-
What arises from the embryonic alar plate?
Sensory neurons
-
What arises from the embryonic basal plate?
Motor Neurons
-
What arises from the embryonic telencephalon
Cerebral Hemispheres and Lateral Ventricles
-
What arises from the embryonic diencephalon?
Thalamus, Optic nn, and 3rd ventricle
-
What arises from the embryonic mesencephalon?
Midbrain and Aqueduct
-
What arises from the embryonic metencephalon?
Pons, cerebellum, and superior 4th ventricle
-
What arises from the embryonic Myelencephalon?
Medulla and inferior 4th ventricle
-
What arises from the embryonic anterior neurpore?
Lamina terminalis
-
What arises from the embryonic neural crest cells?
Peripheral sensory and autonomic nervous nerves and sensory ganglia
-
What is the level of the conus medullaris in a newborn and in an adult?
L3 (newborn), L1 (adult)
-
What are the 3 divisions of the autonomic nervous system?
Sympathetic, parasympathetic, and enteric
-
Which tissues are innervated by the autonomic nervous system?
Smooth muscle, cardiac muscle, and glands
-
Where are the preganglionic cell bodies of the sympathetic nervous system?
Interomedial horn of the spinal cord from T1 to L3
-
Where are the preganglionic cell bodies of the parasympathetic nervous system located?
Brainstem (cranial nerve nuclei) and spinal cord from S2 to S4
-
Which is the primary NT of both sympathetic and parasympathetic ganglia?
Acetylcholine (Ach)
-
Which is the primary type of cholinergic receptor of the sympathetic and parasympathetic ganglia?
Nicotinic
-
Which NT mediates the transmission of impulses from sympathetic neurons to the effector organs?
Norepinephrine (NE)
-
Which NT mediates the transmission of impulses from parasympathetic neurons to effector organs?
Acetylcholine (Ach)
-
Which NT mediates the transmission of impulses from somatic neurons to skeletal muscle?
Acetylcholine (Ach)
-
What tyoe of receptors are present on the effector organs innervated by the sympathetic nervous system?
a1, a2, b1, b2
-
What type of receptor is present in the effector organs innervated by the parasympathetic nervous system?
Muscarinic
-
What type of receptor is present on muscle innervated by the somatic nervous system?
Nicotinic
-
Name the sympathetic receptor subtype and the effect for the ear.
Pupillary dilation (a1)
-
Name the sympathetic response to salivary glands receptor activation.
Increased thick, viscous secretions
-
Name the sympathetic receptor subtype and the effect for the bronchioles.
Bronchodilation (b2), increased secretions
-
Name the sympathetic receptor subtype and the effect for the heart.
Tachycardia, increased contractility, increased AV nodal conduction (all b1)
-
Name the sympathetic receptor subtype and the effect for vascular smooth muscle.
- Vasoconstriction of cutaneous, mucous membrane, and splanchnic vessels
- (a1); Vasodilation in skeletal muscles (b2)
-
Name the sympathetic receptor subtype and the effect for the GI tract.
Decrease muscle motility and tone (b2); contraction of sphincters (a1)
-
Name the sympathetic receptor subtype and the effect for the male sex organs.
Ejaculation (a2)
-
Name the sympathetic receptor subtype and the effect for the uterus.
Relaxation (b2); contraction (a1)
-
Name the sympathetic receptor subtype and the effect for the bladder and ureters.
Relaxation of detrusor (b2); contraction of trigone and sphincters (a1)
-
Name the sympathetic receptor subtype and the effect for the sweat glands.
Increased secretions (muscarinic)
-
Name the sympathetic response to kidney receptor activation.
Increased Renin secretion
-
Name the sympathetic receptor subtype and the effect for adipocytes.
Increased lipolysis (b1, b3)
-
Name the sympathetic receptor subtype and the effect for the pancreas.
Decreased insulin secretion (a2); Increased insulin secretion (b2)
-
What is the effect of the parasympathetic nervous system on the eye?
Pupillary constriction
-
What is the effect of the parasympathetic nervous system on the bronchioles?
Bronchoconstriction
-
What is the effect of the parasympathetic nervous system on the heart?
Bradycardia, decreased contractility, decreased AV nodal conduction
-
What is the effect of the parasympathetic nervous system on the GI tract?
Increased motility and relaxation of sphincters
-
What is the effect of the parasympathetic nervous system on the male sex organs?
Erection
-
What is the effect of the parasympathetic nervous system on the bladder and ureters?
Contraction of the detrusor, relaxation of sphincters and trigone
-
What type of cholinergic receptor mediates parasympathetic organ responses?
Muscarinic
-
What ype of motor fiber innervates extrafusal muscle fibers?
A-alpha
-
What type of muscle fiber innervates intrafusal muscle fibers?
A-gamma
-
Name the function of sensory fiber type Ia (A-alpha).
Proprioception, muscle spindles
-
Name the function of sensory fiber type Ib.
Proprioception, Golgi tendon organs
-
Name the function of sensory fiber type II (A-beta).
Touch, pressure, and vibration; secondary afferents of muscle spindles
-
Name the function of sensory fiber type III (A-delta)
Touch, pressure, fast pain, and temperature
-
Name the function of sensory fiber type IV (C).
Slow pain and temperature (unmyelinated)
-
What types of sensory fibers have the largest diameter and consequently the fastest conduction velocity?
Ia and Ib
-
What type of motor fibers have the largest diameter and consequently the fastest conduction velocity?
A-alpha
-
What type of sensory fiber has the smallest diameter and consequently the slowest conduction velocity?
C
-
What is the electrochemical effect of an inward sodium current on a sensory fiber?
Depolarization
-
Name the function of the sensory receptor in the sensory pathway.
Translate environmental stimulus into an electrical impulse
-
Name the function of the first-order neuron in the sensory pathway.
Carry impulse from sensory receptor into CNS
-
Name the function of the second-order neuron in the sensory pathway.
Carry impulse from primary neuron to the thalamus
-
Name the function of the third-order neuron in the sensory pathway.
Carry impulse from second-order neuron to the cerebral cortex
-
Name the function of the fourth-order neuron in the sensory pathway.
Carry impulses from the third-order neurons to appropriate somatosensory area of cerebral cortex.
-
Name the mechanreceptor subtype: onion-like subcutaneous receptors that respond to vibration and tapping
Pacinian corpuscle
-
Name the mechanreceptor subtype: primary receptors of the dermal papilae that mediate two-point tactile discrimination
Meissner's corpuscle
-
Name the mechanreceptor subtype: Encapsulated receptor that responds to pressure
Ruffini's Corpuscle
-
Name the mechanreceptor subtype: disc-shaped touch receptor of the deep dermis
Merkel disc
-
Sensitive to low-intensity light: Rods or Cones?
Rods
-
Sensitive to high-intensity light: Rods or Cones?
Cones
-
Receptor used primarily for night vision: Rods or Cones?
Rods
-
Receptor used primarily for day vision: Rods or Cones?
Cones
-
Present in fovea: Rods or Cones?
Cones
-
High visual acuity: Rods or Cones?
Cones
-
Receptor which adjusts to low light conditions most rapidly: Rods or Cones?
Cones
-
Receptor capable of color vision: Rods or Cones?
Cones
-
Name the type of muscle sensor: detection of static and dynamic changes in muscle length
Muscle spindles
-
Name the type of muscle sensor: detection of muscle tension
Golgi tendon organs
-
Name the type of muscle sensor: detection of vibration
Pacinian corpuscles
-
Name the type of muscle sensor: detection of pain
Free nerve endings
-
What type of muscle fiber is innervated by gamma-motorneurons and makes up the muscle spindles?
Intrafusal fibers
-
What type of muscle fiber is innervated by alpha-motorneurons and generates the force for muscle contraction?
Extrafusal fibers
-
What type of intrafusal fiber is responsible for the detection of static change in muscle length?
Nuclear Chain fibers
-
What type of intrafusal fiber is responsible for the detection of rate of change in muscle length?
Nuclear bag fibers
-
What type of motorneuron is responsible for ensuring that a muscle cell will respond appropriately throughout contraction, despite changes in tension?
gamma-motorneuron
-
What type of motor reflex, mediated by type Ia afferent fibers, causes muscle contraction in response to muscle stretch?
Stretch or myotatic reflex
-
What type of motor reflex, mediated by type Ib afferent fibers, causes muscle contraction in response to muscle stretch?
Golgi tendon reflex
-
What ype of muscle reflex, mediated by types II, III, and IV afferent fibers, causes ipsilateral flexion and contralateral extension?
Flexor withdrawal reflex
-
What are the components of the afferent limb of a myotatic reflex arc?
Muscle spindle receptor to Ia fiber to dorsal root ganglion
-
What comprises the efferent limb of a myotatic reflex arc?
Ventral motor neuron
-
Name the muscle group and spinal level tested by the ankle jerk reflex.
Gastrocnemius (S1)
-
Name the muscle group and spinal level tested by the knee jerk reflex
Quadriceps (L2-L4)
-
Name the muscle group and spinal level tested by the biceps jerk reflex.
Biceps (C5-C6)
-
Name the muscle group and spinal level tested by the forearm jerk reflex.
Brachioradialis (C5, C6)
-
Name the muscle group and spinal level tested by the triceps jerk reflex.
Triceps (C7-C8)
-
What type of posturing is caused by a transecting lesion above the level of the medulla but below the midbrain?
Decerebrate rigidity
-
What type of posturing is caused by a transecting lesion above the level of the red nucleus (midbrain)?
Decorticate rigidity
-
What are the 3 layers of the cerebellar cortex?
Granular layer (innermost), Purkinje layer (middle), and molecular layer (outermost)
-
What type of cerebellar fibers are important in motor learning?
Climbing fibers
-
Which is the major NT of cerebellar Purkinje cells?
GABA (Note: the ouput of purkinje fibers is always inhibitory)
-
What are the 3 layers of the meninges?
The meninges PAD the CNS: Pia, Arachnoid, Dura
-
What meningeal space, which lies between the pia and arachnoid, contains the CSF?
Subarachnoid space
-
What structure produces CSF?
The choroid plexus of the lateral, 3rd, and 4th ventricles
-
What structures reabsorb CSF into venous circulation?
The arachnoid granulations
-
Track the flow of CSF from the choroid plexus into venous circulation.
Choroid plexus to lateral ventricles to intraventricular foramina (of Monro) to 3rd ventricle to cerebral aqueduct to 4th ventricle to lateral foramina (of Lushka) or median foramen (of Magendie) to subarachnoid space to arachnoid granulations to superior sagittal sinus!
-
What are the 3 major functions of CSF?
- 1. To provide support and protection to the CNS
- 2. To remove metabolic waste products
- 3. To transport hormones and cytokines throughout the CSF and to the systemic circulation
-
Name the blood vessel supplying the anterior 2/3 of the spinal cord, the medullary pyramids, medial lemniscus, and root fibers of CN XII.
Anterior spinal artery
-
Name the blood vessel supplying the retina.
Central artery of the retina (branch of opthalmic artery)
-
Name the blood vessel supplying the lateral geniculate body, globus pallidus, and posterior limb of the inferior capsules
Anterior Choroidal artery
-
Name the blood vessel supplying the hypothalamus and ventral thalamus.
Posterior Communicating artery
-
Name the blood vessel supplying the leg-foot area of motor and sensory cortices.
Anterior Cerebral artery
-
Name the blood vessel supplying the anterior putamen, caudate nucleus, and anteroinferior internal capsule.
Medial Striate arteries (branches of ACA)
-
Name the blood vessel supplying Broca's (expressive) and Wernicke's (receptive) speech areas, face and arm areas of motor cortices, and the frontal eye fields.
Middle Cerebral artery
-
Name the blood vessel supplying the internal capsule, caudate nucleus, putamen, and globus pallidus.
Lateral Striate arteries (branches of MCA)
-
Name the blood vessel supplying the nucleus ambiguus, and the inferior surface of the cerebellum.
Posterior inferior cerebellar artery
-
Name the blood vessel supplying the caudal lateral pontine tegmentum (including portions of the nuclei of CN V and VII) and the inferior cerebellar surface.
Anterior inferior cerebellar artery
-
Name the blood vessel supplying the superior surface of cerebellum, cerebellar nuclei, and cochlear nuclei.
Superior cerebellar artery
-
Name the blood vessel supplying the majority of midbrain, portions of the thalamus, lateral and medial geniculate bodies, occipital lobe, inferior aspect of the temporal lobes, and the hippocampus.
Posterior Cerebral artery
-
Name the blood vessel supplying the majority of the dura.
Middle meningeal artery
-
Name the cerebral veins that drain directly into the superior sagittal sinus.
Bridging veins
-
Name the cerebral vein that drains deep cerebral veins into the straight sinus.
Vein of Galen
-
CN III, V1, V2, and VI, postganaglionic sympathetic fibers, and both internal carotid arteries all pass through which structure?
Cavernous sinus
-
Name the cytoplasmic structure in the nerve cell body and dendrites that is involved in protein synthesis.
Nissl substance
-
Name the type of axonal transport responsible for delivery of synthesized NTs away from the cell body.
Fast anterograde axonal transport
-
Name the type of axonal transport responsible for delivery of cytoskeletal and cytoplasmic components away from the cell body.
Slow anterograde transport
-
Name the type of axonal transport responsible for returning material to the cell body for degradation.
Fast retrograde transport.
-
Name the type of axonal transport that is kinesin dependent.
Fast anterograde axonal transport
-
Name the type of axonal transport that is dynein dependent?
Fast retrograde transport.
-
Name the type of axonal transport responsible for carrying nerve growth factors, viruses, and toxins to cell bodies.
Fast retrograde transport.
-
Name the process of anterograde axonal and myelin degeneration accompanied by Schwann cell proliferation.
Wallerian degeneration
-
Name the process of retrograde neuronal degeneration.
Chromatolysis
-
Name the cell type: primary supportive cell type of the CNS
Astrocyte
-
Name the cell type: myelin-producing cell type of the CNS.
Oligodendrocyte
-
Name the cell type: CNS scavenger cell type
Microglia
-
Name the cell type: CSF-producing cell type of the peripheral nervous sytem.
Ependymal cell
-
Name the cell type responsible for transport between ventricles and neuropil.
Tanycytes
-
What type of intercellular junctions are responsible for maintaining the integrity of the BBB?
Tight junctions
-
What proteins are commonly used to identify astrocytes?
Glial fibrillary acidic protein (GFAP) and glutamine synthetase.
-
Name the process or disease associated with the following neuronal histopathologic finding: lipofuscin granules
Aging
-
Name the process or disease associated with the following neuronal histopathologic finding: depletion of neuromelanin in substantia nigra and Lewy bodies.
Parkinson's Disease
-
Name the process or disease associated with the following neuronal histopathologic finding: Negri Bodies
Rabies
-
Name the process or disease associated with the following neuronal histopathologic finding: Hirano bodies and neurofibrillary tangles.
Alzheimer's diesase
-
Name the process or disease associated with the following neuronal histopathologic finding: Cowdry type A inclusion bodies.
Herpes simplex encephalitis
-
Name the spinal tract responsible for voluntary control of skeletal muscle.
Lateral corticospinal/ pyramidal tract
-
Name the spinal tract responsible for sensation of pain and temperature.
Lateral spinothalamic tract
-
Name the spinal tract responsible for two-point discrimination and vibratory sensation.
Dorsal column- medial lemniscus tract
-
Name the spinal tract responsible for control of facial muscles.
Corticobulbar tract
-
Name the spinal tract responsible for coordination of muscle tone, posture, balance, and motor activity.
Dentothalamic tract
-
Describe the major difference between the innervation of lower and upper facial muscles.
Corticobulbar fibers innervate the lower facial muscles unilaterally while upper facial muscles are innervated bilaterally
-
What type of receptors provide input to the dorsal column-medial lemniscus pathway?
Meissner corpuscles, Pacini corpuscles, joint receptors, muscle spindles, and Golgi tendon organs
-
Name the structure in the spinal cord composed of ascending fibers of the dorsal column-medial lemniscus pathway originating in the upper extremities.
Cuneate fasiculus
-
Name the structure in the spinal cord composed of ascending fibers of the dorsal column-medial lemniscus pathway originating in the lower extremities.
Gracile fasciculus (medial to cuneate fasiculus)
-
At what level of the brainstem do fibers of the dorsal column-medial lemniscus pathway cross?
Caudal medulla
-
What type of receptors provide input to the lateral spinothalmic tract?
Free nerve endings
-
At what level do fibers of the spinothalmic tract cross?
At the same level they enter the spinal cord.
-
Name the structure where fibers of the lateral spinothalmic tract cross the midline.
Ventral white commisure
-
Where do fibers of the dorsal column-medial lemniscus pathway, the trigeminothalmic, and lateral spinothalmic tract all terminate?
The sensory cortex (Brodmann's areas 3, 1, 2)
-
What parts of the cortex gives rise to the fibers of the lateral corticospinal and corticobulbar tracts?
The motor, premotor, and sensory areas of the cortex (Brodmann's areas 6, 4, and 3, 1, 2)
-
Fibers of the lateral corticospinal tract pass through which limb of the internal capsule?
Posterior limb
-
Name the structure where fibers of the lateral corticospinal tract cross the midline.
Medullary pyramids
-
Classify as either an upper motor neuron or a lower motor neuron sign: Spastic paresis.
Upper Motor Neuron
-
Classify as either an upper motor neuron or a lower motor neuron sign: Flaccid paralysis.
Lower Motor Neuron
-
Classify as either an upper motor neuron or a lower motor neuron sign: Babinski's sign (upgoing toes)
Upper Motor Neuron
-
Classify as either an upper motor neuron or a lower motor neuron sign: Fasiculations and fibrillations
Lower Motor Neuron
-
Classify as either an upper motor neuron or a lower motor neuron sign: Areflexia
Lower Motor Neuron
-
Classify as either an upper motor neuron or a lower motor neuron sign: Atrophy
Lower Motor Neuron
-
Classify as either an upper motor neuron or a lower motor neuron sign: Hyperreflexia
Upper Motor Neuron
-
Which cranial foramen does CN 1 pass through?
Cribiform plate of the ethmoid
-
Which cranial foramen does CN 3 pass through?
Optic canal
-
Which cranial foramen do CN 3, 4, V1, and 6 pass through?
Superior orbital fissure (all pass through cavernous sinus as well)
-
Which cranial foramen does CN V2 pass through?
Foramen Rotundum
-
Which cranial foramen does CN V3 pass through?
Foramen Ovale
-
Which cranial foramen do CN 7 and 8 pass through?
Internal auditory meatus
-
Which cranial foramen do CN 9, 10, and 11 pass through?
Jugular foramen
-
Which cranial foramen does CN 12 pass through?
Hypoglossal Canal
-
Name the function and fiber type of cranial nerve 1.
Smell (SVA)
-
Name the function and fiber type of cranial nerve 2.
Vision (SSA)
-
Name the function and fiber type of cranial nerve 3.
Eye movement (GSE), parasympathetic ciliary and pupillary sphincter mm (GVE)
-
Name the function and fiber type of cranial nerve 4.
Contraction of superior oblique m. (GSE)
-
Name the function and fiber type of cranial nerve V1.
Sensation from nose to forehead (GSA)
-
Name the function and fiber type of cranial nerve V2.
Sensation from lateral nose, upper lip, superior buccal area (GSA)
-
Name the function and fiber type of cranial nerve V3.
Sensation from lower face (GSA), movement of muscles of mastication (Masseter, temporalis, medial and lateral pterygoids), tensor veli palatini, and tensor tympani (SVE)
-
Name the function and fiber type of cranial nerve 6
Contraction of Lateral rectus m. (GSE)
-
Name the function and fiber type of cranial nerve 7.
Parasympathetics to lacrimal, submandibular, and sublingual glands (GVE), Mm. of facial expression, stapedius, stylohyoid, and the posterior belly of digastric (SVE), Taste to anterior 2/3 of tongue (SSA), sensation to skin of external ear (GSA)
-
Name the function and fiber type of cranial nerve 8.
Hearing and sense of balance (SSA)
-
Name the function and fiber type of cranial nerve 9.
Parasympathetics to parotid gland (GVE), Motor to stylopharyngeus (SVE), Taste to posterior 1/3 of tongue (SSA), Sensation to parotid gland, carotid body and sinus, pharynx, and middle ear (GVA), Cutaneous sensation to external auditory meatus (GSA)
-
Name the function and fiber type of cranial nerve 10.
Parasympathetics to trachea, bronchi, heart, and GI tract (GVE), Contraction of laryngeal, pharyngel, and esophageal striated mm. (SVE), Taste to epiglottis and palate (SSA), sensation to trachea and GI tract (GVA), Cutaneous sensation to external ear (GSA)
-
Name the function and fiber type of cranial nerve 11.
Contraction of intrinsic mm of larynx via recurrent laryngeal n (cranial division) and movement of Sternocleidomastoid and trapezius mm. (spinal division) (SVE)
-
Name the function and fiber type of cranial nerve 12.
Contraction of muscles of tongue (GSE)
-
Which three cranial nerves are purely sensory nerves?
CN 1, 2, 8
-
Which five cranial nerves are purely motor nerves?
CN 3, 4, 6, 11, 12
-
Which four cranial nerves have both sensory and motor components?
CN 5, 7, 9, 10
-
Which two cranial nerves are rostral to the midbrain?
CN 1, 2
-
Which two cranial nerve nuclei are located in the midbrain?
CN 3, 4
-
Which four cranial nerves have at least a portion of their nucleus in the pons?
CN 5, 6, 7, 8
-
Which seven cranial nerves have at least a portion of their nuclei in the medulla?
CN 5, 6, 7, 8, 9, 10, 11, 12
-
Name the only cranial nerve that crosses the midline and exits the brainstem posterior to the ventricular system.
CN IV- exits the brainstem posteriorly and crosses the midline after exiting the caudal midbrain
-
What nucleus serves as the origin of preganglionic parasympathetic fibers projecting to the ciliary ganglion?
Edinger-Westphal nucleus of CN 3
-
What visceral sensory nucleus, located in the medulla, is a relay center for taste, sensory input from the carotid sinus, carotid body, and the vagus nerve?
Nucleus Solitarius
-
What visceral motor nucleus, located in the medulla, is involved in coordinating swallowing and speech?
Nucleus ambiguus
-
Which is the afferent limb of the corneal reflex?
CN V1
-
Which is the efferent limb of the corneal reflex?
CN 7
-
Ipsilateral blindness would be caused by a lesion at what site within the visual tract?
Transection of the Optic n.
-
Binasal hemianopia would be caused by a lesion at what site within the visual tract?
Bilateral lateral compression of optic chiasm
-
Bitemporal hemianopis would be caused by a lesion at what site within the visual tract?
Midsagittal transection or midline pressure on the optic chiasm (often caused by pituitary tumor)
-
Right hemianopia without macular sparing would be caused by a lesion at what site within the visual tract?
Transection of the left optic radiation
-
Right upper quadrantanopia would be caused by a lesion at what site within the visual tract?
Transection of the lower division of the left optic radiation
-
Right lower quadrantanopia would be caused by a lesion at what site within the visual tract?
Transection of the upper division of the left optic radiation
-
Right hemianopia with macular sparing would be caused by a lesion at what site within the visual tract?
Destruction of the left visual cortex
-
Upper altitudinal hemianopia with macular sparing would be caused by a lesion at what site within the visual tract?
Destruction of the bilateral lingual gyri
-
Lower altitudinal hemianopia with macular sparing would be caused by a lesion at what site within the visual tract?
Destruction of the bilateral cunei
-
What are five key structures of the pupillary light reflex pathway?
Ganglion cells of the retina to pretectal nucleus of the midbrain to Edinger-Westphal nucleus to ciliary ganglion to postganglionic parasympathetic fibers of CN 3.
-
What are five key structures of the pupillary dilation pathway?
- Paraventricular nucleus of the hypothalamus to ciliospinal center of Budge at the level of T1-T2 to superior cervical ganglion to postganglionic sympathetic fibers traveling along the internal carotid
- artery and its branches to the eye
-
What part of the cortex is responsible for voluntary eye movements?
Frontal eye field (Brodmann's area 8)
-
What side will a patient's eyes deviate towards if there is a lesion of the right frontal eye field?
Right side ("look towrds the lesion of frontal eye fields")
-
What structure connects the nucleus of CN 6 and the nucleus of CN 3?
Medial Longitudinal Fasciculus (MLF)
-
What classic idiopathic lesion is characterized by ptosis, miosis, and anhydrosis?
Horner's syndrome
-
What type of lesion will result in medial rectus palsy (inability to adduct the eye) on attempted lateral gaze?
Intranuclear opthalmoplegia (a lesion of the MLF)
-
Name the condition characterized by a pupil that will accommodate bun cannot react to light.
Argyll-Robertson pupil (associated w/ tertiary syphilis, lupus, and DM)
-
Name the condition caused by a lesion in the afferent fibers of the light reflex pathway.
Marcus Gunn Pupil
-
Where does the auditory pathway terminate?
Bilateral input from both auditory tracts terminate in the auditory areas of the cerebral cortex (Brodmann's areas 41 and 42)
-
What type of cells are responsible for relaying auditory stimuli from the organ of Corti to the cochlear nuclei?
Bipolar cells of the spiral or cochlear ganglion
-
What thalamic nucleus plays a key role in relay of impulsesfrom the cochlear nuclei to higher cortical areas?
Medial geniculate body of the thalamus
-
What pontine nucleus plays a key role in sound localization?
Superior olivary nucleus
-
Conduction deafness is caused by a lesion of which components of the auditory system?
Extrenal auditory meatus, tympanic membrane, or the middle ear
-
Sensorinueral deafness is caused by a lesion of which components of the auditory system?
Cochlea, cochlear nerve, or the cochlear nuclei
-
Patients with presbyacusis have trouble hearing what types of sounds?
High frequency sounds
-
Which cells of the vestibular system respond to linear acceleration and deceleration?
The hair cells of the utricle
-
What type of cells are responsible for relaying vestibular stimuli from the hair cells to the vestibular nuclei?
Bipolar cells of the vestibular ganglion
-
What structures provide input to the vestibular nuclei?
Hair cells of the semicircular canal, hair cells of the utricle, and the flocculonodular lobe of the cerebellum
-
What structures receive signals from the vestibular nuclei?
The thalamus, spinal cord, cerebellum, and CNs 3, 4, and 6
-
What are the 3 primary functions of the cerebellum?
Maintenance of posture/ equilibrium, control of muscle tone, coordination of voluntary muscle activity
-
What type of tremor may result from a cerebellar lesion?
Intention tumor
-
A positive romberg sign ( loss of balance when the eyes are closed) suggests a lesion to which tract of the CNS?
Dentothalamic tract (the main cerebellar pathway)
-
Name the thalamic nucleus/nuclei responsible for the relay of impulses for vision.
Lateral geniculate nucleus ("lateral to look")
-
Name the thalamic nucleus/nuclei responsible for the relay of impulses for hearing.
Medial geniculate nucleus ("medial for music")
-
Name the thalamic nucleus/nuclei responsible for the relay of impulses for proprioception, pain, pressure, touch, and vibration.
Lateral portion of ventral posterior nucleus ("posterior for proprioception, pain")
-
Name the thalamic nucleus/nuclei responsible for the relay of impulses for facial sensation
Medial portion of ventral posterior nucleus
-
Name the thalamic nucleus/nuclei responsible for the relay of motor impulses.
Ventral anterior/ lateral nuclei
-
Name the thalamic nucleus/nuclei responsible for the relay of impulses for limbic function.
Dorsomedial, anterior nuclei
-
Name the largest thalamic nucleus.
Pulvinar
-
What is the function of the pulvinar?
Integration of visual, auditory and somesthetic input
-
Which portion of the internal capsule contains fibers of the corticobulbar tract?
The genu
-
Which portion of the internal capsule contains fibers of the corticospinal, spinothalmic, visual, and auditory tracts?
The posterior limb
-
Which arteries supply the posterior limb of the internal capsule?
Perforating branches of the anterior choroidal artery and lenticulostriate arteries
-
Name the major hypothalmic nucleus/ nuclei responsible for regulation of the release of gonadotropic hormones.
Medial preoptic nucleus (which contains the sexually dimorphic nucleus)
-
Name the major hypothalmic nucleus/ nuclei responsible for regulation of circadian rhythms.
Suprachiasmatic nucleus
-
Name the major hypothalmic nucleus/ nuclei responsible for regulation of body temperature.
Anterior nucleus (lesion results in hyperthermia) and posterior nucleus (lesion results in poikilothermia)
-
Name the major hypothalmic nucleus/ nuclei responsible for water balance, synthesis of ADH, oxytocin, and corticotropin-releasing factor.
Paraventricular and supraoptic nuclei
-
Name the major hypothalmic nucleus/ nuclei responsible for regulation of appetite.
Ventromedial nucleus ([lesion result in eating Very Much (hyperphagia, obesity)] and lateral hypothalamic nucleus (lesions cause anorexia and starvation)
-
Name the major hypothalmic nucleus/ nuclei responsible for regulation of hypothalamus.
Arcuate or infandibular nucleus
-
Name the major hypothalmic nucleus/ nuclei responsible for emotional expression.
Mamillary nucleus (a component of the limbic system)
-
What region of the hypothalamus plays a role in stimulation of the parasympathetic nervous system?
Anterior hypothalamus
-
What region of the hypothalamus plays a role in stimulation of the sympathetic nervous system?
Posterior hypothalamus
-
What are the major structures of the Papez circuit?
Septal area, mamillary body, anterior nucleus of thalamus, cingulate gyrus, entorhinal cortex, and hippocampal formation
-
What is the most epileptogenic part of the cerebrum?
The hippocampus
-
What system within the CNS plays a central role in the initiation and coordination of somatic motor activity?
The striatal or extrapyramidal motor system
-
What are the major components of the striatal motor system?
Neocortex, striatum, globus pallidus, subthalamic nucleus, substantia nigra, and thalamus
-
Name the NT: major NT of the PNS
ACh
-
Name the NT: NT which is increased in the CNS in patients with schizophrenia
Dopamine
-
Name the NT: major NT of the parasympathetic nervous system
ACh
-
Name the NT: NT believed to cause panic attacks when released by the locus ceruleus
NE
-
Name the NT: major NT of the preganglionic sympathetic nervous system
ACh
-
Name the NT: NT highly concentrated in the substantia nigra that plays a key role in pain transmission
Substance P
-
Name the NT: major NT of the postganglionic sympathetic neurons supplying sweat glands and certain blood vessels
ACh
-
Name the NT: NT which is depleted from the basal nucleus of Meynert in Alzheimer's disease
ACh
-
Name the NT: NT which is depleted from the substantia nigra in patients with Parkinson's disease
Dopamine
-
Name the NT: NT that causes renal vasodilation
Dopamine
-
Name the NT: NTs (2) believed to be depleted in depression
NE and serotonin
-
Name the NT: powerful analgesic NT exclusively in the hypothalamus
Beta-endorphin
-
Name the NT: opiate peptides which play a role in pain suppression
Enkephalins
-
Name the NT: NT that regulates release of GH and TSH; markedly decreased in Alzheimer's disease
Somatostatin
-
Name the NT: major inhibitory NT of the cortex
GABA
-
Name the NT: major inhibitory NT of the spinal cord
Glycine
-
Name the NT: major excitatory NT of the spinal cord
Glutamate
-
Name the NT: gaseous, vasoactive NT involved in memory
Nitrous Oxide
-
Name the NT: NT important in the initiation of sleep
Melatonin
-
Name the NT: NT which inhibits the reticular activating center, thereby increasing total sleep time?
ACh
-
Which two amino acids can serve as a precursor for catecholamine synthesis?
Phenylalanine and tyrosine
-
What are the 6 layers of the neocortex?
Layer I: molecular, Layer II: external granular, Layer III: extrenal pyramidal, Layer IV: internal granular, Layer V: internal pyramidal, Layer VI: multiform
-
Name the site of a lesion within the cortex capable of causing right-sided flaccid hemiparalysis
Left primary motor area (Brodmann's area 4)
-
Name the site of a lesion within the cortex capable of causing left-sided pronator drift
Right primary motor area (Brodmann's area 4)
-
Name the site of a lesion within the cortex capable of causing loss of abstract thought and self-restraint
Bilateral loss of frontal lobes anterior to the frontal eye fields
-
Name the site of a lesion within the cortex capable of causing slowed speech without any impairment of language comprehension
Broca's speech area (Brodmann's areas 44, 45; always in the dominant hemisphere)
-
Name the site of a lesion within the cortex capable of causing loss of right-sided tactile sensation and proprioception
Left somesthetic area (Brodmann's areas 3, 1, 2)
-
Name the site of a lesion within the cortex capable of causing cortical deafness
Bilateral destruction of the auditory areas (Brodmann's area
-
Name the site of a lesion within the cortex capable of causing inability to understand spoken laguage and verbalize coherent thoughts
Wenicke's speech area (Brodman's area 22)
-
Name the site of a lesion within the cortex capable of causing ipsilateral anosmia (inability to smell)
Primary olfactory area (Brodman's area 34)
-
Name the site of a lesion within the cortex capable of causing Alexia and agraphia (inability to read and write)
Angular gyrus (Brodmann's area 39)
-
Name the site of a lesion within the cortex capable of causing loss of ability to transfer information from short-term to long-term memory
Bilateral destruction of the hippocampal cortex
-
Name the site of a lesion within the cortex capable of causing psychic blindness, hyperphagia, docility, and hypersexuality (Kluver-Bucy synrome)
Bilateral destruction of the anterior temporal lobes
-
Name the site of a lesion within the cortex capable of causing loss of ability to recognize faces
inferomedial right occipitotemporal area
-
Name the site of a lesion within the cortex capable of causing loss of vision in the right visual field with macular sparing
Destruction of the left primary visual area (Brodmann's area 17)
-
Name the term used to describe a deficit in the ability to draw a geometric figure.
Construction apraxia
-
What part of the nervous system is involved in maintaining wakefulness?
Reticular activating system
-
Name the type of neural tube defect exhibiting failure of the posterior vertebral arches to form.
Spina bifida
-
Name the type of neural tube defect exhibiting failure of posterior vertebral arch closure (not evident on clinical examination)
Spina bifida occulta
-
Name the type of neural tube defect exhibiting failure of posterior vertebral arch closure accompanied by herniation of the meninges
Spina bifida cystica
-
Name the type of neural tube defect exhibiting herniation of the meninges outside of the spinal canal
Meningocele
-
Name the type of neural tube defect exhibiting herniation of nervous tissue and meninges outside of the spinal canal
Myelomeningocele
-
Name the type of neural tube defect exhibiting complete cerebral agenesis due to lack of closure of the anterior neuropore
Ancephaly
-
Name the type of neural tube defect exhibiting diverticulum of malformed CNS tissue
Encephalocele
-
What factor is used to screen pregnant mothers for neural tube defects?
Alpha-fetoprotein
-
What is the most common cause of mental retardation?
Fetal alcohol syndrome; often associated with cardiac and facial anomalies
-
Name the condition characterized by an excess of CSF in the cranial cavity
Hydrocephalus
-
What type of hydrocephalus is characterized by obstruction in the flow of CSF through the ventricular system and subarachnoid space?
Noncommunicating hydrocephalus
-
What is the most common reversible cause of dementia in the elderly?
Normal pressure hydrocephalus
-
Normal pressure hydrocephalus is a common complication of what type of intracranial pathology?
Subarachnoid hemorrhage
-
What is the triad of normal pressure hydrocephalus?
Wacky (dementia/ short-term memory loss), Wobbly (ataxic, magnetic gait), and Wet (urinary incontinence)
-
What type of hydrocephalus is characterized by free flow of CSF but abnormal CSF absorption?
Communicating hydrocephalus
-
What congenital malformation of the CNS is characterized by herniation of the cerebellar tonsils and medulla through the formen magnum (which may reslut in obstruction of CSF circulation)
Chiari malformation
-
What congenital malformation of the CNS is associated with syringomyelia (central cavitation of the spinal cord)?
Chiari malformation
-
What is the site of arterial occlusion in a patient presenting with paresis and sensory loss of contralateral lower extremity?
ACA
-
What is the site of arterial occlusion in a patient presenting with hemiparesis, contralateral hemisensory loss, homonymous hemianopsia, and aphasia?
MCA supplying the dominant hemisphere
-
What is the site of arterial occlusion in a patient presenting with LOC, hemisensory loss, and homonymous hemianopsia with macular sparing?
PCA
-
What is the site of arterial occlusion in a patient presenting with amaurosis fugax?
Opthalmic artery
-
What is the site of arterial occlusion in a patient presenting with vertigo, cranial nerve palsies, impaired level of conciousness, and dysarthria?
Vertebrobasilar artery
-
What is the site of arterial occlusion in a patient presenting with sensory neglect and apraxia?
MCA supplying the nondominant hemispeher
-
What is the site of arterial occlusion in a patient presenting with urinary incontinence and suck and grasp reflexes?
Middle or ACA supplying the frontal lobe.
-
What are the most frequent site of embolic occlusion in the cerebral vasculature?
MCA
-
What are the most frequent sites of thrombotic occlusion in the cerebral vasculature?
Carotid bifurcation, MCA, and basilar artery
-
Which cardiac arrhythmia is associated with embolic stroke?
Atrial fibrillation
-
What type of stroke, associated with HTN, causes the formation of small, mon-shaped pits, commonly in the internal capsule or thalamus?
Lacunar infarcts
-
Name the term used to describe small aneurysms of the cerebral vasculature, caused by long-standing HTN, that may result in intracerebral hemorrhage.
Charcot-Bouchard aneurysms
-
What are the most common locations for Charcot-Bouchard aneurysms?
Thalamus and basal ganglia
-
Within the cerebral vasculature, what are the most common sites of berry aneurysm formation?
At the bifurcations of the circle of Willis
-
What is the most common complication of berry aneurysms?
Rupture causing subarachnoid hemorrhage
-
What are three disorders that predispose to the formation of berry aneurysms?
Polycystic kidney disease, Ehlor-sDanlos syndrome, and Marfan's syndrome
-
Which cranial nerve palsy is associated with internal carotid or PCA aneurysms?
CN 3 palsy causing pupillary dilation
-
Name the term used to descibe paroxysmal, self-limiting episodes of neurologic deficit, commonly including transient aphasia.
Transient ischemic attack
-
Which syndrome is characterized by loss of all motor function except that of CNs 3 and 4?
Locked-in syndrome (usually a result of infarction or tumor at the base of the pons)
-
Name the type of seizure associated with LOC followed by loss of postural control, a tonic phase of muscle contraction and clonic limb jerking.
Tonic-clonic seizure
-
Name the type of seizure: a child who appears to be daydreaming is found to have a 3 second spike-and-wave pattern on EEG
Absence seizure
-
Name the type of seizure associated with sudden ,brief muscle contractions.
Myoclonic epilepsy
-
Name the type of seizure associated with motor, sensory, visual, psychic, or autonomic phenomenon with preserved level of conciousness.
Simple partial seziure
-
Name the type of seizure associated with behavioral arrest followed by auditory or visual hallucination, automatisms, and finally by postictal confusion.
Complex partial seizures
-
What disorder is characterized by paroxysmal episodes of sharp, shooting facial pain in the distribution of one or more branches of CN 5?
Trigeminal neuralgia
-
What is the drug of choice for trigeminal neuralgia?
Carbamazepine
-
What is the triad of cerebellar disfunction?
loss of balance (disequilibrium), hypotonia, and loss of coordinated muscle activity (dyssynergia)
-
Name the terms used to describe traumatic injury to the cortex at the site of impact and opposite the side of impact.
Coup injury (at the site of impact), Contrecoup injury (opposite the site of impact)
-
Name the type of intracranial hemorrhage associated with bloody or xanthochromic CSF on lumbar puncture.
Subarachnoid hemorrhage
-
Name the type of intracranial hemorrhage associated with hematoma following the contour of a cerebral hemisphere on CT.
Subdural hematoma
-
Name the type of intracranial hemorrhage associated with laceration of bridging cerebral veins.
Subdural hematoma
-
Name the type of intracranial hemorrhage associated with laceration of middle meningeal artery due to fracture of the temporal bone?
Epidural hematoma
-
Name the type of intracranial hemorrhage associated with lucid interval followed by rapid decline in mental status.
Epidural hematoma
-
Name the type of most common type of intracranial hemorrhage resulting from trauma.
Subdural hematoma
-
Name the type of intracranial hemorrhage associated with ruptured berry aneurysm or arteriovenous malformation.
Subarachnoid hemorrhage
-
Name the type of intracranial hemorrhage seen in patinets with long-standing, poorly controlled HTN.
Intraparenchymal hemrrhage.
-
Name the type of intracranial hemorrhage associated with a lens-shaped hematoma on CT scan.
Epidural hematoma
-
Name the type of intracranial hemorrhage seen more commonly in alcoholics and the elderly.
Subdural hematoma
-
Name the type of meningitis associated with >1000 polys, decreased glucose, and increased protein in CSF.
Bacterial meningitis
-
Name the type of meningitis associated with increased lymphocytes, minor elevation in protein, and normal CSF pressure.
Viral meningitis
-
Name the type of meningitis associated with increased lymphocytes, minor elevation in protein, and elevated CSF pressure.
Fungal meningitis
-
Perivascular cuffing, inclusion bodies, and glial nodules may be seen in what cerebral infection?
Viral meningoencephalitis
-
Name the parasite spread from cats to humans that causes periventricular calcifications and congenital disorders in offspring of infected mothers
Toxoplasma gondii
-
Which infectious disease is characterized by neuronal vacuolization leading to small cysts in the gray matter of the brain without an associated inflammatory response?
Spongiform encephalopathy
-
Which disease is characterized by progressive ataxia, dementia, and spongiform gray matter changes?
Creutzfeldt-Jacob disease
-
What is the most common demyelinating disorder?
Multiple Sclerosis
-
What demyelinating disorder is associated with JC virus infection in AIDs patients?
Progressive multifocal leukoencephalopathy
-
What demyelinating disorder is associated with pereventricular calcification, with spinal lesions typically in the white matter of the spinal cord?
Multiple Sclerosis
-
What postviral autoimmune syndrome causes demyelination of peripheral nerves, especially motor fibers?
Guillain-Barre syndrome
-
What demyelinating disorder is associated with the triad of intention tremor, scanning speech, and nystagmus?
Multiple Sclerosis
-
What demyelinating disorder may present with intranuclear opthalmoplegia (MLF syndrome) or sudden visual loss due to optic neuritis?
Multiple Sclerosis
-
What demyelinating disorder is associated with ascending paralysis, facial diplegia, and autonomic dysfuncion?
Guillain-Barre syndrome
-
What demyelinating disorder is associated with oligoclonal bands in the CSF?
Multiple Sclerosis
-
What demyelinating disorder is associated with albuminocytologic dissociation (increased CSF protein with normal cell count)
Guillain-Barre syndrome
-
What leukodystrophy is associated with gluboid bodies in white matter?
Krabbe's disease
-
What autosomal recessive leukodystrophy is fatal in early childhood?
Metachromatic leukodystrophy
-
What leukodystrophy is associated with deficiency of beta-galactacerebrosidase?
Krabbe's disease
-
What autosomal recessive leukodystrophy is rappidly fatal?
Krabbe's disease
-
What leukodystrophy is associated with progressive paralysis, dementia, and ataxia?
Metachromatic leukodystrophy
-
What leukodystrophy is associated with nervous tissue that demonstrates loss of myelin and appears yellowish brown?
Metachromatic leukodystrophy
-
What leukodystrophy is associated with loss of myelin from globoid and peripheral neurons?
Krabbe's disease
-
What are the two most common causes of dementia in the elderly?
Alzheimer's dementia and multi-infarct dementia
-
What neurodegenerative disorder is associated with hirano bodies, neurofibrillary tangles, and senile plaques (accumulations of beta-amyloid protein)?
Alzheimer's dementia
-
What neurodegenerative disorder causes early onset dementia in patients with Down syndrome?
Werdnig-Hoffman disease
-
What neurodegenerative disorder causes stepwise dementia in a patient with focal neurologic deficits?
Multi-infarct dementia
-
What neurodegenerative disorder is associated with global atrophy and demyelination of the cortex, cerebellum, and brainstem due to the effects of ETOH abuse and thiamine deficiency?
Alcohol encephalopathy
-
What neurodegenerative disorder is associated with progressive dementia with predominantly frontal and temporal gliosis and neuronal loss?
Pick's disease
-
What neurodegenerative disorder is associated with degeneration of the caudate nucleus?
Huntington's disease
-
What neurodegenerative disorder is associated with lewy bodies and depigmentation of the substantia nigra?
Parkinson's disease
-
What neurodegenerative disorder is associated with parkinsonian symptoms with autonomic dysfunction, including orthostatic hypotension?
Shy-Drager syndrome
-
What neurodegenerative disorder is associated with resting tremor, cogwheel rigidity, akinesia, and postural instability?
Parkinson's disease
-
What neurodegenerative disorder can be caused by MPTP use?
Parkinson's disease
-
What neurodegenerative disorder is associated with slowly progressive ataxia, dysarthria, decreased DTRs, positive babinski signs, and sensory loss?
Friedreich ataxia
-
What autosomal recessive neurodegenerative disorder is associated with kyphoscoliosis, diabetes, arrhythmias, and myocarditis?
Friedreich ataxia
-
What autosomal dominant neurodegenerative disorder is associated with anticipation (worsening of disease in future generations) due to increasing number of CAG repeats?
Huntington's disease
-
What neurodegenerative disorder is associated with neuronal loss and gliosis in many spinal tracts?
Friedreich ataxia
-
What neurodegenerative disorder is associated with UMN and LMN signs due to loss of myelinated fibers of the corticospinal tract?
Amyotrophic Lateral Sclerosis
-
What neurodegenerative disorder is associated with tongue fasciculations?
Werdnig-Hoffman disease
-
What neurodegenerative disorder is caused by a viral infection creating an inflammatory response in the anterior horn of the spinal cord resulting in LMN loss?
Poliomyelitis
-
What neurodegenerative disorder is associated with childhood ataxia associated with telangiectasias of the skin and conjunctiva associated with ATM gene mutation.
Ataxia-telangiectasia
-
What neurodegenerative disorder is associated with a floppy baby (hypotonia) due to LMN degeneration?
Werdnig-Hoffman disease
-
Which protein gives rise to the amyloid fibrils of Alzheimer's disease?
A-beta
-
What is the conformation of A-beta protein in neuritic plaques?
beta-pleated sheets
-
The A-beta protein is derived from processing of which laregr molecule?
Amyloid precursor protein (APP)
-
What is the most common pediatric intracranial tumor?
Juvenile pilocytic astrocytoma
-
What is the most common pituitary tumor?
Pituitary Adenoma
-
What is the most common pituitary adenoma?
Prolactinoma
-
What is the most common pediatric supratentorial tumor?
Craniopharyngioma
-
What is the most common primary brain tumor?
Glioblastoma multiforme
-
What is the most common intracranial tumor?
Metastases
-
What malignant pediatric brain tumor metastases through CSF pathways?
Medullablastoma
-
What malignant pediatric brain tumor is found exclusively in the posterior fossa?
Medullablastoma
-
What vascular tumorof the cerebellum and retinais found in patients with von Hippel-Lindau syndrome?
Hemangioblastoma
-
What brain tumor is associated with abundant capillaries and vacuolated foam cells?
Hemangioblastoma
-
What brain tumor is found bilaterally in patients with neurpfibromatosis II?
Acoustic neuroma/ Schwannoma
-
What brian tumor originates from the vestibular division of CN 8?
Schwannoma
-
What brain tumor grows in a mixture of Antoni A or Antoni B patterns?
Schwannoma
-
What brain tumor is characterized by small round blue cells?
Medullablastoma
-
What brain tumor is characterized by bipolar cells, Rosenthal fibers, and microcysts?
Juvenile pilocytic astrocytoma
-
What brain tumor is associated with verocay bodies?
Schwannoma
-
What brain tumor is derived from Rathke's pouch?
Craniopharyngioma
-
What two brain tumors often present with bitemporal hemianopia?
pituitary adenoma and craniopharyngioma
-
What brain tumor is characterized by concentric whorls and calcified Psammoma bodies?
Meningioma
-
What brain tumor arises from ependymal lining of the ventricular system?
Ependymoma
-
What brain tumor commonly arises in the pineal region and commonly causes obstructive hydrocephalus by compromising the aqueduct of Sylvius?
Germinoma
-
What EBV positive B-cell tumor of the CNS is seen in AIDs patients?
CNS lymphoma
-
What brain tumor of the foramen of Monro causes obstructive hydrocephalu?
Colloid cyst of the third ventricle
-
What benign brain tumor characterized by calcifications and cells with fried-egg appearance or perinuclear halos?
Oligodendroma
-
What brain tumor is characterized by highly malignant cells bordering necrotic areas?
Glioblastoma multiforme
-
What benign brain tumor is drived from arachnoid cap cells and exhibits well-defined margins?
Meningioma
-
What disease of the spinal cord is associated with loss of all spinal modalities except tactile discrimination, vibratory sensation, and proprioception?
Ventral spinal artery occlusion
-
What disease of the spinal cord is associated with impaired tactile discrimination, vibratory sensation, and proprioception?
Tabes dorsalis
-
What disease of the spinal cord is associated with loss of pain and temperature sensation and flaccid paralysis of the intrinsic muscles of the hand?
Syringomyelia
-
What disease of the spinal cord is associated with impaired tactile discrimination, vibratory sensation and proprioception, and UMN signs and ataxia?
Vitamin B12 deficiency
-
What complication affecting the brainstem can be caused by rapid correction of hyponatremia?
Central pontine myelinolysis
-
Describe how transtentorial herniation causes contralateral hemiparesis.
compresses the right crus cerebri causing corticospinal and corticobulbar fiber compression (Kernohan's notch)
-
Describe how transtentorial herniation causes pupillary dilation.
tension on CN 3 causes pupillary dilation
-
Name a life-threatening complication of transforaminal herniation?
Duret hemorrhages
-
What is the systemic response to increased intracranial pressure?
Cushing's triad: HTN, bradycardia, irregular respirations
-
What diuretic is commonly used to manage increased intracranial pressure?
Mannitol (osmotic diuretic)
-
What is the protein change associated with prior disease?
conformational changes in PrPc (alpha-helix isoform) to PrPsc (beta-pleated sheet isoform)
-
Give the MOA, IND, and TOX for Carbamezepine.
MOA: Na+ channel blocker IND: tonic-clonic, partial, and Jacksonian seizures TOX: increased LFTs, agranulocytosis, aplastic anemia
-
Give the MOA, IND, and TOX for Ethosuximide.
MOA: May block T-type Ca++ channels in the thalamus IND: absence seizures TOX: GI upset, Stevens-Johnson syndrome
-
Give the MOA, IND, and TOX for Diazepam.
MOA: facilitates GABA action by increasing frequency of Cl channel opening IND: status epilepticus TOX: sedation
-
Give the MOA, IND, and TOX for Lamotrigine.
MOA: Na+ channel blocker IND: adjuvant antiepileptic agent TOX: life-threatening rash and Stevens-Johnson syndrome
-
Give the MOA, IND, and TOX for Phenytoin.
MOA: Na+ channel blocker IND: tonic-clonic, partial, and status TOX: Nystagmus, ataxia, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenic
-
Give the MOA, IND, and TOX for Phenobarbitol.
MOA: facilitates GABA action by increasing duration of CL channel opening IND: tonic-clonic seizures TOX: induces P450, sleepiness
-
Give the MOA, IND, and TOX for Valproic acid.
MOA: unknown, may facilitate GABA action IND: myoclonic seizures TOX: hepatotoxicity, GI toxicity, inhibits P450, thrombocytopenia
-
What is the drug of choice for treatment of simple and complex partial seizures?
Phenytoin, carbamazepine
-
What is the drug of choice for treatment of absence seizures?
Ethosuximide
-
What is the drug of choice for treatment of febrile seizures?
Phenobarbital
-
What is the drug of choice for treatment of myoclonic seizures?
Valproic acid, clonazepam
-
What is the drug of choice for treatment of status epilepticus?
Phenytoin, diazepam
-
What is the drug of choice for treatment of tonic-clonic seziures?
Phenytoin, carbamazepine
-
Give the MOA and IND for Amantidine.
MOA: may enhance dopamine release IND: Helpful for rigidity and bradykinesia
-
Give the MOA, IND, and TOX for Benztropine.
MOA: antimuscarinic IND: adjuvant therapy TOX: Similar to Atropine (hot as a hare, blind as a bat, red as a beet, dry as a bone, mad as a hatter)
-
Give the MOA, IND, and TOX for Bromocriptine.
MOA: dopamine receptor agonist IND: Used with levadopa TOX: hypotension, confusion, hallucinations, nausea
-
Give the MOA, IND, and TOX for Levodopa.
MOA: Dopamine precursor converted to dopamine in CNS IND: Combined with carbidopa, levadopa is the most efficacious regimen for Parkinson's disease TOX: Nausea, tachycardia, hypotension, hallucinations, dyskinesias
-
Give the MOA and IND for Carbidopa.
MOA: Inhibition of dopamine decarboxylase increasing levadopa concentrationin CNS IND: used with levadopa
-
Give the MOA, IND, and TOX for Selegiline.
MOA: inhibition of MAOb increases dopamine levels in CNS IND: used as adjuvant to Levadopa TOX: HTN
-
Give the MOA, IND, and TOX for Halothane.
MOA: CNS depressant IND: prototype general anesthetic, potent anesthetic but weak analgesic TOX: arrhythmias, decreased CO, hypotension, hepatotoxicty
-
Give the MOA and IND for Nitrous oxide.
MOA: CNS depressant IND: weak general anesthetic, strong analgesic
-
Give the MOA, IND, and TOX for Thiopental.
MOA: prolongs inhibitory postsynaptic potentials by increasing GABA levels (similar to phenobarbital) IND: surgical anesthesia TOX: laryngospasm
-
Give the MOA, IND, and TOX for Benzodiazepines (diazepam, midazolam).
MA: facilitates GABA action by increasing frequency of CL channel opening IND: sedative, hypnotic, anxiolytic TOX: sedation
-
Give the MOA, IND, and TOX for Ketamine.
MOA: PCP analog IND: general anesthetic TOX: postoperative hallucinations, amneisa, respiratory depression
-
Give the MOA, IND, and TOX for Propofol.
MOA: CNS depression IND: General anesthetic- rapid onset and clearance TOX: Cannot be given to patients with egg or soybean allergies
-
Give the MOA, IND, and TOX for local anesthetics (procaine, cocaine, tetracaine, lidocaine, bupivacaine).
MOA: Na+ channel blocker IND: anesthetic for minor procedures, spinal blocks TOX: arrythmias, HTN, seizure, cardiotoxicity (bupivacaine)
-
Give the MOA, IND, and TOX for Succinylcholine.
MOA: depolarizing neuromuscular blocker IND: Rapid sequence induction TOX: malignant hyperthermia when given with halogenated inhaled anesthetic; contraindicated in pts with glaucoma because it increases ocular pressure
-
Give the MOA, IND, and TOX for Tubocurarine.
MOA: Nondepolarizing neuromuscular blocker IND: adjuvant to general anesthetics TOX: HTN
-
Why is epinephrine commonly combined with local anesthetics?
To prolong the duration of the anesthetic effect by causing local vasoconstriction
-
What types of fibers are affected most by local anesthetics?
Pain> temp> touch? Pressure; small unmyelinated most affected and large myelinated fibers least affected
-
Which drug is used to reverse the effects of the nondepolarizing muscle blockers?
Neostigmine
-
Which drug is used to treat malignant hyperthermia?
Dantrolene
-
Give the MOA, IND, and TOX for Acetaminophen.
MOA: COX inhibitor IND: Pain, fever (NOT anti-inflammatory)
-
Give the MOA, IND, and TOX for ASA.
MOA: Irreversible inhibition of COX-1 and COX-2 IND: Alangesic, antipyretic, anti-inflammatory, antiplatelet drug TOX: GI ulcers, platelet dysfunction, hypersensitivity reactions, bronchoconstriction, tinnitus, Reye's syndrome
-
Give the MOA, IND, and TOX for Celecoxib.
MOA: Cox-2 Inhibitor IND: Osteoarthritis, rheumatoid arthritis TOX: similar to ASA but less GI toxicity
-
Give the MOA, IND, and TOX for Gabapentin.
MOA: Structural analog of GABA IND: Neuropathic Pain TOX: Sedation, movement disorders
-
Give the MOA, IND, and TOX for Indomethacin.
MOA: Reversible inhibition of COX-1 and COX-2 IND: Acute gout, neonatal PDA TOX: GI upset, HA
-
Give the MOA, IND, and TOX for Meperidine.
MOA: mu opiod receptor agonist IND: Analgesic TOX: Seizures, side effects similar to morphine
-
Give the MOA, IND, and TOX for Morphine.
MOA: mu opiod receptor agonist IND: Analgesic, cough suppressant TOX: Constipation, emesis, sedation, respiratory depression, miosis, urinary retention (note: these symptoms are typical for heroin overdose)
-
Give the MOA and IND for Nalbuphine.
MOA: Opiod mixed agonist-antagonist analgesic that activates kappa and weakly block mu receptors IND: Analgesic with less abuse potential
-
Give the MOA and IND for Naloxone
MOA: mu opiod receptor antagonist IND: Used to reverse the effects of opiod agonists
-
What two types of opiod receptors mediate analgesia, rspiratory depression, and physical dependence?
mu and delta
-
What type of opiod receptors mediate spinal analgesia and the sedative effects of opiods?
kappa
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