomiting or use of laxitives. Body weight is typically normal. Parotitis; enamel erosion; electrolyte disturbances; alkalosis; and dorsal hand calluses are common physical exam/lab findings.
1863
Bulimia nervosa
1864
Q0933:Hallucinations v. Illusion v. Delusions;______ are perceptions in the absense of external stimuli
1865
Hallucinations
1866
Q0934:Hallucinations v. Illusion v. Delusions;__________ are misinterpretations of actual external stimuli
1867
illusions
1868
Q0935:Hallucinations v. Illusion v. Delusions;______ are false beliefs not shared with other members of culture/subculture that are firmly maintained in spite of obvious proof to the contrary
1869
Delusions
1870
Q0936:Delusions v. Loose associations;a _____ is a disorder in the CONTENT of the thought (the actual idea)
1871
delusion
1872
Q0937:Delusions v. Loose associations;a _____ is a disorder in the FORM of the thought (the way the ideas are tied together)
1873
loose association
1874
Q0938:hallucination types;______ and _____ hallucinations are common in schizophrenia
1875
auditory and visual
1876
Q0939:hallucination types;_____ hallucination often occurs as an aura of a psychomotor siezure
1877
olfactory
1878
Q0940:hallucination types;_____ hallucinations are rare
1879
gustatory
1880
Q0941:hallucination types;_____ hallucinations are common in DTs. Also seen in cocaine abusers ("cocaine bugs")
1881
tactile hallucination
1882
Q0942:formication
1883
sensation of ants crawling on one's skin
1884
Q0943:by definition hypnagogic hallucinations occur when?
1885
going to sleep;mneu: hypnaGOgic hallucination occurs while GOing to sleep
1886
Q0944:by definition hypnopompic hallucinations occur when?
1887
while waking from sleep
1888
Q0945:In this disorder a person stops brathing for at least 10 seconds repeatedly during sleep;It is associated with obesit; loud snoring; systemic/pulmonary hypertension; arrhythmias; and possibly sudden death;The individual may become chronically tired.
1889
sleep apnea
1890
Q0946:In this subcagegory of sleep apnea; the pt shows no respiratory effort
1891
central sleep apnea
1892
Q0947:In this subcagegory of sleep apnea; the pt shows respiratory effort against airway obstruction
1893
obstructive sleep apnea
1894
Q0948:This diagnosis is categorizecd by disordered sleepwake cycles. It may include hypnagogic (just before sleep) or hypnopompic (just before waking) hallucinations. The person's sleep episodes start off with REM sleep.
1895
narcolepsy
1896
Q0949:This form of narcolepsy involves a loss of all muscle tone follwing a strong emotional stimulus.
1897
cataplexy
1898
Q0950:Tx for narcolepsy
1899
ampetamines
1900
Q0951:This psychiatric illness is characterized by periods of psychosis and disturbed behavior with adecline in functioning lasting >6months.
1901
schizophrenia
1902
Q0952:Give the DSM criterial for schizophrenia.
1903
2 or more of the following symptoms (1-4 are positive symptoms);1)Delusions;2)Hallucinations ;3)Disorganized thought;4) Disorganized or catatonic behavior;5. "negative symptoms"-flat affect; social withdrawal; lack of motivation; lack of speech or thought.
1904
Q0953:What is the most common type of hallucination in schizophrenia
1905
auditory
1906
Q0954:in schizophrenia; disorganized thought often takes the form of ______
1907
loose associations
1908
Q0955:in the etiology of schizophrenia; what is more important; genetic or enviornmental factors
1909
genetic
1910
Q0956:Symptoms of schizophrenia that last 1-6 mo
1911
schizophreniform disorder
1912
Q0957:Symptoms of schizophrenia that last <1 mo
1913
brief psychotic disorder (usually stress related)
1914
Q0958:Lifetime prevelence of schizophrenia
1915
1.50%
1916
Q0959:schizophrenia typically presents earlier in _______ (males or females)
1917
males
1918
Q0960:this psychiatric condition involves a combination of schizophrenia and a mood disorder
1919
schizoaffective disorder
1920
Q0961:What are the 5 subtypes of schizophrenia
1921
1)disorganized;2) catatonic;3)paranoid;4)undifferentiated;5) residual
1922
Q0962:This is an enduring pattern of perceiving; relating to; and thinking about the enviornment and oneself that is exhibited in a wide reange of important social and personal contexts.
1923
personality trait
1924
Q0963:This results when personality patterns become inflexible and maladaptive; causing impairment in social or occupational functioning or subjective disress. The person is usually not aware of the problem. These disordered patterns are stable only by early adulthood and not usually diagnosed in children.
1925
personality disorders
1926
Q0964:This cluster of personality disorders usually present as "odd" or "eccentric. They cannot develop meaningful social relationships. Give cluster and types.
1927
Cluster A "Wierd";1)Paranoid;2)Schizoid;3) Schizotypal
1928
Q0965:This cluster of personality disorders shows no psychosis but there is a genetic association with schizophrenia.
1929
Cluster A "Wierd";1)Paranoid;2)Schizoid;3) Schizotypal
1930
Q0966:personality disorder characterized by distrust and suspiciousness
1931
paranoid personality disorder
1932
Q0967:main defence mechonism exiped by those with paranoid personality disorder
1933
projection
1934
Q0968:personality disorder characterized by voluntary social withdrawal and limited emotional expression
1935
schizoid
1936
Q0969:personality disorder characterized by interpersonal awkwardness; odd beliefs or magical thinking. Often eccentric in appearance.
1937
Schizotypal
1938
Q0970:This cluster of personality disorders is dramatic; emotiona; and eratic;Give the cluster and the subtypes
1939
Cluster B: "Wild";1)Antisocial;2) Borderline;3) Histrionic;4)Narcissistic
1940
Q0971:This cluster of personality disorders has a genetic associateion with mood disorders and subsance abuse.
1941
Cluster B: "Wild";1)Antisocial;2) Borderline;3) Histrionic;4)Narcissistic
1942
Q0972:personality disorder characterized by disregard and violation of the rights of others; usually manifesting itself in criminality. It affects males > females. Before 18 y/o it is called conduct disorder
1943
antisocial personality diosrder
1944
Q0973:personality disorder characterized by unstable mood and interpersonal relationships; impulsiveness; sense of emptiness. Effects females more than males
1945
Borderline
1946
Q0974:personality disorder characterized by excessive emotionality; attention seeking; sexually provocative
1947
histrionic
1948
Q0975:personality disorder characterized by grandiosity & sense of entitlement. May react to criticism with rage.
1949
Narcissistic
1950
Q0976:This cluster of personality disorders is charicterized by anxiety and fear. Give the cluster and the types.
1951
Cluster C: "Worried";1)avoidant;2)obsessivecompulsive;3)dependant
1952
Q0977:This cluster of personality disorders has a genetic association with anxiety diosrders.
1953
Cluster C: "Worried";1)avoidant;2)obsessivecompulsive;3)dependant
1954
Q0978:personality disorder characterized by sensitivity to rejection; socially inhibited; timid; feelings of inadequacy
1955
avoidant
1956
Q0979:personality disorder characterized by preocupation with order; perfectionism; and control
1957
obsessive-compulsive
1958
Q0980:personality disorder characterized by submissive and clinging behavior. They have an excessive need to be taken care of and low self confidence.
1959
dependant
1960
Q0981:This dz is due to a loss of dopaminergic neurons and excess cholinergic activity
1961
parkinsonism
1962
Q0982:The treatments for parkinson's dz can be summarized by the mneumonic BALSA. What does this stand for
1963
Bromocriptine;Amantadine;Levodopa (w/ carbidopa);Selegine (&COMT inhibitors);Antimuscarinics
1964
Q0983:This drug is an erogot alkaloid an a partial dopamine agonist. The strategy behind this drug is to antagonize dopamine receptors.
1965
bromocriptine
1966
Q0984:This drug may increase dopamine release.
1967
Amantadine
1968
Q0985:This drug is converted to dopamine in the CNS
1969
L-dopa/carbidopa
1970
Q0986:This drug is a selective MAO type B ihibitor. The strategy of this Parkensons drug is that it prevents dopamine breakdown.
1971
Selegiline
1972
Q0987:This drug is a COMT ihibitor. The strategy of these Parkensons drugs is that it prevents dopamine breakdown.
1973
entacapone & tolcapone
1974
Q0988:This drug is an antimuscarinic and thus curbs excess cholinergic activity seen in parkinsons. It improves tremor and rigitity but has little effect on bradykinesia
1975
Benzotropine
1976
Q0989:The MOA of this parkinson's drug is that it increased levels of dopamine in the brain. Unlike dopamine; this drug can cross the blood-brain barrier and is converted by dopa decarboxylase in the CNS to dopamine
1977
L-dopa (levvodopa)/carbidopa
1978
Q0990:What is the most common toxicity of L-dopa
1979
arrhthmias from peripheral conversion to dopamine
1980
Q0991:Why is carbidopa given with levodopa.
1981
carbidopa is a peripheral decarboxylase inhibitor. It is given with L-dopa inorder to limit the peripheral side effects.
1982
Q0992:Long term use of ______ can lead to the of dyskinesia follwing administraiton; and akinesia between doses.
1983
L-dopa
1984
Q0993:This parkinsons drug acts by selectively inhibiting MAO-B; therby increased the availabilty of dopamine.
1985
Selegine
1986
Q0994:This drug is a 5-HT (1D) agonist. It causes vasoconstriction and is used for acute migrane or cluster headache attacks.
1987
Sumatriptan
1988
Q0995:This drug for acute migrane & cluster headache attacks has toxicities that include coronary vasosasm; thereore it is contraindicated in pts with CAD or Prinzmetal's angina
1989
Sumatriptan
1990
Q0996:This drug is 1st line for tonic clonic siezures and status epilepticus prophylaxis. It acts by increased Na+ channel inactivation
1991
phenytoin
1992
Q0997:This drug is first line for tonic clonic siexures and trigeminal neuralgia. It acts by increased Na+ channel inactivation.
1993
Carbazepine
1994
Q0998:This siezure medication blocks voltage gaited Na+ channels; but has no effect on GABA release
1995
Lamotrigine
1996
Q0999:This epilepsy medication acts to increased GABA release. It is also used for peripheral neuropathy
1997
Gabapentin
1998
Q1000:This epilepsy medication acts to block Na+ channels and increased GABA release.
1999
topiramate
2000
Q1001:This epilepsy medication acts to increased GABA action. It is 1st line in pregnant women & children
2001
phenobarbital
2002
Q1002:This epilepsy medication acts to increased Na+ channel inactivation & increased GABA concentration. It is 1st line for tonic-clonic/ myoclonic seizures and can be used for absence seizures.
2003
valproic acid
2004
Q1003:This epilepsy medication is 1st line for absence seizures. It acts by blocking the thalamic T-type Ca++ channesls.
2005
ethsuximide
2006
Q1004:This epilepsyy drug acts by increased GABA action. It is first line for acute status epilepticus. It is also usd for seizures of eclampsia (however NOT 1st line--which is MgSO4)
2007
Benzodiazepines;(diazepam or lorazepam)
2008
Q1005:Give the epilepsy drug associated with the following toxicities;sedation; tolerance; dependence
2009
benzodiazepines
2010
Q1006:Give the epilepsy drug associated with the following toxicities;Diplopia; ataxia; blood dyscrasias (agranulocytosis; aplastic anemia); liver toicity; teratogenesis; induction of cytochrome P-450.
2011
Carbamazepine
2012
Q1007:Give the epilepsy drug associated with the following toxicities;GI distress; lethargy; headache; uticaria; StevensJohnson syndrome
2013
Ethosuximide
2014
Q1008:Give the epilepsy drug associated with the following toxicities;Sedation; tolerance; dependance; induction of cytocrome P-450.
2015
Phenobarbital
2016
Q1009:Give the epilepsy drug associated with the following toxicities;Nystagmus; diplopia; ataxia; sedaton; gingival hyperplasia; hirsuitism; megaloblastic anemia; teratogenesis; SLE-like syndrome; induction of cytocrome P-450.
2017
Phenytoin
2018
Q1010:Give the epilepsy drug associated with the following toxicities;GI distress; rare but fatal hypatotoxicity (measure LFTs); neural tube defects in fetus (spinal bifida); tremor; weight gain.
2019
Valproic acid
2020
Q1011:Give the epilepsy drug associated with the following toxicities;Stevens-Johnson syndrome
2021
Lamotrigine
2022
Q1012:Give the epilepsy drug associated with the following toxicities;Sedation; ataxia
2023
Gabapentin
2024
Q1013:Give the epilepsy drug associated with the following toxicities;Sedation; mental dulling; kidney stones; weight loss
2025
Topiramate
2026
Q1014:The mechanism of this drug is blockade of Na+ channels; inhibition of glutamate release from exitatory presynaptic neurons
2027
phenytoin
2028
Q1015:This drug is 1st line for tonic clonic siezures and for prophylaxis of status epilepticus. It is also a class IB antiarrhythmic.
2029
phenytoin
2030
Q1016:The toxicities of this drug include: nystagmus; ataxia; diplopia; sedation; SLE-like syndrome; induciton of cytocrome P-450. Chronic use produces gingival hyperplasia in children; peripheral neuropathy; hirsutism; megaloblastic anemia (decreased B12); and malignant hyperthermia (rare). It is also teratogenic.
2031
phenytoin
2032
Q1017:This drug acts by facilitating GABA action by increased duration of Cl- channel opening; thus decreased neuron firing
2033
barbituates (phenobarbital; pentobarbital; thiopental; secobarbital);mneu: BarbiDURATe (increased DURATion)
2034
Q1018:This group of drugs is used as a sedative for anxiety; siezures; insomnia; induction of anesthesia
2035
barbituates (phenobarbital; pentobarbital; thiopental; secobarbital)
2036
Q1019:Toxicities of this drug include dependence; additivee CNS depression effects with etoh; respiratory of CV depession (can lead to death. There are also many drug interactions owing to induction of liver microsomal enzymes (cytocrome P-450)
2037
2038
Q1020:this type of drugs is contraindicated in porphyria
2039
2040
Q1021:What do you do if someone ODs on barbituates?
2041
symptom management (assist respiration; manage BP)
2042
Q1022:The mechanism of this drug is to facilitate GABA action by increased frequency of Cl- channel opening
2043
Benzodiazepines (Diazepam; lorazepam; triazolam; temazepam; oxazepam; midazolam; chlordiazepoxide; alprazolam);mneu: FREnzodiazepenes (increased FREquency)
2044
Q1023:Most benzodiazepines have long half-lives and active metabolites. The short acting ones are what? (3)
2045
Triazolam; Oxazepam; Midazolam;mneu: TOM Thumb
2046
Q1024:These drugs are used to treat anxiety; spasticity; status epilepticus; detoxification (esp etoh w/drawl[DTs]); night terrors; & sleep walking.
2047
Benzodiazepines (diazepam; lorazepam; triazolam; temazepam; oxazepam; midazolam; chlordiazepoxide; alprazolam)
2048
Q1025:Toxicity of this drug includes dependence; additive CNS depression effects with alcohol. Less risk of respiratory depressiona nd coma than with barbituates.
2049
2050
Q1026:Treat Benzodiazepine overdose with ________
2051
Flumazenil (competitive antagonist at GABA receptor)
2052
Q1027:These drugs are used to treat anxiety; spasticity; status epilepticus; detoxification (esp etoh w/drawl[DTs]); night terrors; & sleep walking.
2053
2054
Q1028:phenobarbital; pentobarbital; thiopental; secobarbital are ________
2055
barbituates
2056
Q1029:diazepam; lorazepam; triazolam; temazepam; oxazepam; midazolam; chlordiazepoxide; alprazolam are _______ (drug category)
2057
Benzodiazepines
2058
Q1030:Thioridazine; haloperidol; fluphenazine; chlorpromazine are all _______ (drug category)
2059
Antipsychotics (neuroleptics)
2060
Q1031:This drug acts to block dopamine (D2) receptors
2061
antipsychotics (neuroleptics
2062
Q1032:This drug category is used to treat psychosis; acute mania; and tourettes syndrome
2063
antipsychotics
2064
Q1033:Toxicies of this group of drugs include extrapyramidal system (EPS side effects)
2065
antipsychotics
2066
Q1034:Toxicies of this group of drugs include endocrine side effects (e.g; dopamine receptor antagonism hyperprolactinemiagynomastia)
2067
antipsychotics
2068
Q1035:Toxicies of this group of drugs include side effects arising from muscarinic block (dry mouth &constipation); alpha receptors (hypotension) and histamine receptors (sedation)
2069
antipsychotics
2070
Q1036:This toxicity of antipsychotic involves symptoms that include rigidity; myoglobinuria; autonomic instability; hyperpyrexia.
2071
Neuroleptic malignant syndrome
2072
Q1037:How do you treat Neuroleptic malignant syndrome (antipsychotic toxicity)
2073
dandrolene and dopamine agonists)
2074
Q1038:This antipsychotic toxicity includes stereotypic oralfacal movements; probably due to dopamine receptor sensitization; which results from long term antipsychotic use.
2075
Tarditive dyskinesia
2076
Q1039:Evelution of EPs side effects with antipsychotic use:
2077
4 h acute dystonia;4 d akinesia;4 wk akathisia;4 mo tarditive dykinesia;(often reversible)
2078
Q1040:The drugs clozapine; olanzapine; risperidone are of the category _________
2079
Atypical antipsychotis;mneu: i'ts not ATYPICAL for OLd CLOsets to RISPER
2080
Q1041:This group of drugs acts by blocking 5-HT2 and dopamine receptors
2081
Atypical Antipsychotics
2082
Q1042:These drugs are used in treatment of schizophrenia; they are useful for positive and negative symptoms and they have fewer extrapyramidal and anticholinergic side effects than other antipsychotics.
2083
Atypical antipsychotics
2084
Q1043:This atypical antipsychotic is also used for OCD; anxiety disorder; depression; mania; and tourettes syndrome
2085
Olanzapine
2086
Q1044:This atypical antipsychotic may cause agranulocytosis and requires weekly WBC monitoring
2087
Clozapine
2088
Q1045:The mechanism of this drug is not established. It is possibly related to an inhibition of the phosphoinositol cascade.
2089
Lithium
2090
Q1046:This drug is used as a mood stabilizer for bipolar affective disorder. It blocks relapse and acute manic events.
2091
Lithium
2092
Q1047:Toxicity of this drug includes tremor; hypothyroidism; polyuria (ADH antagonist causing nephrogenic diabetes insipidus); teratogenesis;This drug also has a narrow therapeutic window requiring close monitoring of serum levels.
2093
lithium;mneu: LMNOP;Lithium side effects;Movement (tremor);Nephrogenic dbts insipidus;hypOthyroidism;Pregnancy problems
2094
Q1048:ANTIDEPRESSANTS [image]p.371
2095
--
2096
Q1049:The drugs Fluoxetine; sertraline ; paroxetine; and citalopram belong to this category of drugs
2097
Serotonin-specific reuptake Inhibitors (SSRI)
2098
Q1050:This drug is indicated for endogenous depression; and obsessive compulsive disorder
2099
SSRIs
2100
Q1051:This drug boast fewer toxicities than TCAs but has been associated with GI distress; sexual dysfuncion (anorgasmia).
2101
SSRIs
2102
Q1052:When used with MAO inhibitors; SSRIs can cause "serotonin syndrome." What three things does this involve.
2103
hyperthermia; muscle rigidity; CV collapse
2104
Q1053:The drugs Imipramine; amitriptyline; desipramine; nortriptyline; clomipramine; and doxepin are of this medication category
2105
Tricyclic antidepressants
2106
Q1054:These drugs act to block the reuptake of NE and serotonin
2107
2108
Q1055:These drugs are indicated for major depression that does not respond to SSRIs
2109
2110
Q1056:This tricyclic antidepressant is indicated for bedwetting
2111
imipramine
2112
Q1057:This is the only tricyclic antidepressant indicated for OCD
2113
clomipramine
2114
Q1058:The side effects of these drugs include sedation; alpha blocking effects (hypotension); atropine like (anticholinergic) side effects (tachycardia; urinary retention)
2115
2116
Q1059:Secondary TCAs like ______ have less anticholinergic side effects than do tertiary TCAs like amitriptyline
2117
nortriptyline
2118
Q1060:This TCA is the least sedating.
2119
desipramine
2120
Q1061:The side effects of these drugs include sedation; alpha blocking effects (hypotension); atropine like (anticholinergic) side effects (tachycardia; urinary retention)
2121
2122
Q1062:Give the 3 Cs of Tricyclic antidepressant toxicity
2123
Convulsions; Coma; Cadiotoxicity (arrhythmias);also can have respiratory depression & hyperpyrexia?
2124
Q1063:Your elderly pt on TCAs develops confusion and hallucinations. What could this be due to and what is an alternative TCA that could be given?
2125
This could be due to the anticholinergic side effects of TCAs. Use nortriptyline.
2126
Q1064:Bupropion; Venlafaxine; Mirtazapine; Maprotiline; Trazodone belong to what drug category
2127
heterocyclic antidepressents;mneu: You need BUtane in your VEiNs to MURder for a MAP of AlcaTRAZ
2128
Q1065:These are 2nd and 3rd generation antidepressante with varied and mixed mechanisms of action. They are used to treat major depession.
2129
heterocyclic antidepressants
2130
Q1066:This heterocyclic antidepressant is also used for smoking cessation. Its mechanism s not well known. Toxicity includes stimulant effects (tachycardia; insomnia); headache; and siezure in bulimic pts. It does NOT cause sexual side effects.
2131
Buproprion
2132
Q1067:This heterocyclic antidepressant is also used in generalized anxiety disorder. It inhibits serotonin; NE; & dopamine reuptake. Toxicity includes stimulant effects; sedation; nausea; constipation and increased BP.
2133
Venlafaxine
2134
Q1068:This heterocyclic antidepressant is an alpha2 antagonist (increased release of NE and serotonin) and a potent 5-HT(2) & 5-HT(3) receptor antagonist. Toxicity includes sedation increased appetite; weight gain; and dry mouth.
2135
Mirtazapine
2136
Q1069:This heterocyclic antidepressant blocks NE reuptake. Toxicity includes sedation and orthostatic hypotension.
2137
Maprotiline
2138
Q1070:This heterocyclic antidepressant acts primarily to inhibit seratonin reuptake. Toxicity includes sedation; nausea; priaprism; and postural hypotension
2139
Trazodone
2140
Q1071:The drugs Phenelzine & tranylcypromine are of this catigory
2141
Monoamine oxidase Inhibitors (MAOIs)
2142
Q1072:This drug acts by non-selectively inhibiting Monoamine oxidase (MAO)increased levels of amine neurotransmitters
2143
Monoamine oxidase inhibiters (MAOIs)
2144
Q1073:These drugs are used for atypical depression (i.e; with psychotic or phobic features; anxiety; and hypochondriasis.
2145
2146
Q1074:These drugs can cause a hypertensive crisis with tyramine ingestion (wine & cheese) and merperidine. They also can cause CNS stimulation.
2147
2148
Q1075:These drugs are contraindicated with SSRIs or Beta agonists (to prevent seratonin syndrome)
2149
2150
Q1076:CNS anesthetics must be ______ soluable in order to cross teh blood-brain barrier
2151
lipid
2152
Q1077:anesthetics with decreased solubility in blood have ____ induction and recovery times
2153
rapid
2154
Q1078:anesthetics with increased solubility in lipids have ______ potency
2155
increased
2156
Q1079:relative potency of inhalation anesthetics is indicated by what index
2157
Minimal anesthetic concentration
2158
Q1080:Minimal anesthetic concentration is ________ (proportional or inversely proportional) to potency
2159
inversely proportional;potency =1/MAC
2160
Q1081:Fill in the blanks regarding general principles of anesthesia;increased solubility in ______ = ;increased Potency =1/MAC
2161
lipids
2162
Q1082:N2O has low blood and lipid solubility. What is the rate of induction and what is the potency?
2163
fast;low
2164
Q1083:Halothane has increased lipid and blood solubility; and thus ____ potency and ____ induction
2165
high;slow
2166
Q1084:anesthetics with decreased solubility in blood have ____ induction and recovery times
2167
rapid
2168
Q1085:anesthetics with increased solubility in lipids have ______ potency
2169
increased
2170
Q1086:halothane; enflurane; isoflurane; sevoflurane; methoxyflurane; and nitrous oxide are all this type of anesthetic
2171
inhaled anesthetics
2172
Q1087:These drugs result in myocardial & respiratory depression; nausea/emesis; and increased cerebral blood and decreased cerebral metabolic demand.
2173
inhaled anesthetics
2174
Q1088:This inhaled anesthetic has a toxicity of hepatotoxicity
2175
halothane
2176
Q1089:This inhaled anesthetic has a toxicity of nephrotoxicity
2177
methoxyflurane
2178
Q1090:This inhaled anesthetic has a toxicity of seizures.
2179
enflurane
2180
Q1091:This is a rare but very dangerous toxicity of inhaled anesthetics
2181
malignant hyperthermia
2182
Q1092:This is a barbituate intravenous anesthetic. It is high potency (high lipid solubility). It is used for induction of anesthesia and short surgical procedures. It decreases cerebral blood flow.
2183
Thiopental
2184
Q1093:This benzodiazepine given IV is the most common anesthetic used for endoscopy. It may cause severe postoperative respiratory depression; decreased BP; and amnesia.
2185
Midazolam
2186
Q1094:You give your pt Midazolam for his endoscopy. Postoperatively he developse hypotension. What drug do you give him?
2187
flumazenil
2188
Q1095:Thses PCP analogs given IV act as dissociative anesthetics. They are cardiovascular stimulants. They cause hallucinations and bad dreams. They increase cerebral blood flow.
2189
Arylcyclohexamines (Ketamine)
2190
Q1096:These opiates are given IV with other CNS depressants during general anesthesia
2191
morphine; fentanyl
2192
Q1097:This IV anesthetic is used for rapid anesthesia induction and short procedures. It has less postoperative nausea than thiopental.
2193
Propofol
2194
Q1098:What are the IV anesthetics?
2195
Barbituates;Benzodiazepines;Ketamine;Opiates;Propofol;mne u: B.B. King on OPIATES PROPOses FOOLishly
2196
Q1099:This drug is used in the treatment of malignant hyperthermia and neuroleptic malignant syndrome.
2197
dantrolene
2198
Q1100:This condition can be caused by the concomitant use of inhalation anesthetics (except N2O) and succinylcholine.
2199
Malignant hyperthermiia
2200
Q1101:The drugs procaine; cocaine; tetracaine; lidocaine; mepivacaine; pubivacaine are in this category
2201
local anestetics
2202
Q1102:Procaine; cocaine; tetracaine; are considered this type of local anesthetics.
2203
esters
2204
Q1103:lidocaine; mepivacaine; pubivacaine are considered this type of local anesthetics.
2205
amides;mneu: amIdes all have 2 "I"s in their names
2206
Q1104:This group of drugs acts by blocking Na+ channels in nerves by binding to secific receptors on the inner portion of the channel
2207
local anesthetics
2208
Q1105:Your pt has infected tissue that needs to be anesthetized. Do you need more or less local anesthetic?
2209
More-infected tissue is acidic and therefore charged. The charged anesthetics will have trouble penetrating the membrane effectively.
2210
Q1106:Give the order of anesthetic nn block regarding diameter of nn and myelination;small melinated autonomic fibers;large myelinated autonomic fibers;small unmyelinated pain fibers
2211
small diameter> large diameter;Myelinated>unmyelinated;Overall size factor predominates over myelination factor;small unmyelinated pain fibers> small melinated autonomic fibers>large myelinated autonomic fibers
2212
Q1107:What is the order of loss in sensation upon administration of a local anesthetic;touch;pain;pressure; temp
2213
pain>temp>touch>pressure
2214
Q1108:Local anesthetics are usually given with this to enhance local action--decreased bleeding; increased anesthesia by decreased systemic concentration.
2215
epinephrine (or another vasoconstrictor)
2216
Q1109:These drugs are used for minor surgical procedures and as spinal anesthesia.
2217
local anesthetics
2218
Q1110:You want to give you're pt a local anesthetic but she is allergic to esters. Name an amide you can give her.
2219
lidocaine; mepivacaine; bupivancaine
2220
Q1111:a toxicity of this local anesthetic is CV toxicity
2221
bupivacaine
2222
Q1112:a toxicity of this local anesthetic is arrhythmias
2223
cocaine
2224
Q1113:general side effects of local anesthetics may include?
2225
CNS exitation; hypertension; hypotension
2226
Q1114:These drugs are used for muscle paralysis in surgery or mechanical ventilation. They are selective for the motor (v. autonomic) nicotinic receptor
2227
neuromuscular blocking drug
2228
Q1115:The depolarizing neuromuscular blocking drug is __________
2229
succinylcholine
2230
Q1116:The drugs tubocurarine; atracurium; mivacurium; pancuronium; vecuronium; rapacuronium are of this category of neuromuscular blocking drugs
2231
nondepolarizing
2232
Q1117:Nondepolarizing neuromuscular blocking drugs compete with ____ for receptors
2233
ACh
2234
Q1118:In order to reverse the blockade of nondepolarizing blocking agents you can use __________
2235
any cholinesterase inhibitor;e.g; neostigmine; edrophonium
2236
Q1119:With depolarizing neuromuscular blocking drugs phase I is known as the ___________ phase
2237
prolonged depolarization phase
2238
Q1120:With depolarizing neuromuscular blocking drugs phase I -prolonged depolarization - is potentiated by what?
2239
cholinesterase inhibitors
2240
Q1121:With depolarizing neuromuscular blocking drugs phase II is known as the ___________ phase
2241
repolarized but blocked phase
2242
Q1122:after initiating paralysis with a depolarizing neuromuscular blocking drugs; is it possible to reverse the effects.
2243
During phase II (repolarized but blocked phase) only-- the antidote consists of cholinesterase inhibitors (e.g; neostigmine)
2244
Q1123:name two diseases that affect the CEREBRAL CORTEX
2245
1) Alzheimer's disease 2) Pick's disease
2246
Q1124:name two diseases that affect BASAL GANGLIA & BRAIN STEM:
2247
1) Huntington's disease 2) Parkinson disease
2248
Q1125:in the spinal cord;name 3 degenerative MOTOR NEURON diseases;Name 3 degenerative SPINOCEREBELLAR diseases
2249
1)ALS = amyotrophic lateral sclerosis 2)Werdnig-Hoffmann disease 3) Polio;1) Olivo-ponto-cerebellar atrophy 2) Friedreich's ataxia 3) subacute combined degeneration [B12 deficiency]
2250
Q1126:what is the most common cause of elderly dementia?
2251
Alzheimer's
2252
Q1127:name two pathological findings characteristic of Alzheimer's
2253
1) senile plaques = intracytoplasmic inclusion bodies 2) neurofibrillary tangles (abnormally phosphorylated tau protein)
2254
Q1128:what is the 2nd most common cause of dementia in elderly?
2255
multi-infarct dementia in elderly\\
2256
Q1129:How can Alzheimer also affect intracranial vasculature?
2257
amyloid angiopathy --> intracranial hemorrhage
2258
Q1130:The familial form of Alzheimer's is associated with what chromosomes and (name the allele's name in 2 of the 4)
2259
chromosome 1; 14; 19 (APO-E4 allele); 21 (p-App gene)
2260
Q1131:What is pathognemomic with Pick's disease upon histology?
2261
Pick bodies = intra-cytoplasmic inclusion bodies
2262
Q1132:What cortical areas does Pick's disease affect
2263
Frontal and temporal lobes (remember; sharp; atrophic appearance of gross specimen)
2264
Q1133:What is the inheritance pattern of Huntington's
2265
Auto Dominant
2266
Q1134:What are some symptoms of Huntingtons?
2267
1) chorea 2) dementia
2268
Q1135:Huntington's is due to atrophy of _____ what?
2269
atrophy of caudate nucleus = loss of GABA-nergic neurons
2270
Q1136:what is the genetic abnormality of Huntington's?
2271
1) Chr. 4 - expansion of CAG repeats
2272
Q1137:Parkinson disease is associated with what pathology findings?
2273
1) Lewy bodies 2) depigmentation of substantia nigra (loss of dopaminergic neurons)
2274
Q1138:rare cases of Parkinson's have been linked to what contaminant of certain illicit drugs?
2275
MPTP = contaminant to street drug
2276
Q1139:Parkinson's can make you feel in a "TRAP" = ?
2277
T = tremor at rest; R = cogwheel rigidity; A = akinesia ; Postural instability
2278
Q1140:ALS = Lou Gehrig's disease (the Iron Horse of the Yankees; hero of Joe DiMaggio) = what signs is ALS associated with?
2279
Both UMN and LMN deficits
2280
Q1141:Werdnig-Hoffman disease - presents as birth as?
2281
1) floppy baby syndrome 2) note tongue fasciculations as well (also seen in ALS)
2282
Q1142:for Polio; what kind of signs to you see?
2283
predominantly LMN deficits.
2284
Q1143:name 4 types of cranial related hemorrhages (think of layers that could possibly be involved)
2285
1) epidural hemorrhage 2) subdural h 3) subarachnoid h 4) parenchymal h
2286
Q1144:what is a common site of epidural hematoma/hemorrhage
2287
1) rupture of MMA: middle meningeal artery; often 2ndary to fracture of temporal bone
2288
Q1145:what does CT show for epidural h?
2289
biconcave disc NOT crossing suture lines
2290
Q1146:what else do you see in epidural hematoma?
2291
lucid interval
2292
Q1147:How do subdural h. most often occur?
2293
rupture of bridging veins (think; elderly being jolted in roller coaster)
2294
Q1148:subdural hematoma is venous bleeding so how would this influence symptomatic findings?
2295
venous = less pressure = delayed onset of symptoms
2296
Q1149:what types of people do you see subdural h.?
2297
1) elderly; 2) alcoholics 3) blunt trauma/sudden change in velocity injuries
2298
Q1150:for SUBDURALs what do you see upon CT?
2299
1) crescent-shaped hemorrhage instead 2) YES IT does cross the suture lines
2300
Q1151:subarachnoid hemorrhage is often seen where (name 2 types
2301
rupture of 1) aneurysm (usually Berry aneurysm) or an 2)AVM
2302
Q1152:symptoms of subarachnoid hemorrhage?
2303
the worst headache of my life
2304
Q1153:since its subarachnoid (hemorrhage); what do you see on what test?
2305
bloody or xanthochromic CSF on spinal tap
2306
Q1154:name 4 risk factors for parenchymal hematoma
2307
1) HTN 2) amyloid angiopathy 3) diabetes mellitus 4) tumor
2308
Q1155:most common site for Berry aneurysms
2309
bifurcation of the anterior communicating artery (Circle of Willis)
2310
Q1156:berry aneurysms are associated with which genetic diseases
2311
adult polycystic disease; Ehlers-Danlos s; and marfan's
2312
Q1157:Classic triad of Multiple Sclerosis
2313
SIN: Scanning speech; intention tremor; nystagmus (affect woman 20-30s)
2314
Q1158:Prevalence of MS
2315
increase prevalence w/ increased distance from the equator
2316
Q1159:Clinical s/s of MS; labs; pathology.
2317
periventricular plaques; preservation of axons; loss of oligodentrocytes; reactive astrocystic gliosis; increased protein in csf(IgG) in CSF; relapsing course; optic neuritis; MLF syndrome; hemiparesis; bladder/bowel incontinence)
2318
Q1160:Progressive multifocal leukoencephalopathy (PML) is associated w/
2319
JC virus and seen in 2-4 % of AIDS pts (reactivation or latent infect)
2320
Q1161:pathogenesis of Guillian-Barre syndrome
2321
Inflammation and demyelination of peripheral nerves and motor fibers of the ventral roots (sensory effec less severe than motor)
2322
Q1162:s/s of Guillian-Barre syndrome; lab findings
2323
symmetrical ascending muscle weakness beginning in the distal lower extremities. Autonomic fxn may be severely affected (eg. Cardiac irregularities; HTN; or hypoTN) Findings: inc. csf protein w/ normal cell count ("albuminocytologic dissociation") elevated protein may lead to papilledema
2324
Q1163:association between G-B syndrome and
2325
herpesvirus or camplobacter jejuni infection; inoculations; and stress but no definitive link to a pathogen
2326
Q1164:organism causing polio and mechanism of action
2327
poliovirus; transmitted via fecal oral route and enters blood stream then into CNS where it causes destruction of the anterior horn of S.C. leading in turn to LMN destruction
2328
Q1165:s/s of polio
2329
malaise; HA; fever; nausea; abd. Pain; sore throats; signs of LMN signs
2330
Q1166:lab findings of polio
2331
csf w/ lymphocytic pleocytosis w/ slight elevation of protein; virus recovered from stool or throat
2332
Q1167:describe Broca's (expressive) aphasia
2333
confluent aphasia w/ intact comprehension broca's is broken speech
2334
Q1168:describe Wernicke's (aphasia)
2335
Fluent aphasia w/ impaired concentration Wernick's ="What?" W area located in superior temperal gyrus
2336
Q1169:describe two types of partial seizures
2337
1.simple partial (awareness is intact)--motor; sensory; autonomic; psychic 2.Complex partial (impaired awareness)
2338
Q1170:describe types of Generalized seizure ( diffuse)
2339
1.absence- blank stare (petit mal) 2.myoclonic- quick repetitive jerks 3.tonic-clonic- alternating stiffening and mvmt (grand mal) 4. Tonic- stiffening 5.atonic-"drop" seizures
2340
Q1171:what are the causes of seizures in children?
2341
genetic; infection; trauma; congenital; metabolic
2342
Q1172:what are the causes of seizures in adults?
2343
tumors; trauma; stroke; infection
2344
Q1173:what are the causes of seizures in elderly?
2345
stroke; tumor; trauma; metabolic; infection
2346
Q1174:what is Horner's syndrome?
2347
sympathectomy of face (lesion above T1) 1.Ptosis 2.anhidrosis and flushing of affected side 3.miosis [PAM is horny]
2348
Q1175:Horner's syndrome is associated w/ what type of tumor?
2349
pancoast tumor
2350
Q1176:what is syringomyelia?
2351
enlargement of the central canal of the S.C. Crossing fibers of spinothalamic tract are damaged.
2352
Q1177:what are the s/s of syringomyelia?
2353
b/l loss of pain and temp sensation in the upper extremities w/ the touch sensation. Most common at C8-T1
2354
Q1178:syringomyelia commonly seen in what pts?
2355
pts w/ Arnold-Chiari malformation
2356
Q1179:Tabes dorsalis what infection is tabes dorsalis associated w/?
2357
teriary syphilis
2358
Q1180:Tabes dorsalis what happens in the CNS?
2359
degeneration of dorsal columns and dorsal root
2360
Q1181:Tabes dorsalis dorsalis also is associated with what s/s?
2361
charcot's joint; shooting (lightning) pain; Argyll Robertson pupils; and absence of DTRs
2362
Q1182:Where are skeletal motor neurons and preganglionic autonomic neurons derived?
2363
Neural Tube
2364
Q1183:What form postganglionic autonomic neurons and sensory neurons?
2365
Neural Crest cells
2366
Q1184:What do all ganglia contain?;(2)
2367
Sensory neurons;or;Postganglionic autonomic neurons;(both from neural crest cells)
2368
Q1185:Neural crest cells which migrate to the Adrenal Medulla to form postganglionic sympathetic neurons?
2369
Chromaffin cells
2370
Q1186:What type of defect in development causes an increase in ;Alpha-feto protein?
2371
Neural tube defect
2372
Q1187:Aside from the epidermis; hair and nails; what else does the Surface Ectoderm make?;(5)*
2373
A PILE;Anterior Pituitary;Parotid gland;Inner ear;Lens of the eye;Enamel of teeth
2374
Q1188:Germ layer that forms the retina; CNS and pineal gland?
2375
Neuroectoderm;(Neural tube)
2376
Q1189:What (3) systems are formed by the Mesoderm?;What organs from other systems?;(3)
2377
Musculoskeletal ;(all bone and muscle);Cardiovascular;(heart; blood; lymph; vessels);Reproductive organs;Organs;Spleen;Adrenal cortex;Kidney and ureter
2378
Q1190:What part of the thyroid is formed by the Neural crest cells?
2379
Parafollicular (C) cells
2380
Q1191:What germ layer forms every organ aside from the neurological; integumentary; musculoskeletal; reproductive and CV systems (and the spleen; adrenal and kidney)?
2381
Endoderm;(every individual organ aside from those mentioned)
2382
Q1192:What germ layer makes the dura?
2383
Mesoderm;(others from Neural crest)
2384
Q1193:Where are the preganglionic neuron cell bodies?
2385
in the CNS;(postganglionic cell bodies are in the ganglion = PNS)
2386
Q1194:What drives all sympathetic preganglionic neurons?
2387
Hypothalamic fibers
2388
Q1195:Which is Preganglionic versus Postganglionic: White rami or gray rami?
2389
Pre = White;Post = Gray
2390
Q1196:The Otic ganglion supplies what nerve to where?
2391
CN-9;to Parotid gland
2392
Q1197:What ganglion supplies CN-3 to the ciliary muscle and the pupillary sphinctor?
2393
Ciliary ganglion
2394
Q1198:What are the parasympathetic preganglionic neurons?;(7)
2395
CN-3;CN-7;CN-9;CN-10;S-2;S-3;S-4
2396
Q1199:What are the (5)* secondary vesicles and their adult derivatives from top to bottom?
2397
Todd Detests STYs;Telencephalon = Cerebral Hemispheres;;Diencephalon = Thalamus;;meSencephalon = Midbrain;meTencephalon = Pons / Cerebellum*;;mYelencephalon = Medulla
2398
Q1200:The (4) parts of the Ventricles are derived from which vesicles?
2399
Telencephalon = Lateral;Diencephalon = Third;Mesencephalon = Aqueduct;Metencephalon = Fourth (top);Myelencephalon = Fourth (bottom)
2400
Q1201:(3) Differential Dx of ailments that affect the axon in Retrograde Transport
2401
Herpes virus;;Polio;;Tetnus toxin
2402
Q1202:In Spina Bifida; where is the defect?;What prevents this?
2403
Vertebral arches;prevents it;Folic Acid
2404
Q1203:difference b/t Meningocele and Meningomyelocele?
2405
Meningocele = meninges only;Meningomyelocele = meninges and cord
2406
Q1204:which spinal formation defect is the most severe?
2407
Spina bifida w/ Myeloschisis;(neural tube is open on the back--not covered w/ skin);also called Rahischosis
2408
Q1205:Muscular demyelinating dz that affects only the Optic nerve in the CNS?
2409
Multiple Sclerosis
2410
Q1206:Which CN exits dorsally?
2411
CN-4;Trochlear nerve
2412
Q1207:CNS cell;physical support and repair; maintains BBB;what is the cellular marker?
2413
Astrocyte;;marker;GFAP
2414
Q1208:CNS cell;lines the ventricles
2415
Ependymal cells
2416
Q1209:CNS cell;only supportive CNS cell from the Mesoderm;what is its action?
2417
Microglia;(phagocytosis)
2418
Q1210:CNS cell;most common type of glial cell in white matter
2419
Oligodendroglia
2420
Q1211:CNS cell;cell associated w/ acoustic neuroma
2421
Schwann cell
2422
Q1212:Sensory cell;Light discriminatory touch on hairless skin (palms; soles; fingers)
2423
Meissner's corpuscles
2424
Q1213:Sensory cell;deep cell involved in pressure; coarse touch; vibration and tension
2425
Pacinian corpuscle
2426
Q1214:Sensory cell;in dermis of fingertips; hair follicles and hard palate for light; crude touch
2427
Merkel's corpuscles
2428
Q1215:which peripheral nerve layer is the permeability barrier and must be rejoined in microsurgery for limb attachment?
2429
Perineurium
2430
Q1216:What cells make the CSF?
2431
Choroid plexus
2432
Q1217:What is the path of CSF to the Subarachnoid space?;(8)
2433
LM3 S4 LMS;Lateral ventricle ->;Monroe (foramen) -> Third ventricle ->;Sylvius Aqueduct -> Fourth Ventricle ->;Luschka and Magendie foramen ->;Subarachnoid space
2434
Q1218:Which is always abnormal in CSF;Monocytes;Lymphocytes;PMNs
2435
PMNs;(bacterial meningitis)
2436
Q1219:Dx;Excessive dilation of ventricles
2437
Hydrocephalus
2438
Q1220:At what level does the spinal cord end?;Subarachnoid space?;Where is lumbar puncture performed?
2439
Cord ends: L2;meninges end: S2;puncture: L3 - L5
2440
Q1221:which part of the spinal cord is sensory versus motor?
2441
Dorsal = Sensory;Ventral = Motor
2442
Q1222:in the spinal cord; where are the ascending and descending tracts versus the cell bodies?
2443
White matter = Tracts;Gray = Cell bodies
2444
Q1223:Which horn of the spinal cord participates in reflexes?
2445
Dorsal horn
2446
Q1224:Where is pressure; vibration; touch and proprioception in the spinal cord?
2447
Dorsal columns
2448
Q1225:Where is the voluntary motor section of the spinal cord?
2449
Lateral corticospinal tract
2450
Q1226:Where is the pain and temperature section of the spinal cord?
2451
Spinothalamic tract;(anterior to the ventral horns)
2452
Q1227:Where are the cell bodies of an Upper Motor Neuron?
2453
UMN = Brain stem and Cerebral Cortex
2454
Q1228:What connects the two hemispheres?
2455
Corpus Callosum
2456
Q1229:Where is it in cortex?;Vision
2457
Occipital lobe
2458
Q1230:Where is it in cortex?;Hearing
2459
Temporal lobe
2460
Q1231:Where is it in cortex?;Taste
2461
Insula;(below postcentral gyrus)
2462
Q1232:Where is it in cortex?;Reading and writing
2463
Angular gyrus
2464
Q1233:Where is it in cortex?;Primary Motor
2465
Precentral gyrus
2466
Q1234:Where is it in cortex?;Primary Sensory
2467
Postcentral gyrus
2468
Q1235:Where is it in cortex?;Wernicke's area
2469
Temporal lobe; superior gyrus
2470
Q1236:Where is it in cortex?;Broca's area
2471
Frontal lobe near lateral fissure
2472
Q1237:What structures does the needle go thru in a lumbar puncture?;(7)
2473
Skin -> Ligaments -> Epidural space -> Dura mater -> Subdural space -> Arachnoid -> Subarachnoid space (for CSF)
2474
Q1238:What is different if a lesion on the corticospinal tract occurs above versus below the pyramidal decussation (medulla)?
2475
Above = Contralateral side weakness;;Below = Ipsilateral side weakness
2476
Q1239:If you ask a patient to place their feet together and close their eyes; and the patient sways (positive Romberg sign); where is the lesion?
2477
Dorsal columns;(if swaying w/ eyes open = cerebellar damage)
2478
Q1240:where does neuron 1 end in the Dorsal column-medial lemniscus pathway?
2479
Ipsilateral nucleus cuneatus or gracilis in Medulla
2480
Q1241:Which of the major tracts crosses at the level of the entering first neuron?
2481
Spinothalamic tract
2482
Q1242:where is the lesion anywhere along the spinothalamic tract in the cord or brainstem?
2483
Contralateral to signs
2484
Q1243:where is the first synapse in the spinothalamic tract?;where does the second neuron cross?
2485
Ipsilateral Dorsal gray matter at the entry level of the neuron;Second neuron crosses on the same level in the white commissure and ascend laterally
2486
Q1244:What is the Babinski sign?
2487
Dorsiflexion of big toe and fanning of the others
2488
Q1245:Landmark for a pudendal nerve block
2489
Ischial spine
2490
Q1246:Landmark for lumbar puncture
2491
Iliac crest
2492
Q1247:CN responsible for;movement of the face muscles
2493
CN-7;Facial
2494
Q1248:CN responsible for;sensation of the face
2495
CN-5;Trigeminal
2496
Q1249:CN responsible for;taste from anterior 2/3 or tongue
2497
CN-7;Facial
2498
Q1250:CN responsible for;taste from posterior 1/3 or tongue
2499
CN-9;Glossopharyngeal
2500
Q1251:CN responsible for;Tongue movement
2501
CN-12;Hypoglossal
2502
Q1252:CN responsible for;Mastication
2503
CN-5;Trigeminal
2504
Q1253:CN responsible for;Crying
2505
CN-7;Facial
2506
Q1254:Exit from the skull of the 3 parts of the Trigeminal nerve
2507
Standing Room Only;V-1: Superior Orbital Fissure;V-2: Rotundum (foramen);V-3: Ovale (foramen)
2508
Q1255:Which cross-section of the spinal cord has;1. greatest amount of Gray matter;2. Lateral horns
2509
1. Lumbar;;2. Thoracic
2510
Q1256:Dx;LMN symptoms bilaterally; including flaccid paralysis
2511
Polio
2512
Q1257:Dx;lesion in white matter of cervical spine due to demyelination; scanning speech; intention tremor; Nystagmus
2513
Multiple sclerosis;its a SIN to have MS;Scanning speech;Intention tremor;Nystagmus
2514
Q1258:Dx;Bilateral dorsal column signs below lesion; positive Romberg; locomotive ataxia; reactive to accomodation but not light; shooting pain
2515
Tabes Dorsalis;(syphillis);(accomodation but not light = Argyll Robertson pupils)
2516
Q1259:Dx;Everything gone except the dorsal columns
2517
Ventral Artery occlusion;(Anterior Spinal Artery)
2518
Q1260:Dx;Bilateral loss of pain and temp in upper extremities but still has touch
2519
Syringomyelia;(enlargement of central canal of spinal cord)
2520
Q1261:Dx;Combined upper and lower motor neuron deficits w/o any sensory deficit
2521
ALS;(Amylotrophic Lateral Sclerosis)
2522
Q1262:Dx;demyelination of dorsal columns; lateral corticospinal tract; ataxic gait; hyperreflexia; impaired position and vibration
2523
Vitamin B-12 neuropathy;(Friedrich's ataxia)
2524
Q1263:Dx;Non-fluent aphasia w/ intact comprehension
2525
Broca's aphasia;(BROken speech);(Nonfluent/Expressive/Motor)
2526
Q1264:Dx;Fluent aphasia w/ impaired comprehension
2527
Wernicke's aphasia;(Wordy; Wernickies = "What?");(Fluent/Receptive/Sensory)
2528
Q1265:Dx;Sudden flailing of one arm;where is lesion?
2529
Hemiballismus;lesion;Contralateral Subthalamic Nucleus
2530
Q1266:Dx;Slow; writhing movements; especially in fingers;where is lesion?
2531
Athetosis;lesion;Basal Ganglia
2532
Q1267:Dx;Sudden jerky purposeless movements;where is lesion?
2533
Chorea;lesion;Basal Ganglia
2534
Q1268:(7)* functions of the Hypothalamus
2535
TAN HATS;Thirst and water balance;Adenohypophysis;Neurohypophysis;Hunger;Autono mic regulation / Circadian rhythm;Temperature;Sexual urges and emotions
2536
Q1269:Nucleus in Hypothalamus;Thirst and water balance
2537
Supraoptic;;(holding a pee makes you feel water up past your eyeballs)
2538
Q1270:Nucleus in Hypothalamus;Destruction leads to Anorexia
2539
Lateral;(destroying "Lateral" makes you thin)
2540
Q1271:Nucleus in Hypothalamus;Destruction leads to hyperphagia and Obesity
2541
Ventromedial;(destroying makes you grow ventrally and medially)
2542
Q1272:portion of Hypothalamus;Regulates Parasympathetics;what else does it regulate?
2543
Anterior;also: Cooling when hot;[Wear a CAP when you are hot];(Cooling - Anterior - Parasymp)
2544
Q1273:portion of Hypothalamus;Regulates Sympathetics;what else does it regulate?
2545
Posterior;;also: Heat when cold
2546
Q1274:Nucleus in Hypothalamus;Destruction leads to Rage;normally leads to pleasure
2547
Septal nucleus;(Septal = Sexual urges)
2548
Q1275:Which nucleus for ADH and Oxytocin?
2549
ADH = Supraoptic;Oxytocin = Paraventricular
2550
Q1276:Portion of Thalamus;Visual
2551
Lateral Geniculate Nucleus;(LGN);(Lateral for Light)
2552
Q1277:Portion of Thalamus;Auditory
2553
Medial Geniculate Nucleus;(MGN);(Medial for Music)
2554
Q1278:Portion of Thalamus;Body sensations - pressure; touch; vibration
2555
Ventral Posterior Lateral;(VPL);V = Vibration;P = Pressure;L = Light touch
2556
Q1279:Portion of Thalamus;Facial sensation
2557
Ventral Posterior Medial;(VPM);[Very Pleasant Mug (face)]
2558
Q1280:Portion of Thalamus;Motor
2559
Ventral Lateral/Anterior nuclei ;(VL/VA);[Volumes of Lifting and Aerobics]
2560
Q1281:Major relay for ascending sensory info that ultimately reaches the cortex
2561
Thalamus
2562
Q1282:Portion of the brain responsible for Feeding; Fighting; Feeling; Flight and F-cking
2563
Using "LIMBS" for all 5 F's;Limbic system
2564
Q1283:Portion of the brain tha is important for voluntary movements and making postural adjustments
2565
Basal Ganglia
2566
Q1284:Where does the Direct and Indirect pathway of DA from Substantia Nigra go to first?;Second?;Third?
2567
First;both to Putamen;Second;Direct (+) = Globus Pallidus Internal (GPi);Indirect (-) = GPe;Third;GPi -> Thalamus or Pedunculopontine nucleus in spine;GPe -> GPi or Subthalamic Nucleus (to GPi)
2568
Q1285:Numbered areas of Brain;1. 1;2;3;2. 4;3. 6;4. 8
2569
1. Sensory;2. Motor;3. Premotor;4. Frontal eye fields
2570
Q1286:Numbered areas of Brain;1. 17;2. 22;3. 41; 42;4. 44; 45
2571
1. Principal Visual cortex (occipital);2. Assoc Auditory (Wernicke);3. Primary Auditory;4. Motor Speech (Broca)
2572
Q1287:Lesion;lack of social judgement
2573
Frontal lobe
2574
Q1288:Brain Vessel;Leg and foot area of the motor and sensory cortices; medial surface of the brain
2575
Anterior Cerebral artery
2576
Q1289:Brain Vessel;supplies the trunk; arm and face of the motor and sensory cortices; Wernicke and Broca's areas; Lateral aspect of the brain
2577
Medial Cerebral artery
2578
Q1290:Brain Vessel;may cause visual field defects; most common Circle of Willis aneurysm
2579
Anterior Communicating artery
2580
Q1291:Brain Vessel;causes CN-3 palsy
2581
Posterior Communicating artery
2582
Q1292:Brain Vessel;division of middle cerebral artery; "arteries of stroke"; supply internal capsule; caudate; putamen; globus pallidus
2583
Lateral Striate
2584
Q1293:what would a stroke in the anterior part of the circle of willis give?
2585
sensory and motor dysfunction;aphasia
2586
Q1294:How would a stroke in the posterior part of the circle of willis present?;(3)
2587
cranial nerve deficits; coma; ataxia
2588
Q1295:Main vein return of the CSF
2589
Superior Sagittal sinus
2590
Q1296:what protects a clavical fracture from a brachial plexus injury?
2591
Subclavius muscle
2592
Q1297:Initial sign of an acute appendicitis appears in what dermatome?
2593
T-10;(at the belly butTEN)
2594
Q1298:what nerve refers gall bladder pain to the right shoulder?
2595
Phrenic nerve
2596
Q1299:dermatome for the Inguinal Ligament
2597
L1 = IL
2598
Q1300:what monitors muscle length?;muscle tension?
2599
Length = muscle Spindles;Tension = Golgi Tendon organs
2600
Q1301:What are the Thenar and Hypothenar muscles?;(3 each)
2601
Thenar = Thumb;OAF (Oppose; Abduct; Flex);POLLICIS;Hypothenar is pinky;OAF ;DIGITI MINIMI
2602
Q1302:(4)* muscles that the Radial nerve innervates
2603
BEST ("great extensor nerve");Brachioradialis;;Extensors of wrist and fingers;;Supinator;;Triceps
2604
Q1303:(3) Vagal Nuclei and their function (and any assoc CN)
2605
nucleus Solitarius = Sensory of viscera (incl taste);CN-7; 9; 10;nucleus aMbiguus = Motor of pharynx and esophagus;CN-9; 10; 11;Dorsal Motor = Parasymp to heart; lungs and UGI
2606
Q1304:What cranial nerves have exits through the sphenoid bone?
2607
CN-2 to CN-6
2608
Q1305:what cranial nerves pass through the Cavernous Sinus?;(5)
2609
eye muscle nerves (CN-3; 4; 6);and ;V-1 and V-2
2610
Q1306:What vessel passes through the cavernous sinus?;Which is the only "free floating" cranial nerve in the cavernous sinus?
2611
Internal carotid;;CN-6
2612
Q1307:Definition;takes venous blood from the eyes and superficial cortex to the internal jugular; also houses the pituitary
2613
Cavernous sinus
2614
Q1308:(3) muscles that close the jaw
2615
M = Munch;Masseter;;teMoralis;;Medial pterygoid
2616
Q1309:muscle that lowers the jaw;what are all muscles of mastication innervated by?
2617
Lowers = Lateral pterygoid;;Innervated: V-3
2618
Q1310:What are the "glossus" muscles innervated by?
2619
all except PALATOglossus are innervated by the hypoGLOSSal nerve (Palat = vagus);Palat = vagus;-glossus = hypoglossal
2620
Q1311:What are the "palat" muscles innervated by?
2621
all except Tensor veli Palatini are innervated by the Vagus (Tensor = V-3);Palat = Vagus;TENSor was too TENSE and is V-3
2622
Q1312:what innervates each of the eye muscles?
2623
LR6 SO4 R3;Lateral Rectus = CN-6;Superior Oblique = CN4;Rest = CN-3
2624
Q1313:Movement of following eye muscles;1. Superior Oblique;2. Superior Rectus;3. Inferior Oblique;4. Inferior Rectus
2625
1. DOWN nasal;2. up lateral;3. UP nasal;4. down lateral;Rectus = Lateral (like LR);Oblique = Opposite direction
2626
Q1314:CN and nuclei involved in a normal pupillary light reflex
2627
CN-3 -> Pretectile nuclei ->;Edinger-Westphal nuclei
2628
Q1315:Sounds and CN used to test;1. palate elevation;2. tongue;3. lips
2629
1. Kuh-kuh (CN-10);2. La-la (CN-12);3. Mi-mi (CN-7)
2630
Q1316:Extraocular eye movements during REM is due to what area of the brain?
2631
Paramedian Pontine Reticular Formation;(PPRF)
2632
Q1317:Aphasia w/ poor repitition and good comprehension; fluent speech
2633
Arcuate Fasciculus;(connects Wernicke to Broca)
2634
Q1318:Dx;Hyperorality; hypersexuality; disinhibited behavior;where is lesion?
2635
Kluver-Bucy syndrome;lesion;bilateral Amygdala
2636
Q1319:Where is lesion?;Spacial neglect syndrome
2637
Right parietal lobe
2638
Q1320:Where is lesion?;Tremor at rest; chorea; athtosis
2639
Basal Ganglia
2640
Q1321:Where is lesion?;Truncal ataxia; dysarthria
2641
Cerebellar Vermis;(Vermis is central and affects Central part of body)
2642
Q1322:Where is lesion?;Coma
2643
Reticular Activating system
2644
Q1323:what type of amyloid is w/ alzheimers?;what chromosome/allele w/ familial form?;(2)
2645
Beta-amyloid;Chrom 1; 14; 19 - APOE4 allele;Chrom 21 - pApp gene
2646
Q1324:Dx;dementia; aphasia; parkinsonian aspects;what is sign/protein problem?;where is problem in brain (lobes)?
2647
Pick's Dz;Pick bodies = TAU protein;Frontal or temporal lobes only
2648
Q1325:MCC of dementia in elderly?;2nd MCC?
2649
MCC = Alzheimers;2nd MCC = Multi-infarct dementia
2650
Q1326:Dx;chorea; dementia;what part of brain is atrophied?;what chromosome problem?;what NT problem?
2651
Huntington's Dz;CAG repeats on chrom 4 =;Caudate (C) loses ACh (A) and GABA (G)
2652
Q1327:Dx;Tremor at rest; Rigidity; Akinesia; Postural instability;what is sign in brain?
2653
Parkinson's;(TRAPped in body);sign: Lewy Bodies
2654
Q1328:Dx;"floppy baby"; tongue fasciculations; median age of death is 7 months;where is problem?
2655
Werding-Hoffmann Dz;prob: degeneration of Anterior horns
2656
Q1329:Dx;CSF has lymphocytic pleocytosis w/ slight protein elevation. Virus is recovered from stool or throat
2657
Poliovirus
2658
Q1330:classic triad of Multiple Sclerosis
2659
SIN;Scanning speech;;Intention tremor / Incontinence;Nystagmus
2660
Q1331:Tx for MS
2661
Beta-interferon
2662
Q1332:Dx;demyelinating dz seen w/ AIDS;what virus?
2663
Progressive Multifocal Leukoencephalopathy;(PML);virus: JC virus
2664
Q1333:Dx;symmetric ascending muscle weakness due to demyelination of PNS; diplegia; CV irregularities; papilledema;Causes (2)
2665
Gullian-Barre syndrome;causes;Herpesvirus;Campylobacter infection
2666
Q1334:Tx for Gullian-Barre;(2)
2667
First line;Respiratory support;also;plasmapheresis
2668
Q1335:Seziure type;Consciousness intact
2669
Simple Partial
2670
Q1336:Seziure type;Blank stare
2671
Absent (Petite mal)
2672
Q1337:Seizure type;Quick; repetitive jerks
2673
Myoclonic
2674
Q1338:Seizure type;Alternating stiffening and movement
2675
Tonic-Clonic (Grand mal)
2676
Q1339:Seizure type;Stiffening
2677
Tonic
2678
Q1340:Seizure type;"drop" seizures
2679
Atonic
2680
Q1341:Intracranial hemorrhage;CT shows "biconcave disk" not crossing suture lines
2681
Epidural hematoma;(middle meningeal artery)
2682
Q1342:Intracranial hemorrhage;CT shows crescent-shaped hemorrhage that crosses suture lines
2683
Subdural hematoma;(bridging veins)
2684
Q1343:Intracranial hemorrhage;"worst HA of life"; bloody spinal tap
2685
Subarachnoid hemorrhage;(berry aneurysm)
2686
Q1344:(3) Dx assoc w/ berry aneurysms
2687
APKD;;Ehlers-Danlos;;Marfan's
2688
Q1345:what are clinical presentations of brain tumors due to?
2689
Mass effects;(seizures; dementia; etc)
2690
Q1346:MCC brain tumor in adult
2691
Glioblastoma multiforme
2692
Q1347:Dx;"butterfly glioma" - can cross the corpus callosum
2693
Glioblastoma Multiforme
2694
Q1348:Dx;"Pseudopalisading" tumor cells boarder the areas of necrosis and hemorrhage
2695
Glioblastoma Multiforme
2696
Q1349:Dx;spindle cells concentrically arranged in whorled pattern of this brain tumor; psammoma bodies; arises from arachnoid cells; on surface
2697
Meningioma
2698
Q1350:Dx;"fried egg" cells - round nuclei w/ clear cytoplasm in frontal lobes
2699
Oligodendroglioma
2700
Q1351:Dx;childhood brain tumor; diffusely infiltrating; posterior fossa; Rosenthal fibers - eosinophilic corkscrew appearance
2701
Pilocytic Astrocytoma
2702
Q1352:Dx;childhood brain tumor; rosettes or pseudorosettes; radiosensitive; neuroectodermal origin
2703
Medulloblastoma
2704
Q1353:Dx;perivascular pseudorosettes; rod-shaped blepharoplasts; MC in ventricles
2705
Ependymoma
2706
Q1354:Dx;childhood brain tumor w/ foamy cells and high vascularity;what is it assoc with?;what is the ectopic production?
2707
Hemangioblastoma;assoc w: Von Hippel-Lindau;ectopic: EPO -> polycythemia
2708
Q1355:Dx;benign childhood tumor from Rathke's pouch and can cause bitemporal hemianopsia
2709
Craniopharyngioma
2710
Q1356:Dx;Ipsilateral loss of all sensation; contralateral loss of pain and temp
2711
Brown-Sequard syndrome
2712
Q1357:Dx;Ptosis; anhidrosis; miosis of face;Can be associated w/ spinal cord lesion above what level?
2713
Horners syndrome;(PAM is Horny);w/ spine above T-1
2714
Q1358:Nerve w/ site of injury;Shaft of humerus
2715
Radial
2716
Q1359:Nerve w/ site of injury;Supracondyle of humerus
2717
Median
2718
Q1360:Nerve w/ site of injury;Medial epicondyle
2719
Ulnar
2720
Q1361:Nerve w/ site of injury;Surgical neck of humerus
2721
Axillary
2722
Q1362:Dx;loss of triceps brachii; brachioradialis; extensor carpi radialis longus
2723
Radial nerve injury;(Radial = wRist drop)
2724
Q1363:Dx;no loss of power in any arm muscles; loss of forearm pronation; wrist flexion; finger flexion; several thumb movements; thenar atrophy
2725
Median nerve injury;("Pope's Blessing" = cross in the median)
2726
Q1364:Dx;impaired wrist flexion and adduction; and impaired adduction of the thumb and last two fingers
2727
Ulnar nerve injury;(Claw hand)
2728
Q1365:Dx;Anterior shoulder dislocation; loss of deltoid action
2729
Axillary nerve injury
2730
Q1366:Dx;difficulty flexing elbow; loss of function of coracobrachialis; biceps; and brachialis muscles (and biceps reflex)
2731
Musculocutaneous nerve injury
2732
Q1367:Bracial plexus is assoc w/ what 5 spinal nerves?
2733
C5; C6; C7; C8; T1
2734
Q1368:what is the order of the (5)* main nerves as they come off the brachial plexus (top to bottom)?
2735
CAMel RUn;musculoCutaneous;Axillary;Median;Radial;Ulna
2736
Q1369:Dx;limb hangs at side; medially rotated and forearm is pronated;where is problem?;what is common cause?
2737
Erb-Duchenne Palsy;("Waiter's Tip");C5 and C6 (upper trunk) injury;occurs as delivery trauma
2738
Q1370:What innervates the lateral and anterior foot?
2739
PED = Peroneal Everts and Dorsiflexes;Deep Peroneal = Anterior;Superficial Peroneal = Lateral
2740
Q1371:What innervates the posterior foot and plantar flexes?
2741
TIP = Tibial Inverts and Plantarflexes;(can't stand on TIPtoes)
2742
Q1372:what nerve corresponds to L3-L4?
2743
Femoral
2744
Q1373:Dx;delivery causes atrophy of thenar; hypothenar and interosseous muscles; sensory deficit on medial forearm; dissapearance of radial pulse w/ movement of head to opposite side;what is compressed?;(2)
2745
Thoracic Outlet Syndrome;(Subclavian artery and inferior Trunk (C8; T1) of brachial plexus)
2746
Q1374:Which is the only sympathetic that secretes ACh?
2747
Sweat gland
2748
Q1375:How do you tell where a CN-12 lesion is?;(3 steps)
2749
1. have person stick tongue out to determine if flaccid or spastic paralysis;2. look to which side it deviates;3. LMN (flaccid) deviates toward side of lesion; UMN (spastic) deviates away from side of lesion;(Lmn = Lick your wound (same side))
2750
Q1376:what/where is Deviation of CN-5 lesion?
2751
Jaw towards lesion side
2752
Q1377:Test for unilateral lesion of cerebellum?
2753
Rhomberg - patient falls Toward side of lesion
2754
Q1378:Deviation of CN-10?
2755
Uvula deviates AWAY from side of lesion
2756
Q1379:Deviation of CN-11?;(2)
2757
Shoulder droop on side of lesion;weakness on turning head to contralateral side
2758
Q1380:what (2) CN have UMN and LMN symptoms if there is a lesion?
2759
CN-7;CN-12
2760
Q1381:which CN problem?;Palatal sagging and vocal cord paralysis
2761
CN-10
2762
Q1382:(4) nuclei associated w/ CN-9;which deals w/ the gag reflex?
2763
Spinal V;Solitarius (tongue);Inf. Salvitory (Parotid);Ambiguus (gag reflex)
2764
Q1383:A tumor of the internal jugular at the petrosus temporal bone would have an effect on what CN?
2765
CN-9; 10; 11
2766
Q1384:what ganglion / nerve does a right turn inside the skull?
2767
Geniculate ganglion of the Facial nerve
2768
Q1385:Dx;brain tumor causing truncal ataxia; wide-based gait; projectile vomiting
2769
Meduloblastoma
2770
Q1386:in a Webber hearing test; how do you tell what type of problem it is if the sound localizes to one side?
2771
Ipsilateral = Conduction loss;Contralateral = Sensorineural loss
2772
Q1387:what is the specific ganglia for the tear-producing part of CN-7?
2773
Pterygopalatine ganglion;;(spit = submandibular gang);(all 3 originally from Superior salivary nuclei)
2774
Q1388:how do you know if patient has UMN or LMN CN-7 lesion?
2775
UMN - contralateral LOWER face only;LMN - Ipsilateral UPPER and LOWER face;(Bells Palsy)
2776
Q1389:what Dx can you see Bell's Palsy?;(5)*
2777
ALexander BELL w/ STD;AIDS;Lyme dz;Sarcoid;Tumors;Diabetes
2778
Q1390:Herniation syndromes;can compress cerebral artery
2779
Cingulate herniation;(under falx)
2780
Q1391:Herniation syndromes;Coma and death can result when it compresses brainstem
2781
Central Transtentorial herniation
2782
Q1392:Herniation syndromes;medial; temporal lobe herniation
2783
Uncal
2784
Q1393:Herniation syndromes;herniates into foramen magnum
2785
Cerebellar tonsillar
2786
Q1394:Dx;contrlateral hemiparesis; ipsilateral dilated pupil; ipsilateral gaze preference; caudal displacement of brainstem (Duret hemorrhages)
2787
Uncal herniation
2788
Q1395:where is lesion for a Left homonymous hemianopia
2789
right optic tract
2790
Q1396:Where is the substantia nigra and VTA located?
2791
Midbrain
2792
Q1397:how can you tell if CN-4 lesion is on the nerve or the nucleus?
2793
Nerve = head-tilt away from lesion;;Nucleus = head-tilt towards lesion
2794
Q1398:Dx;small irregular pupil that does not react to light but does to accomodation;what to Dx is it seen in?
2795
Argyll-Robertson the diabetic hooker w/ syphillis;"Accomodates but does not react";seen in;Diabetes;Syphillis
2796
Q1399:visual field defect;right temporal lobe lesion or Meyer's loop
2797
Left upper quadrantic anopsia
2798
Q1400:visual field defect;right upper (cuneate) calcarine fissure
2799
Left lower quadrantic anopsia;(w/ macular sparing)
2800
Q1401:visual field defect;right occipital lesion
2801
Left hemianopia w/ macular sparing
2802
Q1402:Dx;person cannot move right eye to left lateral but can converge both eyes to center;what muscle and CN involved?;what Dx is it commonly seen in?
2803
lesion of Medial Longitudinal Fasciculus (MLF);(medial rectus palsy; normal w/ convergence; CN-3; CN-4);MLF w/ MS
2804
Q1403:NT changes;Anxiety;(3)
2805
Inc NE;Dec GABA;Dec 5-HT
2806
Q1404:NT changes;Depression;(2)
2807
Dec NE;Dec 5-HT
2808
Q1405:NT changes;Alzheimer's
2809
Dec ACh
2810
Q1406:NT changes;Huntington's Dz;(2)
2811
Dec GABA;Dec ACh
2812
Q1407:If you shine a light in patient's right eye and both pupils constrict; then shine it in left eye and they both dilate; where is the lesion?
2813
Left Retinal outflow tract of Optic nerve
2814
Q1408:Difference b/t MRI T1 and T2
2815
T1 = Black water;T2 = white water
2816
Q1409:Order of deep cerebellar nuclei from lateral to midline;(4)*
2817
Dont Eat Greesy Food;D;E;G;F
2818
Q1410:In the cerebellum;where are the parallel fibers?;Dendrites of Purkinje cells?
2819
Parallel = Granular layer;Dendrites of Purkinje = Molecular layer
2820
Q1411:Bridge b/t thinking brain and emotional brain
2821
Cingulate
2822
Q1412:regulates placement and memory
2823
Hippocampus
2824
Q1413:Regulates reward system; important in drug addiction
2825
Nucleus Accumbens
2826
Q1414:where is the most likely place of a lesion for Aphasia?
2827
Temporal lobe
2828
Q1415:What is the electrolyte flow for depolarization of hair cells in the cochlea?
2829
K+ into the cell depolarizes
2830
Q1416:What receptor measures steady pressure on the skin?
2831
Ruffini endings
2832
Q1417:What receptor measures vibration on the skin?
2833
Pacinian corpuscle
2834
Q1418:what tracts are in the Inferior (3); Middle (1) and Superior (2) cerebellar peduncles?*
2835
DIBs On TVS in the PM;Inferior - Dorsal (cord); vestiBulocerebellar; Olive;Superior - Tectocerebellar; Ventral;Middle - Pontocerebellar
2836
Q1419:when a person moves his head to the right; what happens in the semicircular canal?;(2)
2837
both (R and L) bend away from the Kinocilium;;Cupula moves to opposite side
2838
Q1420:when light strikes the eye; what are the steps?;(6)
2839
Light -> CIS changes to TRANS ->;Inc Rhodopsin -> Inc Transducin ->;Dec cGMP -> Dec Na+ -> Hyperpolarization
2840
Q1421:if nystagmus is a symptom of a cerebellar lesion; where is the lesion?
2841
Flocculonodular lobe
2842
Q1422:what is the equation for intensity of hearing?
2843
Intensity = 20 x log (sound/threshold)
2844
Q1423:what are two places in the ear that hear high-frequency sounds?;example of a low-frequency place?
2845
Base;Oval window;Round window;(Apex - Helicotrema hears low sounds)
2846
Q1424:what occurs with the biceps and triceps regarding Ia and Ib fibers when flexing the biceps?
2847
Flex biceps;Bicep - ;Ia Dec firing (compressed);Ib Inc firing (tension/contract);;Triceps - ;Ia Inc firing (stretched);Ib has no change
2848

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Neuroscience Flash Facts

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atrophy of left optic nerve

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dorsiflection and eversion of foot (common peroneal nerve)

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carpal tunnel syndrome; median nerve compression

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Q0007:man presents with one wild; flailing arm;where is the lesion

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contralateral subthalamic nucleus (hemiballismus)

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right parietal lobe

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ulnar nerve due to broken medial condyle

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Q0011:midshaft break of the humerus;what nerve and artery likely to be damaged

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radial nerve and deep brachial artery; which run together

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Bell's palsy; cn vii

Neuroscience Flash Facts

Neuroscience Flash Facts

carpal tunnel; median nerve

Neuroscience Flash Facts

Neuroscience Flash Facts

Neuroscience Flash Facts

Q0015:episodes of hypoglycemia; blood analysis reveals no elevation in c protein;what diagnosis?

Neuroscience Flash Facts

factitious disorder; self scripted insulin

Neuroscience Flash Facts

Q0016:headache; visual disturbance; galactorrhea; amenorrhea;what dx?

Neuroscience Flash Facts

Neuroscience Flash Facts

Neuroscience Flash Facts

Neuroscience Flash Facts

Neuroscience Flash Facts

Neuroscience Flash Facts

Q0019:child "paces out". quivering lips during spells;dx?

Neuroscience Flash Facts

Neuroscience Flash Facts

Q0020:man on antidepressants has mydriasis and becomes constipated;what is cause of sx?

Neuroscience Flash Facts

Neuroscience Flash Facts

Neuroscience Flash Facts

tyramine (wine or cheese)

Neuroscience Flash Facts

Neuroscience Flash Facts

"Waiter's tip" Erb-Duchenne palsy; traction of upper trunk (C5; C6)

Neuroscience Flash Facts

Neuroscience Flash Facts

lower trunk (C8; T1)

Neuroscience Flash Facts

Neuroscience Flash Facts