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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)
Q0006:patient cannot turn her head to the left and has right
shoulder droop?;what structure is damaged?
Right CNXI (runs thru jugular foramen with IX and X)
innervating sternocleidomastoid and trapezius muscles
Q0007:man presents with one wild; flailing arm;where is the
lesion
contralateral subthalamic nucleus (hemiballismus)
Q0008:patient with cortical lesion does not know that he has
a disease;where is the lesion
right parietal lobe
Q0009:patient cannot protruede tongue toward left side and
has a right sided spastic paralysis;wehre is the lesion?
left medulla
Q0010:after fall that injures elbow; pt can't feel medial
palm;which nerve and what injury?
ulnar nerve due to broken medial condyle
Q0011:midshaft break of the humerus;what nerve and artery
likely to be damaged
radial nerve and deep brachial artery; which run together
Q0012:patient cannot blink right eye or seal lips and has mild
ptosis on right side;what is diagnosis; what nerve affected?
Bell's palsy; cn vii
Q0013:patient complains of pain; numbness; and tingling. on
exam; wasting of thenar eminence;what diagnosis; what nerve?
carpal tunnel; median nerve
Q0014:during a particular stage of sleep; man has variable
blood pressure; penile tumescence; and variable eeg;what
stage?
rem
Q0015:episodes of hypoglycemia; blood analysis reveals no
elevation in c protein;what diagnosis?
factitious disorder; self scripted insulin
Q0016:headache; visual disturbance; galactorrhea;
amenorrhea;what dx?
prolactinoma
Q0017:middle aged pt with dizziness and tinnitus. ct shows
enlarged internal acoustic meatus;what dx?
schwannoma
Q0018:25 year old female with uniocular vision loss; slurred
speech. history of weakness and paresthesias that have
resolved;dx?
MS
Q0019:child "paces out". quivering lips during spells;dx?
absence seizure
Q0020:man on antidepressants has mydriasis and becomes
constipated;what is cause of sx?
tricyclic antidepressants
Q0021:woman on MAO inhibitor has hypertensive crisis
after a meal;what did she ingest?
tyramine (wine or cheese)
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?
"Waiter's tip" Erb-Duchenne palsy; traction of upper trunk
(C5; C6)
Q0023:injury to what part of the brachial plexus results in a
hand that looks like a claw?
lower trunk (C8; T1)
Q0024:what are symptoms of an injury to the lower trunk of
the brachial plexus?
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
Q0025:Which nerves arise from the posterior cord of the
brachial plexus?
axillary nerve and radial nerve
Q0026:injury to the posterior cord of the brachial plexus
results in what?
wrist drop and deltoid paralysis
Q0027:what nerve roots serve the long thoracic nerve?
C5; C6; C7
Q0028:What happens when the long thoracic nerve is
damaged?
winged scapula
Q0029:What nerve supplies function to the deltoid muscle?
From where on the brachial plexus does it derive?
Axillary nerve from the posterior cord
Q0030:A lesion in the radial nerve causes what?
wrist drop (extensor muscles of wrist) and sensory deficit on
posterior arm and dorsal hand of first 3.5 digits
Q0031:what muscle protects the brachial plexus from injury
during a clavicle fracture?
subclavius muscle
Q0032:injury to musculocutaneous nerve will cause what
motor defect
difficulty in flexing elbow
Q0033:abduction and opposition of thumb and finger flexion
is controlled by what nerve?
median nerve
Q0034:ulnar nerve supplies what motor and sensory
function?
Motor: adduction of thumb; palmar and dorsal interosseus
muscles. Sensory: palmar and dorsal aspect of little finger and
half of ring finger
Q0035:Shoulder dislocation typically causes what brachial
plexus injury?
Axillary nerve paralysis (cannot abduct arm past 90 degrees)
Q0036:a midshaft humerus fracture can affect which nerves?
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
Q0037:a supracondylar humerus fracture or a palmar wrist
injury will affect what nerve?
median nerve affecting flexion of fingers and
abduction/opposition of thumb as well as sensation of
majority of palmar aspect of hand
Q0038:a fracture of medial epicondyle of humerus or wrist
fracture on medial aspect of wrist will affect what nerve?
ulnar nerve; resulting in an inability to adduct or abduct
fingers or adduct thumb and sensation of last 1.5 digits
Q0039:What muscles are innervated by the radial nerve?
Brachioradialis; Extensors of wrist and fingers; Supinator;
Triceps
Q0040:What motor and sensory functions does the obturator
nerve serve?
adduction of thigh; and sensory on medial aspect of thigh
Q0041:anterior hip dislocation affects what nerve?
obturator nerve
Q0042:pelvic fracture affects what nerve?
femoral nerve
Q0043:what motor and sensory functions does the femoral
nerve have?
flexion of thigh and extension of leg; sensory on anterior thigh
and medial leg
Q0044:trauma to lateral aspect of leg or fibula neck fracture
may damage what nerve?
common peroneal nerve
Q0045:what motor and sensory functions does the common
peroneal nerve serve?
eversion and dorsiflexion of foot; extension of toes; sensory
on anterolateral leg and dorsal foot
Q0046:knee trauma can affect what nerve?
tibial nerve
Q0047:tibial nerve serves what motor and sensory functions?
inversion and plantarflexion of foot and flexion of toes;
sensory to sole of foot
Q0048:posterior hip dislocation and polio may affect what
nerve?
superior gluteal nerve or inferior gluteal nerve
Q0049:the superior gluteal nerve serves what functions?
abduction of thigh (positive trendelenburg sign if damaged)
Q0050:damage to the inferior gluteal nerve causes what motor
deficits?
inability to jump; climb stairs; or rise form seated position
(gluteus maximus paralysis)
Q0051:Deep Fibular Nerve
FOOT DROP; paresthesia in webspace between big toe and
second toe
Q0052:Femoral Nerve
(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
Q0053:Superior Gluteal Nerve
(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
Q0054:Inferior Gluteal Nerve
(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
Q0055:Superficial Fibular Nerve
impaired eversion and dorsal sensation; but extension is intact
Q0056:Tibial Nerve
"tarsal tunnel syndrome" = decreased flexion of big toe;
difficulty standing on tiptoe
Q0057:Obdurator Nerve
(L2-4; anterior division; medial thigh-adductors- exits via
obdurator canal);impaired adduction of thigh at hips
Q0058:Terrible triad
anterior cruciate ligament;medial collateral ligament;medial
meniscus
Q0059:Anterior drawer sign
tibia displaced anteriorly to femur in flexed knee;indicated
ACL tear
Q0060:Sx of torn Medial collateral ligament
pain when leg is rotated medially at the knee (abnl passive
abduction)
Q0061:Foot drop (loss of dorsiflexion)
tibialis anterior;Comon peroneal nerve;(L4-S2);(PED:
Peroneal Everts and Dorsiflexes)
Q0062:Loss of plantar flexion
gastroc and soleus;Tibial N;(L4-S3);TIP: Tibial Inverts and
Plantarflexes (if injured; can't stand on TIPtoes)
Q0063:Loss of knee jerk
Femoral Nerve;L2;3;4
Q0064:Loss of hip adduction
Obdurator (L2;3;4)
Q0065:Vertebral disk herniation usu occurs between which
vertebrae?
between L5 and S1;Sciatica!
Q0066:Lumbar puncture pierces which structures?
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
Q0067:Which nerve extends the knee?
femoral
Q0068:Which nerve flexes the knee?
Tibial
Q0069:Nerves that contain fibers from the superior rami of
the plexus (L2-L4) innervate muscles in the
anterior compartment (that act at the hip and knee joint).
Q0070:Nerves that contain fibers from the inferior rami of the
plexus (S1-S3) innervate muscles of
the leg (that act on ankle and foot joints)
Q0071:Dermatome paresthesia at the anterior thigh
L3
Q0072:Dermatone paresthesia at the medial leg
L4
Q0073:Dermatome paresthesia at the anterior leg and dorsum
of foot
L5
Q0074:Dermatome paresthesia at the lateral foot and sole
S1
Q0075:Patellar tendon reflex
L4
Q0076:Achilles tendon reflex
S1
Q0077:Obturator nerve comes from
L2-L4 (anterior division)
Q0078:Femoral
L2-L4 (posterior division)
Q0079:Common Fibular comes from roots
L4 L5 S1 S2 (posterior division)
Q0080:Tibial nerve comes from roots
L4 L5 S1-S3 (anterior division)
Q0081:Motor weakness with obturator lesion
adduction of thigh (affected hip flexors and hip adductors)
Q0082:motor weakness with femoral lesion
extension of knee
Q0083:motor weakness with common fibular lesion
foot drop (dorsiflexion; foot eversion)
Q0084:motor weakness with tibial lesion
no plantar flexion or toe flexion
Q0085:Pregnancy can cause compression of
L3/obturator
Q0086:Psoas abscess can cause a lesion of
Femoral
Q0087:Common (4) injuries to the Common Fibular nerve
1) compression at fibula neck;2) hip fracture or dislocation;3)
misplaced gluteal injection;4) piriformis syndrome
Q0088:Penetrating trauma to buttock or hip
fracture/dislocation can cause nerve damage to
Common fibular or tibial
Q0089:Recurrent Laryngeal nerve The recurrent laryngeal
nerve is a branch of which cranial nerve?
CN X
Q0090:Recurrent Laryngeal nerve Which muscles does it
supply?
intrinsic muscles of the larynx except the cricothyroid muscle
Q0091:Recurrent Laryngeal nerve What structure does the
right recurrent laryngeal nerve wrap around?
right subclavian artery
Q0092:Recurrent Laryngeal nerve What structure does the left
recurrent laryngeal nerve wrap around?
arch of the aorta and the ligamentum arteriosum
Q0093:Recurrent Laryngeal nerve In what kind of surgery can
this nerve be damaged in?
thyroid surgery
Q0094:Recurrent Laryngeal nerve What happens when this
nerve gets damaged?
hoarseness
Q0095:Name the layers of the scalp
skin; connective tissue; aponeurosis; loose connective tissue;
pericranium (SCALP)
Q0096:Name the meninges.
Dura; arachnoid; and pia (DAP)
Q0097:Recurrent Laryngeal nerve What space is found
between the dura and arachnoid?
subdural space
Q0098:Between what meninges is the subarachnoid space
located?
between the arachnoid and the pia
Q0099:What is found in the subarachnoid space?
CSF
Q0100:In which scalp layer are the emissary veins found?
loose connective tissue
Q0101:Nerve Injury Injury to what nerve causes loss of
dorsiflexion of foot
common peroneal (L4-S2) (PED = Peroneal Everts and
Dorsiflexes)
Q0102:Nerve Injury Injury to what nerve causes loss of
plantar flexion
tibial (L4-S3) (TIP = Tibial Inverts and Plantarflexes; if
injured; can't stand on TIPtoes)
Q0103:Nerve Injury Loss of Knee Jerk?
Femoral (L2-L4)
Q0104:Nerve Injury Loss of hip adduction? Roots?
Obturator (L2-L4)
Q0105:Nerve Injury In adults; where does the spinal cord
end?
L1-L2
Q0106:Nerve Injury Where does the subarachnoid space end?
S2
Q0107:Nerve Injury divide the 31 spinal nerves into their
divisions
8Cs; 12Ts; 5Ls; 5Ss; 1 coccygeal
Q0108:What cell is responsible for physical support and
repair; as well as K+ metabolism
astrocytes
Q0109:what are the phagocytic cells of the nervous system
microglia
Q0110:what cells produce myelin in the CNS
oligodendricytes
Q0111:what cells produce myelin in the PNS
Schawnn cells
Q0112:What three structures form the BBB
Choroid plexus epithelium; Intracerebral capillary
endothelium; Arachnoid (remember CIA)
Q0113:Do nonpolar/lipid soluble substances or polar; water-
soluble substances pass through the BBB more easily?
Nonpolar/lipid soluble
Q0114:Why is L-dopa; not dopamine; the treatment of choice
in Parkinson's Disease
L-dopa crosses the BBB
Q0115:What are the functions of the hypothalamus (7)
Thirst; Adenohypophysis control; Neurohypophysis
hormone synthesis; Hunger; Autonomic regulation (including
circadian rhythms); Temperature regulation; Sexual urges
(TAN HATS)
Q0116:anterior hyporthalamus control function?
Cools body when hot;Anterior Cooling = A/C
Q0117:Does the posterior hypothalamus control heat
conservation?
Yes; think no Posterior hypothalamus = poikilotherm (cold
blooded snake)
Q0118:Which nucleus is responsible for hunger?
Lateral nucleus
Q0119:Which nucleus is responsible for satiety?
ventromedial nucleus (without which you grow ventrally and
medially
Q0120:Which nuclei of the hypothalamus project axons into
the posterior pituitary?
supraoptic nuclei (ADH) and paraventricular nuclei
(oxytocin)
Q0121:What is the function of the lateral geniculate nucleus?
Visual pathway (remember Lateral is needed to Look)
Q0122:What is the function of the medial geniculate nucleus?
Auditory pathway (remember Medial is to hear Music)
Q0123:Function of the ventral posterior nucleus; lateral part
(VPL)?
receives body senses (proprioception; pressure; pain; touch;
vibration)
Q0124:Function of the ventral posterior nucleus; medial part
(VPM)?
receives facial sensations; including pain
Q0125:Ventral Nuclei (VA/VL) functions?
Motor
Q0126:What are the functions of the limbic system?
Feeding; Fighting; Feeling; Flight; and Sex (the five Fs)
Q0127:What two areas does the hippocampus project to?
the subiculum (mammillary nuclei) and the septal area
Q0128:Trace the pathway from Mammillary body to
hippocampus.
Mammillary body; anterior nucleus of thalamus; cyngulate
gyrus; entorhinal cortex; hippocampus
Q0129:Basal ganglia Describe the primary function fo the
basal ganglia.
The basal ganglia mediates voluntary movements and postural
adjustments
Q0130:Basal ganglia What are the roles of the direct and
indirect pathways?
Indirect pathway inhibits movement; Direct pathway
facilitates movement.
Q0131:Basal ganglia Delineate the flow of processing in the
direct pathway.
Putamen (inhibitory) => Gpi (inhibitory) => Thalamus:
inhibition of Gpi => activation of thalamus
Q0132:Basal ganglia Delineate the flow of processing in the
indirect pathway.
Putamen (inhibitory) => GPe (inhibitory) => {STN
(excitatory)=>GPi (inhibitory)} =>Thalamus; induces
excitation of Gpi => inhibition of thalamus
Q0133:What is the anatomical defect in Parkinson's Dz?
Loss of substantia nigra pars compacta (SNc) dopamine
output to putamen => activation of indirect pathway and
inhibition of direct pathway
Q0134:What is the clinical presentation and cause of chorea?
sudden; jerky; purposeless movements; caused by basal
ganglia lesionChorea= dancing; think choreography
Q0135:What is the clinical presentation and cause of
athetosis?
slow; writhing movements; especially of fingers; caused by
basal ganglia lesion
Q0136:What is the clinical presentation of hemiballismus?
sudden; wild flailing of 1 arm; half ballistic= as in throwing a
baseball
Q0137:What is the anatomical defect in hemiballismus?
contralateral subthalamic nucleus lesion
Q0138:Where is the primary sensory cortex (S1) located?
anterior aspect of parietal lobe
Q0139:in smaller muscles; how many muscle fibers does an
alpha motor neuron innervate?
just a few - results in finer control of movement
Q0140:cerebellum influences motor activity on which side?
ipsilateral - projects to contralateral motor cortex and red
nuclei whose fibers cross back over
Q0141:what does the anterolateral system/spinothalamic tract
carry?
pain; temperature; crude touch; and pressure
Q0142:what information do the dorsal columns carry?
fine touch; vibration; concious proprioception
Q0143:where does the corticospinal tract deccussate?
as it descends through the inferior aspect of the medulla
through the medullary pyramids
Q0144:where do the dorsal columns cross over?
between their nuclei in the brainstem and the thalamus via the
arcuate fibers of the medial lemniscus
Q0145:where do the axons of the spinothalamic tract cross
over?
almost immediately after their first-order synapes in the
dorsal horn
Q0146:what are the neurological deficits that occur in Brown-
Sequard syndrome?
ipsilateral motor loss and loss of touch; vibration;
propriceptive sense; contralateral pain and temperature loss
Q0147:where do the motor and sensory deficits manifes in
patients with a lesion of the internal capsule?
corticospinal tract; dorsal columns; and spinothalamic tract
travel to or from the cerebral cortex through the posterior limb
- contralateral hemiplegia and contralateral sensory loss
Q0148:what is the primary mode of analgesic relief of opiods?
inhibition of the spinothalamic tract
Q0149:what disorder is characterized by loss of pyramidal
cells in the cerebral motor cortex that leads to fibrosis of the
lateral corticospinal tracts
ALS
Q0150:what is usually spared in ALS?
sensory tracts and cognitive function
Q0151:what are signs of UMN lesions?
spastic paralysis; hyperactive deep tendon reflexes; and
clonus - UMNs are tonically inhibitory to LMNs
Q0152:what are signs of LMN lesions?
hporeflexia; fasciculations; flaccid paralysis
Q0153:familial forms of ALS have been associated with what?
mutations in the zinc/copper superoxide dismutase gene;
which plays an important role in scavenging free radicals in
metabolically active cells such as neurons
Q0154:periventricular plaques on MRI and oligoclonal bands
in CSF are indicative of what?
MS
Q0155:what is destroyed in Parkinson's?
dopaminergic neurons in the substantia nigra
Q0156:what kind of drug is bromocriptine?
dopamine receptor agonist
Q0157:what is benztropine? why is it useful in PD?
anticholinergic - relative excess of Ach because of dopamine
deficiency; anticholinergics can be useful in treating motor
symptoms
Q0158:what compound that may be found in ilicit drugs can
cause PD?
MPTP - selectively destroys neurons in the substantia nigra
Q0159:what is the difference between tremor in PD and
tremor in cerebellar dysfunction?
PD - resting tremor;cerebellar dysfunction - tremor associated
with volitional movements
Q0160:what is MG often associated with?
thymoma
Q0161:what is the pathophysiology of motor weakness in
MG?
antibodies to the post-synaptic nicotinic ACh receptors on
skeletal muscle fibers
Q0162:what type of receptors are nicotinic receptors?
ligand-gated sodium channels
Q0163:what kind of drug is edrophonium?
short-acting cholinesterase inhibitor - increases concentration
of ACh in synaptic cleft
Q0164:what are the long-acting cholinesterase inhibitors?
pyridostigmine and neostigmine
Q0165:what are the side effects of cholinesterase inhibitors?
excessive PNS stimulation - diarrhea; miosis; bronchospasm;
excessive urination; bradycardia; salivation; lacrimation; also
sweating because SNS stimulates sweating via ACh
Q0166:how do you treat organophosphate poisoning?
treatment aimed at reducing total cholinergic activity -
palidoxine regenerates active cholinesterase; and
anticholinergic atropine
Q0167:what is Lambert-Eaton syndrome?
AI disease with antibodies to voltage-gated calcium channels
located in terminal bouton of presynaptic neurons result in
impaired ACh release
Q0168:what is Lambert-Eaton syndrome often associated
with?
paraneoplastic syndromes; particularly small cell CA of lung
Q0169:bilateral loss of pain and temperature sensation?
syringomyelia
Q0170:what is syringomyelia?
expanded fluid-filled cavity in spinal cord that affects the
spinothalamic tract
Q0171:what produces atrophy of the muscles of hands and
hypoactive reflexes of the upper extremities in syringomyelia?
expansion of the syrinx to compress the ventral horns -
produces LMN signs
Q0172:what should you examine for masses in a patient with
trigeminal neuralgia?
posterior fossa
Q0173:what drug is used to treat trigeminal neuralgia?
carbamazapine - reduces rate of nerve transmission by
inhibiting voltage-gated sodium channels of neurons
Q0174:what are CSF findings in MS?
oligoclonal immunoglobulin bands (absent in serum); elevated
IgG; and myelin basic protein
Q0175:this is a disease that involves demyelination of various
white matter areas of the CNS
MS
Q0176:what cell type is attacked and destroyed during an
exacerbation of MS?
oligodendrocytes
Q0177:this syndrome is due to demyelination of peripheral
nerves
Guillan-Barre
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)
ischemic stroke
Q0179:this type of stroke results predominantly from
trauma; ruptured AV malformation; ruptured aneurysm; or
vessel rupture due to hypertension
hemorrhagic
Q0180:how does atrial fibrillation predispose to stroke?
makes it easier for blood to pool and clot within the atria; and
the clots can then embolize to brain
Q0181:what serves the motor and sensory cortex devoted to
the contralateral leg?
anterior cerebral artery
Q0182:what does the MCA supply?
motor and sensory cortex for contralateral upper extremity;
head; neck; and face
Q0183:what artery supplies Broca's and Wernicke's areas?
MCA (typically on left)
Q0184:occlusion of what can cause left homonymous
hemianopsia?
right posterior cerebral artery - supplies visual cortex in
occipital lobe
Q0185:worst headache of life; N&V; stiff neck; photophobia?
subarachnoid hemorrhage
Q0186:where do you do an LP?
L3-L4 or L4-L5 (SC terminates at L1-L2)
Q0187:what are the common causes of subarachnoid
hemorrhage?
ruptured berry aneurysm; ruptured AVM; head trauma (most
common)
Q0188:patients with PKD most often have berry aneurysms
in what location?
bifurcation of anterior communicating artery
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
hydrocephalus
Q0190:CSF flows from the lateral ventricles into the third
ventricle via what?
foramen of Monroe
Q0191:CSF flows from the third ventricle to the fourth
ventricle via what?
cerebral aqueduct (aqueduct of Sylvius)
Q0192:how is CSF reabsorbed?
empties into dural venous sinuses via arachnoid granulations
Q0193:trauma that causes unconsciousness followed by lucid
interval followed by confusion; lethargy; disorientation
epidural hematoma - intracranial bleeding that dissects
periosteal dura away from skull
Q0194:this is composed of a periosteal layer adherent to bone
and a meningeal layer continuous with the arachnoid layer
dura mater
Q0195:what artery is most commonly involved in an epidural
hematoma?
middle meningeal artery - ruptures between dura and skull
Q0196:this layer attaches directly to brain parenchyma
pia
Q0197:does CSF show RBCs in an epidural bleed?
no - blood does not reach subarachnoid space where CSF is
located
Q0198:what structures are typically involved in a subdural
hematoma?
bridging veins that interconnect the subarachnoid space and
the dural (venous) sinuses - more common in elderly people
whose brains have atrophied
Q0199:what carries the efferent part of the corneal reflex?
facial nerve - causes contraction of the orbicularis oculi
Q0200:what carries the afferent part of the corneal reflex?
V1
Q0201:anticonvulsant with gingival hyperplasia; nystagmus;
and ataxia as side effects?
phenytoin
Q0202:anticonvulsant with hepatotoxicity as potential side
effect?
valproic acid
Q0203:anticonvulsants that can cause Stevens-Johnson
syndrome?
lamotrigine; ethosuximide
Q0204:anticonvulsants that can cause respiratory depression?
phenobarbital; diazepam
Q0205:anticonvulsant that can cause agranulocytosis?
carbamazepine
Q0206:anticonvulsant that can cause tremor?
gabapentin
Q0207:what is the first line treatment for absence seizures?
ethosuximide
Q0208:what effects do most anticonvulsants have on neuronal
discharge?
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
Q0209:how are AD and Pick's disease different?
AD: diffuse cerebral atrophy;Pick's: selecive atrophy of
frontal and temporal lobes
Q0210:what class of drug is used to treat AD?
cholinesterase inhibitors - AD is associated with selective
destruction of cholinergic neurons
Q0211:if a patient with AD has depression; what drugs
should not be prescribed?
TCAs because they have powerful anticholinergic side effects
that may exacerbate the cognitive decline due to AD
Q0212:what is the mechanism whereby short-term memory is
consolidated into long-term memory?
long-term potentiation - occurs in hippocamus
Q0213:what is the second most common cause of dementia in
the elderly?
multi-infarct dementia - focal neurologic defects
Q0214:what is the most common primary brain tumor?
astrocytoma
Q0215:what is the worst grade of astrocytoma?
glioblastoma multiforme
Q0216:what type of tumor has a characteristic
pseudopaliasding arrangement of tumor cells?
glioblastoma multiforme
Q0217:why are lomustine and carmustine more suitable for
treating brain tumors?
belong to a class of alkylating agents - nitrosureas - can
effectively penetrate the BBB
Q0218:what is a meningioma?
benign tumor that arises from the arachnoid cells of the
meninges - external to brain and so usually can be surgically
resected
Q0219:Which cranial nerve opens eyelids?
III
Q0220:Which cranial nerve tastes from anterior 2/3 of tongue?
VII
Q0221:Which cranial nerve salivates from the submaxillary
glands?
VII
Q0222:Which cranial nerve salivates from the submandibular
glands?
VII
Q0223:Which cranial nerve closes eyelids?
VII
Q0224:Which cranial nerve tastes from posterior third of
tongue?
IX
Q0225:Which cranial nerve salivates from parotid gland?
IX
Q0226:Which cranial nerve monitors carotid body and sinus
chemo and baroreceptors?
IX
Q0227:Which cranial nerve tastes from epiglottic region?
X
Q0228:Which cranial nerve swallows?
X
Q0229:Which cranial nerve elevates palate?
X
Q0230:Where in the brain stem is the nucleus of the follow
cranial nerve: 3
Midbrain
Q0231:Where in the brain stem is the nucleus of the follow
cranial nerve: 4
Midbrain
Q0232:Where in the brain stem is the nucleus of the follow
cranial nerve: 5
Pons
Q0233:Where in the brain stem is the nucleus of the follow
cranial nerve: 6
Pons
Q0234:Where in the brain stem is the nucleus of the follow
cranial nerve: 7
Pons
Q0235:Where in the brain stem is the nucleus of the follow
cranial nerve: 8
Pons
Q0236:Where in the brain stem is the nucleus of the follow
cranial nerve: 9
Medulla
Q0237:Where in the brain stem is the nucleus of the follow
cranial nerve: 10
Medulla
Q0238:Where in the brain stem is the nucleus of the follow
cranial nerve: 11
Medulla
Q0239:Where in the brain stem is the nucleus of the follow
cranial nerve: 12
Medulla
Q0240:Lateral or medial in brainstem: Sensory cranial nerve
nuclei
Lateral (because Medial for Motor)
Q0241:Lateral or medial in brainstem: Motor cranial nerve
nuclei
Medial for Motor
Q0242:What CNs are in the following nucleus and what kind
of information does it carry: Nucleus Solitarius
8; 9; 10;Visceral sensory information (Solitarius is Sensory)
Q0243:What CNs are in the following nucleus and what kind
of information does it carry: Nucleus Ambiguens
9; 10; 11;Motor innervation of pharynx larynx and upper
esophagus (aMbiguens is Motor)
Q0244:What CNs are in the following nucleus and what kind
of information does it carry: Dorsal motor nucleus
Sends parasympathetic fibers to heart; lungs; and upper GI
Q0245:What opening does the following structure pass
through: Ophthalmic artery
Optic canal
Q0246:What opening does the following structure pass
through: Central retinal vein
Optic canal
Q0247:What opening does the following structure pass
through: CN III
Superior orbital fissure
Q0248:What opening does the following structure pass
through: CN IV
Superior orbital fissure
Q0249:What opening does the following structure pass
through: CN V1
Superior orbital fissure;Mnemonic for CN V: (Standing room
only)
Q0250:What opening does the following structure pass
through: CN VI
Superior orbital fissure
Q0251:What opening does the following structure pass
through: Ophthalmic vein
Superior orbital fissure
Q0252:What opening does the following structure pass
through: CN V2
Foramen rotundum;Mnemonic for CN V: (standing Room
only)
Q0253:What opening does the following structure pass
through: CN V3
Foramen ovale;Mnemonic for CN V: (standing Room only)
Q0254:What opening does the following structure pass
through: Middle meningeal artery
Foramen spinosum
Q0255:What opening does the following structure pass
through: Middle meningeal vein
Foramen spinosum
Q0256:What opening does the following structure pass
through: Recurrent branch of V3
Foramen spinosum
Q0257:What opening does the following structure pass
through: Accessory meningeal artery
Foramen ovale
Q0258:What opening does the following structure pass
through: Lesser petrosal nerve
Foramen ovale
Q0259:What opening does the following structure pass
through: Bridging veins
Foramen ovale
Q0260:What opening does the following structure pass
through: CN VII
Internal auditory meatus
Q0261:What opening does the following structure pass
through: CN VIII
Internal auditory meatus
Q0262:What opening does the following structure pass
through: CN IX
Jugular foramen
Q0263:What opening does the following structure pass
through: CN X
Jugular foramen
Q0264:What opening does the following structure pass
through: cranial roots of CN XI
Jugular foramen
Q0265:What opening does the following structure pass
through: Jugular vein
Jugular foramen
Q0266:What opening does the following structure pass
through: Inferior petrosal nerve
Jugular foramen
Q0267:What opening does the following structure pass
through: Posterior meningeal artery
Jugular foramen
Q0268:What opening does the following structure pass
through: Sigmoid sinus
Jugular foramen
Q0269:What opening does the following structure pass
through: spinal roots of XI
Foramen magnum
Q0270:What opening does the following structure pass
through: brain stem
Foramen magnum
Q0271:What opening does the following structure pass
through: vertebral artery
Foramen magnum
Q0272:What opening does the following structure pass
through: CN XII
Hypoglossal canal
Q0273:Neural Crest Derivatives?;10
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
Q0274:Asymptomatic defect in vertebtral arches
Spina Bifida Occulta
Q0275:Meninges project through the vertebral defect
Spina Bifida w/ Meningocele
Q0276:What Labx do you ask for in Spina Bifida?
Alfa-feto protein (increased)
Q0277:What happens in meningmyelocele?
Meninges and spinal cord project through vertebral defect
Q0278:What are the FOUR sympathetic ganglions?
1) Superior Cervical Ganglion;2) Middle Cervcial;3)
Vertebral;4) Cervicothoracic
Q0279:What level does the Lateral Horn of the Sympathetic
system comprises?
T1-L2
Q0280:What are the Four cranial ganglia of the
Parasympathetic System?
1) Ciliary ganglion;2) Submandibular;3) Pterygopalatine;4)
Otic
Q0281:What cranial nerves are Parasympathic?
1) III;2) VII;3) IX 3;7;9
Q0282:What controls the foregut and midgut in the
parasympathetic?
Vagus X; at terminal ganglia
Q0283:What Parasympathetic controls the Hindgut?
Pelvic Splachnic Nerves S2-S4
Q0284:Ciliary Ganglion controls what CN and muscle?
Parasymp. CN III;Ciliary m.
Q0285:Submandibular galgion controlled by?
Parasymp. CN VI;Submandibular and sublingual glands
Q0286:Pterygopalatine ganglion is in control of?
Parasymp;Lacrimal glands;Nasal;Oral;CN VII
Q0287:Otic Ganglion controls what?
Parasymp. CV IX;Parotid Gland
Q0288:Decrease in Alfa-feto Protein in Pregnancy equals?
Down Syndrome
Q0289:Forebrain TEL;DI;Midbrain MES;Hindbrain MET;MI
Telencephalon;Diencephalon;Mesencephalon;Metencepahol;
Myelencephalon
Q0290:Telecephalon? CNS Structure + what ventricle is
formed?
Cerebral Hemis. Lat. Ventri
Q0291:Diecephalo? makes what structure in CNS and what
Ventricles?
Thalamus; Pineal Third Vent;Gland; neurohypo;physis;
hypotha-;lamus; retina
Q0292:Mesencephalon? CNS/Ventricle
Midbrain Cerebral Acued.
Q0293:Metencephalon
PONS Cerebellum 4th Ventri
Q0294:Myelencephalon
Medulla 4th Ventri
Q0295:Who makes the PONS Bridge?
Mesencephalon
Q0296:What makes Craniopharyngiomas?
Remannts of Rathke's Pouch that compress optich chiasm
Q0297:Anterograde movement by?
Kinesin
Q0298:Retograde movement in CNS?
Dyenin
Q0299:These viruses affect retrograde movement?
Herpes;Polio;Rabie;Tetanus
Q0300:Oligodendrocyte vs Schwan?
Oligo can myelinate more than 1 cell; sometimes up to 50
cells!
Q0301:Hair cells are derived from what layer?
Ectoderm
Q0302:Substantia Nigra derives from with plate? Alar or
Basal?
Basal
Q0303:Polyhydramnios caused by?
Anencephaly
Q0304:Oligohydramnios?
Potter's Syndrome (Bilateral Renal Agenesis);
Oligohydramnios causes limb deformities and pulmonary
hipoplasia
Q0305:What connects the lateral ventricles?
Foramen of Monroe (Mon Roe)
Q0306:What connects the 3rd ventricle with the 4th?
Acueduct of Sylvius
Q0307:What connects the ventricles and the subarachnoid
space? And where is this located?
Located in the 4th ventricle;Three openings;1) Two Lateral
formaina of Luschka;2) Median foramina of Magendie
Q0308:Normal pH of CSF?
7.33
Q0309:CSF has higher concentrations of ____ than blood?
Cl-; Ca2+; HCO3- and glucose
Q0310:How are protein levels in CSF compared to blood?
Lower
Q0311:How are Sodium levesl in CSF compared to blood?
Same about 138 mEq/L
Q0312:Are PMN normal in CSF?
No!!! Bacterial Meningitis
Q0313:What does it mean when there is an increase in protein
in CSF?
Possibly a CNS tumor
Q0314:Define Hydrocephalus?
Increase in volume (excess) or pressure of CSF producing
ventricular dilation
Q0315:Communicating Hydrocephalus;What are the
underlying causes?
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)
Q0316:Noncommunicating Hydrocephalus
undersecretion/ obstruction of CSF flow;1)tumor blocking
foramen Monro; cerebral aqueduct; 4th ventricle or Fomanina
Magendie or Lushka.
Q0317:Mechanism of Normal Pressure hydrocephalus?
- CSF not absorbed by arachnoid villi;- ventricles enlarged;-
ventricles press agains cortex and skull
Q0318:Symptoms of NPH (normal pressure hydrocephalus)?
1) confusion;2) gait apraxia;3) urinary incontinence;stiff legs;
dementia ;confused with Alzheimer;like magnetic feet stuck to
the ground
Q0319:Blood-brain barrier regulated by what type of cells?
What type of junctions?
- Tight Junctions in the capillary endothelium;- Astrocytes
Q0320:Where is CSF produced?
Choroid Plexus
Q0321:What part of hypothalamus is controlled by
sympathetic?
Posterior Hypothalamus;remember to use your posterior to
be sympathetic w/ someone
Q0322:Sympathetic Response? Think of the tiger chasing you
- 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
Q0323:Horner Sx is an attack to sympathetic. What are the
symptoms?
- Miosis enophthalmos;- pseudotosis ;- Anhydrosis (can't
sweat);- lack of piloerection
Q0324:What kind of neurons does the ventral horn contains?
Motorneurons
Q0325:What kind of neurons does the dorsal horn control?
Sensory neurons
Q0326:What 2 motorneurons does the ventral horn have?
Alpha and Gamma
Q0327:What do alpha motorneurons control?
skeletal muscle (extrafusal fibers)
Q0328:What do gamma motorneurons control?
muscle spindle contractile intrafusal fibers
Q0329:Neural Systems
3 Major Neural Systems
Q0330:Motor Systems composed of?
1) Upper Motorneuron;2) Lower Motorneuron
Q0331:Where are the bodies of the upper motor neurons
found?
1) Red nucleus;2) Reticular Formation;3) Lateral Vestibular
Nuclei of the brain stem;4) Cerebral Cortex (Most Important)
Q0332:What tract are the upper motor neurons run in?
Corticospinal Tract
Q0333:Where is the motor cortex located in the brain? What
lobe of the brain?
1) Precentral Gyrus of the Frontal Lobe;2) Premotor Area
both 60%;3) 1ry + 2ry somatosensory cortical areas of
parietal lobe 40% of fibers
Q0334:Where do corticospinal tract fibers exit the cerebral
cortex?
In the Internal Capsule
Q0335:Dorsal Horns transmit what type of stimulus?
Sensory
Q0336:Ventral Horns transmit which type of stimulus?
Motor (Remember S&M)
Q0337:What happens to the corticospianl tract at the lower
medulla?
They cross the decussation of the pyramids continue
contralaterally
Q0338:Decorticate rigiditiy is caused by?
Lesions above the midbrain
Q0339:A lesion below the midbrain causes what type of
rigidity?
Decerebrate Rigidity
Q0340:What reflexes are lost in an Upper Motorneuron
Lesion?;Reversal of Reflexes
1) Babinski Reflex (extension instead of flexion);2) Abdominal
Reflex Lost;3) Cremasteric Reflex Lost
Q0341:What are the two sensory systems?
1) Dorsal Column-Medial Meniscal System;2) Anterolateral
(Spinothalamic) System
Q0342:Where is the 1st order neuron for the Sensory
Systems?
Dorsal Root Ganglion (Pseudounipolar neuron)
Q0343:Where is the 2nd order neuron?
- Starts in Brain stem or Spinal Cord before crossing ;- it then
crosses;Second Order Always crosses
Q0344:Where is the 3rd order neuron?
Thalamus (T for Third);It already has crossed to the other
side
Q0345:What does the Dorsal Column-medial leminiscal
system convey? (DC-ML)
Propioception and Stereoception;- sensory info. for
discriminatory touch;- joint position;- vibratory;- pressure
sensation from trunk and limbs
Q0346:What type/class of fibers does the Dorsal Column
(DC-ML) system have?
Class II or A-beta
Q0347:Which part of the Dorsal Column is located medially?
(Which Fasciculus)
Fasciculus Gracilis
Q0348:What does the fasciculus gracilis control? (Closest to
the midline)
Lower Extremities;- Remember that you are graceful when
you walk;- Also; gracilis muscle is on the medial aspect of the
leg/thigh
Q0349:What part of the brainstem is the 2nd order neuron
located?
Medulla
Q0350:Does the second order neuron for sensory pathway
cross the midline?
YES! It crosses; axon doesn't cross but dendrite and body
crosses
Q0351:Where do 2nd order Dorsal Column cells synapse?
Medulla ;Nucleus Gracilis;Nucleaus Cuneatus
Q0352:Where do 3rd order of the Dorsal Column-Medial
Leminiscus System (DC-MLS) cells synapse?
Medial Leminiscus like its name;Part of the Thalamus;in the
Ventroposterolateral Nucleus (VPL)
Q0353:What does the fasciculus gracilis control? (Closest to
the midline)
Lower Extremities;- Remember that you are graceful when
you walk;- Also; gracilis muscle is on the medial aspect of the
leg/thigh
Q0354:What part of the brainstem is the 2nd order neuron
located?
Medulla
Q0355:Does the second order neuron for sensory pathway
cross the midline?
NO! It crosses at the 3rd order neuron in the Thalamus
Q0356:Where do 2nd order Dorsal Column cells synapse?
Medulla ;Nucleus Gracilis;Nucleaus Cuneatus
Q0357:Where do 3rd order of the Dorsal Column-Medial
Leminiscus System (DC-MLS) cells synapse?
Medial Leminiscus like its name;Part of the Thalamus;in the
Ventroposterolateral Nucleus (VPL)
Q0358:Where is the 2nd order neuron?
Brain stem or Spinal Cord before crossing
Q0359:Where is the 3rd order neuron?
Thalamus (T for Third);It already has crossed to the other
side
Q0360:What does the Dorsal Column-medial leminiscal
system convey? (DC-ML)
Propioception and Stereoception;- sensory info. for
discriminatory touch;- joint position;- vibratory;- pressure
sensation from trunk and limbs
Q0361:What type/class of fibers does the Dorsal Column
(DC-ML) system have?
Class II or A-beta
Q0362:Which part of the Dorsal Column is located medially?
(Which Fasciculus)
Fasciculus Gracilis
Q0363:Decorticate rigiditiy is caused by?
Lesions above the midbrain
Q0364:A lesion below the midbrain causes what type of
rigidity?
Decerebrate Rigidity
Q0365:What reflexes are lost in an Upper Motorneuron
Lesion?;Reversal of Reflexes
1) Babinski Reflex (extension instead of flexion);2) Abdominal
Reflex Lost;3) Cremasteric Reflex Lost
Q0366:What are the two sensory systems?
1) Dorsal Column-Medial Meniscal System;2) Anterolateral
(Spinothalamic) System
Q0367:Where is the 1st order neuron for the Sensory
Systems?
Dorsal Root Ganglion (Pseudounipolar neuron)
Q0368:Where can you find 2nd order neuron in the Dorsal
Column pathway? What Nuclei?
Brainstem;- Medulla;Nucleus Gracilis;Nucelus Cuneatus
Q0369:What pathway crosses the midline in the sensory
pathways?
The 2nd order neuron always crosses; need two lines to make
a cross
Q0370:Where is the 3rd order neuron located in the Dorsal
Column Medial Leminiscus (DC-MLS) Pathway? Which
nucleus?
Brainstem;- Thalamus;- At the medial lemniscus like its
name;- It is found in the Ventroposterolateral Nucleus
Q0371:Where do the 3rd order Neurons project in the Dorsal
Column Pathway?
To the ANTERIOR portion of the PARIETAL Lobe;-
Primary somethetic (somatosensory) area;- located in the
Postcentral gyrus
Q0372:How do you determine a lesion to the Dorsal Column?
Loss of Joint sensation;- vibratory ;- pressure sensation;-
two-point discrimination;- loss of the ability to identify
characteristics of an object
Q0373:What is asterognosis?
Identify;- shape;- size;- consistency;- form;of an object using
the sense of TOUCH
Q0374:How do you diagnose Dorsal Column Pathway lesion?
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
Q0375:What is another name for the Anterolateral System?
Spinothalamic Tract System
Q0376:What does the Anterolateral System sense?
- pain;- temperature;- crude touch sensations
Q0377:Via what fibers do the dorsal root ganglia enter the
spinal cord?
Dorsal Root Fibers;- via A-Delta ;- Class III;- Class IV
Q0378:What is the backup of the Corticospinal Tract
Lesions?
The backup is that 20% of the fibers do not cross;- the
conscious crosses;unconscious doesn't cross
Q0379:What do direct fibers that do NOT cross controll?
They control proximal pathways giving function to the
proximal extremities
Q0380:What is a picture of a Monkey's Bottom w/ flowers?
Medulla Oblongata IX; X; XII
Q0381:What is the function of a bipolar neuron?
They are responsible for special senses;- vision;- smell;- taste
Q0382:Function of a pseudounipolar neuron?
It is a scanning neuron
Q0383:Where are 3ry (Tertiary) neurons of the Dorsal
Column Systems located?
Thalamus (Remember T is for Third/Tertiary and
Thalamus);They cross
Q0384:What happens to all the lesions that are unilateral in
the Spinal Cord or the Brain Stem?
They result in a contralateral loss of pain and temperature
Q0385:Where is the 2nd Neuron located for the Anterolateral
(Spinothalamic) System?
Dorsal HORN Gray Matter
Q0386:What order neuron crosses in the Anterolateral AL-
SpT tract?
2nd order neuron
Q0387:Where do the axons of the 2nd order neuron enter?
Ventral White Commissure
Q0388:Where does the analgesia begin after a lesion of the
anterolateral/spinothalamic tract?
1 or 2 segments below the contralateral side of the lesion.
Q0389:What information does the spinocerebellar pathways
carry?
Unconscious propioceptive input from muscle spindles and
GTOs to cerebellum
Q0390:What two major spinocerebellar pathways are there?
Dorsal and Cuneocerebellar;(Dorsal and Ventral)
Q0391:Where are the 2nd order neuron from the Dorsal
Spinocerebellar tract found?;(What nucleus);At what level?
- Clarke Nucleus;- Spinal Cord level (T1-L2)
Q0392:Where are the bodies of the cuneocerebellar tact
found? (What nucleus);At what level?
- External Cuneate Nucleus;- Medulla
Q0393:What information is gathered from the dorsal
spinocerebellar pathway?
Input from lower extremities and lower trunk
Q0394:What information is gathered by the Cuneocerebellar
tracts?
Propioceptive input to the cerebellum from upper extremities
and upper trunk
Q0395:What disease atacks the Spinocerebellar tract?
Friederich's Ataxia
Q0396:What form of inheritance is Friederich's Ataxia?
Autosomal Recessive
Q0397:What are the symptoms in a hemisection of the spinal
cord?
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
Q0398:What is another name for hemisection of the spinal
cord?
Brown-Sequard Sx
Q0399:What pathways are interrupted by a hemisection?
1) corticospinal;2) dorsal columns;3) spinothalamic
(anterolateral)
Q0400:What spinal cord lesion is caused by Vitamin B12
Deficiency?
Subacute Combined Degeneration
Q0401:What other Diseases cause Subacute Combined
Degeneration (SCD)?
- Vitamin B12;- Pernicious Anemia;- AIDS
Q0402:What pathway is damaged in Polio?
LMN
Q0403:What pathway is damaged in Tabes Dorsalis?
Dorsal Column
Q0404:What Pathway is damaged in Amyotrophic Lateral
Sclerosis?
- Corticospinal Tract ;- LMN
Q0405:What pathways are damaged in Anterior Spinal Artery
occulsion (ASA)?
- LMN;- Spinothalamic tract (SpTh);- Corticospinal tract
(CST);- LMN;Except Dorsal Column (DC) is spared
Q0406:What pathways are damaged in Subacute combined
degeneration?
- Corticospinal Tract (CT);- Dorsal Column;- Spinocerebellar
Tract
Q0407:What sign do we find on Dorsal Column lesion?
Romberg's Sign (+)
Q0408:What tract is damaged in Syringomyelia?
- Spinothalamic (SpTh);- LMN
Q0409:What is a late complication of Syringomyelia?
Horner Syndrome (ptosis; miosis; anhydrosis)
Q0410:What tracts are damaged in Hemisection: Brown-
Sequard Sx?
- DC;- CST;- SpTh;- LMN;All of them!;If lesion is above T1
then Horner Sx. (Ipsilateral)
Q0411:Which side is affected in Horner Sx lesion at T1-
T4?;Above T1?
Contralateral side;Above T1 is ipsilateral side
Q0412:What happens in Vitamin B12 Def?
Demyelination of Spinal Cord Tracts
Q0413:What tracts are affected by Vitamin B12 deficiency?
- Dorsal Columns (DC);- Spinocerebellar Tracts ;-
Corticospinal Tracts (CTS)
Q0414:Patient with paresthesias; bilateral spastic weakness;
Babinksi sign and antibodies to intrinsic factor? Diagnosis
Dx:?
Dx: Subacute combined degeneration;Intrinsic Factor is
deficient and wont let the ileum absorb Vitamin B12
Q0415:How are Multiple Sclerosis; Vitamin B 12 deficiency
and Subacute Combined Degeneration similar?
They are all conditions where CNS is demyelinated
Q0416:What cells are within the white matter of spinal cord?
Oligodendrocytes;- they create the myelin for all axons inside
the CNS and tracts of white matter
Q0417:What tract is injured in a patients with signs of UMN
and LMN?
Amyotrophic Lateral Sclerosis (ALS)
Q0418:Which cells regenerate in the PNS? Why?
Cells in the Ventral Root;- they contain myelin from Schwann
Cells which promote regeneration of cut axons.
Q0419:What are the three Ps of Tabes Dorsalis?
1) Pain;2) Paresthesia;3) polyuria;Argyll Robertson
Pupils;Last P is Pupil Defect!
Q0420:What structures degenerates in MS?
Myelin containing nerves;i.e. Optic Nerves; formed by
oligodendrocytes not schwann(PNS)
Q0421:What test do you find positive in MS?
Heterogeneous Immunoglobulin G Staining w/ oligoclonal
banding
Q0422:Charactestic of Syringomyelia?
Bilateral loss of pain and temperature
Q0423:What level does the fasciculus cuneatus begins?
T5 segment
Q0424:What cells are affected in LMN lesions?
Alpha motor neurons in the ventral horns
Q0425:What cells manage the reflex contraction of muscle and
extension of oposite muscles?
Muscle Spindles
Q0426:What are does the anterior spinal artery supply?
Ventrolateral 2/3's of the spinal cord;- DC are spared;- NO
problems in pain and temp.
Q0427:What is affected if the spinothalamic tract on the left
side is affected?
Pain and temperature sensations on the right leg
Q0428:Where do axons of fasciculus cuneatus have their
bodies in?
Dorsal Root Ganglia
Q0429:The Brain Stem
pg. 363
Q0430:What three parts make the Brainstem?
1) midbrain;2) pons;3) medulla
Q0431:What cranial nerves arise from the midbrain?
1) oculomotor III;2) trochlear IV;3 and 4
Q0432:What cranial nerves enter or exit the pons?
V; VI; VII; VIII;5-8
Q0433:What three cranial nerves enter or exit from the
medulla?
IX; X; XII
Q0434:Are Motor Nuclei located medially or lateral?
Medial M=Medial M=Motor
Q0435:What are some of the symptoms for a pineal tumor?
Parinaud Sx;1) paralisis of upward gaze;2) noncummunicating
hydrocephalus
Q0436:What cranial nerve is affected in Neurofibromatosis II?
VIII; associated with Schwannomas
Q0437:What happens to a lesion of the nucleus ambiguus?
Ipsilateral paralysis of the soft palate;- uvula deviates away
from the lesion;- nasal regurgitation of liquids;- hoarseness;-
difficulty swallowing
Q0438:What does the solitary nucleus control?
solitary sounds like salivary and taste;- it controls the taste
and visceral sensory neurons
Q0439:What cranial nerve does the spinal nucleus control?
Trigeminal nerve V
Q0440:What is the major parasympathetic nucleus in the
brain stem? Where is it located?
Dorsal motor nucleus in the 4th ventricle
Q0441:What cranial nerves does the nucleus solitarius
control?
VII; IX; X;7;9;10
Q0442:What nerve is NOT affected when there is an
intramedullary lesion?
Spinal Accesory Nerve (XI)
Q0443:What muscles does the spinal accesory nerve
innervate?
1) sternocleidomastoid ;2) trapezius
Q0444:Where is the abducens nucleus found?
Floor of the 4th ventricle;- lateral to the MLF
Q0445:What happens when the abducens nucleus has a
lesion?
- ipsilateral facial paralisis of the VII nerve;- inability to look
to the side of the lesion
Q0446:Where does the facil nerve exit the brain?
pontomedullary junction
Q0447:What is the superior olivary nucleus responsible for?
It receives auditory impulses from both ears by cochclear
nuclei;- cochclear nuclei at pontomedullary junction
Q0448:Where are vestibular nuclei found?
posterior surface of pons
Q0449:What three structures are found in the pontomedullary
junction?
- Facial motor nucleus exits fibers;- cochlear nuclei
Q0450:What four nerves emerge from the pons?
V-VIII;5;6;7;8;at the pontomedullary junction
Q0451:What is another name for midbrain?
Mesencephalon
Q0452:What structures pass through the midbrain?
- cerebral acueduct;- superior colliculi;- inferior colliculi
Q0453:What is the function of the inferior colliculi?
processes auditory information received bilaterally from
cochlear nuclei
Q0454:What is the function of superior colliculi?
help direct movement of both eyes in gaze
Q0455:What two nerve emerge from midbrain?
oculomotor III;trochlear IV;3;4
Q0456:What do the cerebral peduncles contain?
Corticospinal fibers;corticobulbar fibers
Q0457:How do oculomotor nucleus exists the midbrain?
ventrally in the interpenducular fossa
Q0458:How do trochlear nerves exit?
posterior midline inferior to the inferior colliculi
Q0459:How does the ear protect itself against damage to the
inner ear from loud sounds?
It contracts the stapedius and tensor tympani muscles
Q0460:What happens to the Upper Face and Lower Face in a
corticobulbar lesion?
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.
Q0461:What are the components of the ear?
1) external ear;2) middle ear;3) inner ear
Q0462:What structures make up the external ear?
Pinna;External Auditory Meatus
Q0463:What makes up the middle ear?
- Temporal Bone;- tympanic membrane;- connecting it to the
oval window
Q0464:What bones are included in the middle ear?
malleus;stapes;incus
Q0465:What makes up the inner ear?
- labyrinth;- channels (semicircular ducts and cochlear duct)
Q0466:What is the characteristic of endolymph?
It contains the same characteristics as intracellular fluid
Q0467:What is the characteristic of perilymph?
It is ionically extracellular fluid
Q0468:How does sound travel from the ear to the brain?
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
Q0469:What is stimulated in low-frequency sounds?
Apex of of the cochlea
Q0470:What is stimulated in high-frequency sounds?
Base of the cochlea
Q0471:Does perilymph move towards or away the direction
of movement?
Toward
Q0472:How does endolymph move?
Against the direction of movement
Q0473:Static Laberynth is made up of?
Striola;Otoconia;Kinocillium
Q0474:How can you tell if there is excitation from the
kinocillium?
They are pointing toward the striola
Q0475:What are the components of the dynamic laberynth?
Ampulla; endolymph; hair cells; crystals
Q0476:What consists in a Pinealoma Sydrome?
Insomnia; headache and can't look up
Q0477:What is the mechanism of damage in a pinealoma?
- Damage to the superior colliculus center for upward gaze;-
pupillary constriction for accomodation;- decrease in
melatonin;- decrease in sleep patterns;- headache from tumor
compression
Q0478:- Can't follow Upward gaze;- Hydrocephalus;-
Headache;- Pupils Accomodate but not react;Diagnostic?
Pinnealoma/Parinaud Sx
Q0479:What nerve is intact when you have good
convergence?
III adducts well
Q0480:Patient difficulty swallowing and palata droopped;
what center is affected?
Nucleus Ambiguus
Q0481:Cranial Nerve nuclei in Midbrain
CN-3 and CN-4
Q0482:Cranial nerve nuclei in Pons
CN-5 to CN-8
Q0483:Cranial nerve nuclei in Medulla
CN-9 to CN-12
Q0484:CN's which pass thru sphenoid (middle cranial fossa)
CN II-VI
Q0485:pathway of CNI
cribiform plate
Q0486:CN's which pass through bones of posterior cranial
fossa (temporal or occipital)
CNVII-XII
Q0487:CNII exit from skull
Optic canal
Q0488:CN that exit skull via Superior Orbital Fissure
CN-III; CN-IV; CN-V1; CN-VI
Q0489:CNV2: exit from skull
Foramen rotundum
Q0490:CNV3: exit from skull
Foramen Ovale
Q0491:middle meningeal artery: entrance into skull
Foramen spinosum
Q0492:CNVII: exit from skull
internal auditory meatus
Q0493:CNIX exit from skull
jugular foramen
Q0494:CNXII: exit from skull
hypoglossal canal
Q0495:spinal root CNXI: entrance into skull
foramen magnum
Q0496:decreased pain and temp sensation over lat. aspects of
both arms. where is the lesion
syringomyelia
Q0497:penlight in pts right eye produces bilateral pupillary
constriction. when moved to the left eye; there is paradoxical
dilation;what is the defect?
atrophy of L optic nn
Q0498:decresassed prick sensation on lateral aspect of leg and
foot;deficit in what mm action can also be expected
dorsiflexion & eversion of foot (common peronial nn)
Q0499:pt presents w/ tingling over lateral digits of her R
hand;What is the dx
carpal tunnel syndrome;median nn compression
Q0500:decreased plantar flexion and decreased sensation over
back fo thigh; calf; and latereal half of foot;what spinal nn
tibial (L4-S3)
Q0501:pt in MVA can't turn head to L & has rightt shoulder
droop;What sx is damaged.
R CN XI (inn SCL & trap mm)
Q0502:pt presents w/ one wild flailing arm. where is the
lesion?
contralateral subthalamic nuccleus (hemiballismus)
Q0503:pt w/ cortical lesion does not know he has a dz. where
is the lesion?
right paraietal lobe
Q0504:pt cannot protrude tongue toward L side and has a R-
sided spastic paralysis. Where is the lesion?
L medulla; CN XII
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.
ulnar nn due to broken medial condyle
Q0506:pt presents to ER after falling on arm. X-ray shows
midshaft break of the humerus? Which nn & aa are most lkely
damaged?
radial nn & deep brachial aa (run together
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.
bell's palsy; CN VII
Q0508:pt c/o numbness; & tingling sensation. She has wasting
of thenar eminence. What is the dx/ What nn is affected?
carpel tunnel syndrome (medial nn)
Q0509:stage of sleep where there is variable BP; penile
tumescence & variable EEG.
REM
Q0510:person demands only the best & most famous doctor
in town;what personality d/o
narcissistic personality d/o
Q0511:nurse has episodes of hypoglycemia; blood analysis
shows no elevation in C protien. What is the dx.
factitious d/o. self scripted insulin
Q0512:woman presents w/ headache; visual disturbance;
galactorrhea and amenorrhea;what is the dx
prolactinoma
Q0513:pt experiences dizziness & tinnitis. ct shows enlarged
internal acoustic meatus. What is the dx
schannoma
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
MS
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?
absence seizures
Q0516:man on several meds including antidepressants and
antihypertensives; has mydriasis and becomes constipated.
What is the cause of his symptoms
TCA
Q0517:woman on MAO inhibitor has hypertensive crisis
after a meal. What did she ingest?
tyramine (wine or cheese)
Q0518:This CNS support cell helps maintain the blood-brain
barrier. It's cell marker is GFAP
astrocyte
Q0519:this CNS support cell makes up the inner lining of the
ventricles
ependymal cells
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.
microglia.
Q0521:This CNS support cell is responsible for myelin
production
oligodendroglia
Q0522:This pns support cell is responsible for peripheral
myelin production
schwann cell
Q0523:All CNS/ PNS support cells (except the microglia
which originates from mesoderm)originate from this primary
germ cell layer.
ectoderm
Q0524:autopsy done on pt w/ HIV shows these support cells
transformed into virus filled multinucleated giant cells in CNS
microglia
Q0525:these CNS support cells are destroyed in MS
oligodendroglia
Q0526:Acoustic neuroma is a neoplasm of this PNS support
cell commonly associated with the internal acoustic meatus
(CN VII; VIII)
schwann cell
Q0527:Give following peripheral nn layers from inner most to
outermost ;nn fibers;endoneurium;epineurium;perineurium
endoneurium-perineurium-epineurium-nn fibers
Q0528:this peripheral nn layer must be rejoined in
microsurgery for limb reattachment
perineurium
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.
meissner's corpuscle
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.
pacinian corpuscle
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
merkel's corpuscle
Q0532:when you hear high frequency sound; this part of the
cochlea is responding (narrow & stiff)
base
Q0533:when you hear low frequency sound; this part of the
cochlea is responding (wide and flexible)
apex
Q0534:perilymph in the inner ear is similar to (ECF or ICF)
ECF (high Na+)
Q0535:when you hear high frequency sound; this part of the
cochlea is responding (narrow & stiff)
base
Q0536:endolymph in the inner ear is similar to (ECF or ICF)
ICF (K+)
Q0537:Utricle and saccule of the inner ear contain maculae
which detect which type of acceleration?
linear
Q0538:Semicircular canals of the inner ear contain ampullae
which detect which type of acceleration?
angular
Q0539:hearing loss in the elderly usually begins with which
type of frequency
high frequencies
Q0540:blood brain barrier is formed by which 3 structures:
1)astrocyte processes;2) basement membrane;3)tight jx b/n
nonfenestrated capillary endothelial cells
Q0541:glucose and amino acids cross the blood-brain barrier
by which method.
carrier mediated transport mechanism
Q0542:what crosses blood brain barrier more redily. water
soluble substances or lipid soluble substances?
lipid soluble
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.
either;1)Thirst;or;2)Temperature
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.
Either;1) Adenohypophysis control;or;2)Autonomic
regulation
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.
Either;1) Adenohypophysis control;or;2)Autonomic
regulation
Q0546:the hypothalamus wears TAN HATS is a mneumonic
for the fxns of the hypothalamus? ;What does the N stand for
Neurohypophysis hormones (synthesized in hypothalamic
nucleii)
Q0547:the hypothalamus wears TAN HATS is a mneumonic
for the fxns of the hypothalamus? ;What does the H stand for
Hunger
Q0548:the hypothalamus wears TAN HATS is a mneumonic
for the fxns of the hypothalamus? ;What does the S stand for?
Sexual urges
Q0549:destruction of the lateral nucleus of the hypothalamus
results in what type of food intake?
anerexia & starvation
Q0550:destruction of the ventromedial nucleus of the
hypothalamus results in what type of food intake?
hyperphagia and obesity
Q0551:Anterior hypothalamus regulates what division of the
ANS.
parasympathetic
Q0552:Posterior hypothalamus regulates what division of the
ANS.
Sypathetic
Q0553:This nucleus controls circadian rhythms.
suprachiasmatic nucleus
Q0554:This nucleus controls thirst and water balance
supraoptic nucleus
Q0555:This part of the hypothalamus (anterior or posterior)
kicks in and regulates heat concervation when cold.
posterior hypothalamus
Q0556:This part of the hypothalamus (anterior or posterior)
coordinates cooling when hot.
anterior hypothalamus
Q0557:When this nucleus of the hypothalmus is destroyed--
rage results?
septal nucleus
Q0558:The posterior pituitary (neurohypophysis) recieves
hypothalamic axonal projections from the supraoptic nucleii
and releases what hormone?
ADH
Q0559:The posterior pituitary (neurohypophysis) recieves
hypothalamic axonal projections from the paraventricular
nucleii and releases what hormone?
oxytocin
Q0560:this part of the brain is the major relay for ascending
sensory informationthat ultimately reaches the cortex?
thalamus
Q0561:This geniculate nucleus of the thalamus (lateral or
medial) is involved in relaying visual sensory information to
the cortex.
lateral
Q0562:This geniculate nucleus of the thalamus (lateral or
medial) is involved in relaying auditory sensory information
to the cortex.
medial geniculate nucleus (MGN)
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.
Ventral Posterior Nucleus; Lateral part (VPL)
Q0564:This nucleus of the thalamus is involved in relaying
FACIAL sensation information to the cortex via CN V
Ventral Posterior nucleus; medial part (VPM)
Q0565:This nucleus of the thalamus is involved in relaying
motor information to the cortex.
Ventral Anterior/Lateral nucleus (VL)
Q0566:This "system" of the brain is responsible for the 5 Fs.
Feeding; Fighting; Feeling; Flight; and Fucking.
limbic system
Q0567:This part of the brain is important in voluntary
movements and making postural adjustments.
basal ganglia
Q0568:Parkinson's dz symptoms are do to decreased imput
from this part of the basal gangia.
substantia nigra.
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
decreased ;decreased
Q0570:In the basal ganglia; _________ (D1)facilitates
movement
direct pathway
Q0571:In the basal ganglia; _________ (D2)inhibits
movement
indirect pathway
Q0572:In the cerebral cortex associative auditoritory fx is
associated with which area?
Wernicke's area (22)
Q0573:In the cerebral cortex speech motor fx is associated
with which area?
broca's area
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.
frontal lobe
Q0575:anterior cerebral artery hemarrage could result in
sensory motor problems in which location of the body?
lower extremity
Q0576:anterior cerebral aa supplies what part of the brain
medial surface
Q0577:hemhorrage of the middle cerebral aa would involve
what part of the brain.
lateral
Q0578:hemhorrage of the middle cerebral aa could involve
what pathologies?
motor & sensory deficits of teh trunk-arm-face; Broca's and
Wernicke's speech areas
Q0579:Anterior communicating artery lesion is the most
common circle of Willis aneurism. It may cause this deficit.
visual field defect
Q0580:Posterior communicating artery is also a common area
of aneurism. It can result in this cranial nn palsy.
CN III
Q0581:A stroke in this general part of the circule of wilis can
cause general sensory and motor dysfunction and aphasia
anterior circle
Q0582:A stroke in this general part of the circle of wilis can
cause cranial n deficits (vertigo; visual deficits); coma;
cerebellar deficits (ataxia)
posterior circle
Q0583:this division of the middle cerebral aa is a common site
of stroke. It feeds the internal capsule; caudate; putamen; &
globus pallidus
lateral striate
Q0584:Cerebral veins drain into the venous sinuses which
drain into what?
internal jugular vv
Q0585:lateral ventricle drains into the 3rd ventricle via the
foramen of _______.
monro
Q0586:3rd ventricle drains into the 4th ventricle via the
aquaduct of ________
sylvius
Q0587:4th ventricle drains into the subarachnoid space via the
foramina of ________ (laterally) and the foramina of
________ (medially
Luschka;Magendie
Q0588:How many spinal nn are there total?
31;8-C;12-T;5-L;5-S;1-coccygeal
Q0589:Vertibral disk herniation usually occurs between what
levels_______
L5-S1
Q0590:At what levels do you want do a LP
L3-L5 ;(spinal cord extends to lower border of L2;
Subarachnoid space extends to lwer border of S2)
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
skin/superficial fascia;Ligaments ;Epidural space;Dural
matter;Subdural space;Arachnoid;Subarachnoid space CSF
Q0592:Should you pierce the Pia matter in a lubar puncture?
No
Q0593:These columns relay sensation of pressure; vibration;
touch; and proprioception to the cerebral cortex.
dorsal columns
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.
fascciculus cuneatus
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.
fasciculus gracilis
Q0596:These tracts relay sensation of pain and temperature
up the spinal cord to the cerebral cortex
spinothalamic tract
Q0597:These tracts relay motor signals from the brain down
teh spinal cord.
lateral corticospinal tract
Q0598:what is more lateral in the dorsal columns the
fasciculus cuneatus or fasciculs gracilis
fasciculus cuneatus
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)
Sensation enters the DORSAL ROOT GANGLION to ascent
the spinal cord IPSILATERALLY in the DORSAL
COLUMN.
Q0600:Describe the location of the first synapse of that
vibratory (or pressure; touch; proproceptive) sensation (must
give nucleus and brain location)
NUCLEUS CUNEATUS or GRACILIS in the MEDULLA
Q0601:Describe the 2nd order neuron of that vibratory (or
pressure; touch; proproceptive) sensation. (decussation &
ascention)
decussates in the MEDULLA and ascends
CONTRALATERALLY in the MEDIAL LEMNISCUS
Q0602:Describe the 2nd synapse of that vibratory (or
pressure; touch; proproceptive) sensation. (Nucleus and brain
location)
VPL of the THALAMUS
Q0603:Describe the final destination of the 3rd order neuron
of that vibratory (or pressure; touch; proproceptive)sensation
SENSORY CORTEX
Q0604:Describe the path of an ascending pain (or
temperature) sensation after it signals a sensory nn up until
its first synapse
travels from sensory nn endigns (A-delta and C-fibers)and
enters spinal cord ipsilaterally.
Q0605:Describe the first synapse of ascending pain and
temperature sensation
IPSILATERAL synapse with gray matter in spinal cord.
Q0606:Describe the 2nd order neuron transmission of the
ascending pain and temperature sensation. (decussation &
ascention)
Decussates at the ANTERIOR WHITE COMMISSURE and
ascends CONTRALATERAL in the SPINOTHALAMIC
TRACT
Q0607:Describe the 2nd synapse of the ascending pain and
temp sensation?
VPL of thalamus
Q0608:Describe the 3rd order neuron final destination of the
ascending pain and temperature sensation.
sensory cortex
Q0609:You want to move you're right arm? Describe the 1st
order neuron pathway.
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.
Q0610:You want to move you're right arm? Describe where
the 1st synapse occurs.
CELL BODY OF THE ANTERIOR HORN (SPINAL
CORD)
Q0611:You want to move you're right arm? Describe the 2nd
order neuron.
LOWER MOTOR NEURON leaves the spinal cord.
Q0612:You want to move you're right arm? Describe where
the 2nd synapse occurs.
neuromuscular jx
Q0613:Give the brachial plexus dx from the BP
damage;Upper trunk (C5; C6)
waiters tip
Q0614:Give the diagnosis from the location of Brachial Plexus
damage;Lower trunk (T1;C8)
claw hand
Q0615:Give the diagnosis from the location of Brachial Plexus
damage;Posterior chord (C5-T1)
Wrist drop
Q0616:Give the diagnosis from the location of Brachial Plexus
damage;Long Thoracic Nerve
Winged scapula
Q0617:Give the diagnosis from the location of Brachial Plexus
damage;Axillary nn
Deltoid paralysis
Q0618:Give the diagnosis from the location of Brachial Plexus
damage;Radial nn
Sadurday night palsy
Q0619:Give the diagnosis from the location of Brachial Plexus
damage;musculocutaneous nn
difficulty flexing elbow; variable sensory loss
Q0620:Give the diagnosis from the location of Brachial Plexus
damage;Median nn
decreased thumb fx-Pope's blessing
Q0621:Give the diagnosis from the location of Brachial Plexus
damage;Ulnar branch
Intrinsic mm of hand; claw hand
Q0622:What mm protects brachial plexus from injury in the
case of the relatively common clavicle fracture
subclavius
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.
Radial nn;mneu:RAD=BEST;Brachioradialis; Extensors or the
wrist and fingers; Supinator; and Triceps.
Q0624:Thenar mm (3);Hypothenar mm (3)
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)
Q0625:Clinically important Landmarks;-Ischial spine?;-2/3 of
the way from the umbilicus to the anterior superior Iliiac
Spine;-Iliac Crest
Pudendal nn block;McBurney's Pt-Appendix;Lumbar
puncture
Q0626:Landmark Dermatomes;Posterior half of the scull
"cap"
C2
Q0627:Landmark Dermatomes: high turtle neck shirt
C3
Q0628:Landmark Dermatomes: low collar shirt
C4
Q0629:Landmark Dermatomes: T4
nipple;T4 at the "teat pore"
Q0630:Landmark Dermatomes: xyphoid process
T7
Q0631:Landmark Dermatomes: Umbilicus
T10;T10 at the belly butTEN
Q0632:Landmark Dermatomes: Inguinal ligament
L1 ;L1 is IL
Q0633:Landmark Dermatomes: includes the kneecaps
L4;down on L4s (all 4s)
Q0634:Landmark Dermatomes;erection; and sensation of
penile and anal zones
S2;3;4;S2;3;4 keeps the penis off the floor
Q0635:Gallbladder pain is referred to the right shoulder via
this nn
phrenic nn
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
muscle spindle
Q0637:these monitor mm lenth. For example help you pick
up a heavy suitcase when you didn't know how heavy it was.
muscle spindles
Q0638:This senses tension and provides inhibitory feedbach
to alpha motor neurons
golgi tendon organs
Q0639:These monitor mm tension. For example make you
drop a heavy suitcase you've been holding for too long
golgi tendon organs
Q0640:CNS stimulates the gamma motor neuron which
contracts intrafusal fiber and causees an increased sensitivity
of the reflex arc
gamma loop
Q0641:Clinical reflexes;-Achillies;-Patella;-Biceps;-Triceps:
S1;2;L3;4;C5;6;C7;8
Q0642:Dorsiflexion of the big toe and fanning of other toes;
sign of UMN lesion; but normal reflex in 1st year of life
Babinski
Q0643:Primitive Reflexes;extension of limbs when
startled;(normally disappear w/in 1st year. May reemerge
following a frontal lobe lesion)
moro reflex
Q0644:Primitive Reflexes;nipple seeking;(normally disappear
w/in 1st year. May reemerge following a frontal lobe lesion)
rooting reflex
Q0645:Primitive Reflexes;grasps objects in palm;(normally
disappear w/in 1st year. May reemerge following a frontal
lobe lesion)
palmar reflex
Q0646:Primitive Reflexes;large toe dorsiflexes w/ plantar
stimulation;(normally disappear w/in 1st year. May reemerge
following a frontal lobe lesion)
babinski reflex
Q0647:CNs that lie medially at brainstem
III; VI; XII;mneu: 3(x2)=6(x2)=12
Q0648:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;smell
CNI-olfactory(S)
Q0649:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;Sight
CN II: Optic (S)
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
CN III: Oculomotor (M)
Q0651:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;Eye movement (down & medial)
CN IV: Trochlear (M)
Q0652:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;Mastication; Facial sensiation
CN V: Trigeminal (B)
Q0653:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;Eye movement (lateral)
CN VI: Abducens (M)
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.
CN VII: Facial (B)
Q0655:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;Hearing; balance
CN VIII: Vestibulocochlear (S)
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
CN IX: Glossopharyngeal (B)
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
CN X: Vagus (B)
Q0658:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;Head turning; shoulder shrugging
CN XI: Accessory (M)
Q0659:Give Cranial nn by Fx: Is it Motor or sensory or
Both?;Fx;tongue mvmt
CN XII: Hypoglossal (M)
Q0660:Cranial nn nucleii located in the Midbrain
CN III; IV
Q0661:Cranial nn nucleii located in the Pons
CN V-VIII
Q0662:Cranial nn nucleii located in the Medulla
IX-XII
Q0663:Cranial nn nucleii located in the Midbrain
CN III; IV
Q0664:Cranial nn more lateral in the brainstem tend to be
______; those more medially tend to be _______
sensory;motor
Q0665:This vagal nucleii recieves visceral sensory information
(e.g; taste baroreceptors; and gut distension) from cranial nn
VII; IX; & X
Nucleus Solitarius
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.
Nucleus aMbiguous
Q0667:This vagal nucleii sends autonomic (parasympathetic)
fibers to heart; lungs; and upper GI
Dorsal motor nucleus
Q0668:Crandial nn and vessel pathways;Cribiform plate
CN I
Q0669:Crandial nn and vessel pathways;optic canal
CN II; opthalmic artery; central retinal vein
Q0670:Crandial nn and vessel pathways;Superior orbital
fissure
(CN III; IV; V1;VI; opthalmic vv)
Q0671:Crandial nn and vessel pathways;Foramen Rotundum
CN V2
Q0672:Crandial nn and vessel pathways;Foramen Ovale
CN V3
Q0673:Crandial nn and vessel pathways;Foramen spinosum
middle meningeal aa
Q0674:Crandial nn and vessel pathways;Internal auditory
meatus
CN VII; VIII
Q0675:Crandial nn and vessel pathways;Jugular foramen
CN IX;X;XI; jugular vv
Q0676:Crandial nn and vessel pathways;Hypoglossal canal
CN XII
Q0677:Crandial nn and vessel pathways;Foramen magnum
Spinal roots of CN XI; brainstem; vertebral arteries
Q0678:a collectionof venous sinuses on either side of the
pituitary
cavernous sinus
Q0679:nn that pass through cavernous sinuses
nn that control extaocular mm (CN III; IV; VI) plus V1 & V2
Q0680:pt presents w/ opthalmoplegia; & opthalmic and
mandibular sensory loss;what is a possible dx?
Cavernous sinus syndrome (e.g; due to mass effect
Q0681:Muscles of mastication;3 mm that close the
jaw;innervated by?
Masseter; teMporalis; Medial pterygoid;inn: V3;mneu: Ms
Munch
Q0682:Muscles of mastication;1 mm opens the
jaw;innervated by:
Lateral pterygoid;inn: V3;mneu: Lateral Lowers
Q0683:All mm with the root glossus in their names are
innervated by?;Except one exception. What is it and what is
the innervation.
hypoglossal;palatoglossus (inn by vagus)
Q0684:All mm with the root palat in their names are
innervated by this;One exception what is it innervated by?
vagus;;exception: tensor veli palatine (inn by Mandibular
branch of CN V)
Q0685:CN IV innervates what mm? What direction would
you look?
SO--towards your nose
Q0686:CN VI innervates what mm. What direction would
you look
LR-laterally
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)
Pupillary light reflex
Q0688:Saying KLM outloud tests what three CNs?
K (vagus) palate elevation;L (hypoglossal) tongue;M (facial)
lips
Q0689:What waveform?;awake (eyes open); alert; active
mental concentration
Beta (highest frequency; lowest amplitude)
Q0690:What waveform?;awake (eyes closed)
alpha
Q0691:What waveform?;light sleep;What stage of sleep is
this? What percentage of total sleep time is this in young
adults?
Theta;1;5%
Q0692:What waveform?;deeper sleep;What stage of sleep is
this? What percentage of total sleep time is this in young
adults?
Sleep spindles and K complexes;2;45%
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?
Delta (lowest frequency; hightest amplitude);3-4;25%
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?
Beta;REM ;25%;mneu: At night; BATS Drink Blood
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.
REM
Q0696:principle neurotransmitter involved in REM sleep
Ach
Q0697:REM sleep _______ (increases or decreases) with age
decreases
Q0698:neural tube defects are associated with lack of this
vitamen intake during pregnancy
folic acid
Q0699:neural tube defects are associated with elevated levels
of this in amniotic fluid and maternal serum
alpha fetoprotein levels
Q0700:This describes failure of bony spinal canal to close;
but no structural herniation. Usually seen at lower vertebral
levels
spinal bifida occulta
Q0701:This describes when the meninges herniate throgh a
spinal canal defect
meningocele
Q0702:This describes when meninges and spinal cord herniate
through spinal canal defects
meningiomyelocele
Q0703:Give the area of the brain lesion?;motor
(nonfluent/expressive) aphasia with good comprehension
broca's area
Q0704:Give the area of the brain lesion?;sensory
(fluent/receptive) aphagia with poor comprehension
Wernicke's area
Q0705:Give the area of the brain lesion?;conduction aphagia;
poor repitition with good comprehension; fluent speech
Arcuate fasciculus ;(connects Wernicke's to Broca's area
Q0706:Give the area of the brain lesion?;Kluver-Bucy
Syndrome (hyperorality; hypersexuality; disinhibited
behavior)
Amygdala (bilateral)
Q0707:Give the area of the brain lesion?;Personality changes
and deficits in concentration; orientation; and judgement; may
have reemergence of primitive reflexes
frontal lobe
Q0708:Give the area of the brain lesion?;Spacial neglect
syndrome (agnosia of the contralateral side of the world)
Right parietal lobe
Q0709:Give the area of the brain lesion?;coma
reticular activating system
Q0710:Give the area of the brain lesion?;wernicke-korsakoff
syndrome
mamillary bodies (bilateral)
Q0711:Give the area of the brain lesion?;tremor at rest;
chorea; or athetosis
basal ganglia
Q0712:Give the area of the brain lesion?;Intention tremor;
limb ataxia
cerebellar hemisphere;mneu: cerebellar hemispheres are
LATERALLY located--affect LATERAL limbs. Vermis is
CENTRALLY located-affects CENTRAL body
Q0713:Give the area of the brain lesion?;truncal taxia;
dysarthria
cerebellar Vermis ;mneu: cerebellar hemispheres are
LATERALLY located--affect LATERAL limbs. Vermis is
CENTRALLY located-affects CENTRAL body
Q0714:Give the area of the brain lesion?;contralateral
hemiballismus
subthalamic nucleus
Q0715:Chorea--sudden; jerky; purposeless movements are
characteristic of a lesion in this part of the brain. Give the
classic dz example.
Basal ganglia;Huntington's dz
Q0716:Athetosis are slow; writhing movements; especially of
the fingers. This is characteristic of a lesion in this part of the
brain
basal ganglia
Q0717:hemiballismus involves the sudden wild flailing of 1
arm. What kind of lesion does this indicate (& on what side)
contralateral subthalamic nucleus;(results in loss of inhibition
of thalamus through globus pallidus)
Q0718:Broca's lesion is nonfluent aphagia with intact
comprehension it involves this gyrus
inferior frontal gyrus
Q0719:Wernicke's aphagia is fluent aphagia with impared
comprehension it involves this gyrus
superior temporal gyrus
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)
Alzheimers dz
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
10%
Q0722:What is the 2nd most common cause of dementia in
the elderly
multi-infarct dementia ;(may cause amyloid angiopathy)
Q0723:pt presents with dementia; aphasia; parkinsonian
aspects; associated with intracellular aggregated tau protien
and is specific for frontal and temporal lobes.
Pick's dz
Q0724:pt presents with chorea and dementia. Autopsy
shows atrophy of caudate nucleus (loss of GABAergic
neurons).
Huntinton's dz
Q0725:Dz associated with chromasome 4--expansion of CAG
repeats.
Huntinton's dz;mneu: CAG-Caudate loses ACh & GABA.
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.
Parkinson's dz;mneu: TRAP=Tremor (at rest); Rigidity;
Akinesia; and Postural instability (you are TRAPped in your
body.
Q0727:Dz associated with BOTH LMN & UMN signs; no
sensory defect. Also known as Lou Gehrig's dz
Amyotrophic lateral Sclerosis (ALS)
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.
Werdnig-Hoffmann dz
Q0729:dz follws infection with poliovirus; LMN signs.
Associated with degeneration of anterior horns.
Polio
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?
Poliomyelits
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.
poliomyelitis
Q0732:This dz shows increased prevalence with increased
distance from the equator.
MS
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.
MS
Q0734:dz associated with a relapsing-remitting course.
MS
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.
MS
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.
MS
Q0737:This demyelinating dz is associated with the JC virus
and is seen in 2-4% of AIDS pts.
Progressive multifocal leukoencephalopathy (PML)
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.
Guillian-Barre Syndrome (acute idiopathic polyneuritis)
Q0739:Guillian-Barr has been associated with certain
infections including (2)
herpesvirus or Campylobacter jejuni
Q0740:seizures involving only one area of the brain
partial seizures
Q0741:simple partial seizures
1 area of the brain;conciousness intact
Q0742:complex partial seizures
1 area of the brain;impaired consciousness
Q0743:generalized seizures
diffuse areas of brain
Q0744:generalized siezures involving a blank stare
absence (petit mal)
Q0745:generalized siezures involving quick repetitive jerks
myoclonic
Q0746:Generalized siezure involving alternating stiffening and
movement
tonic-clonic
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?
epidural hematoma
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?
Subdural hematoma
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?
Subarachnoid hemorrhage
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.
Berry aneurysms
Q0751:most _______ (childhood v. adult) tumors are
supratentorial; while most ________childhood v. adult)
tumors are infratentorial.
adult;childhood;Note: 50% of brain tumors are metastases
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.
Glioblastoma multiforme (grade IV astrocytoma)
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.
Meningioma
Q0754:On pathology this primary brain tumor shows spindle
cells concentrically arranged in a whorled pattern and
psammoma bodies (laminated calcification) What is it?
Meningioma
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?
Schwannoma
Q0756:Bilateral schwannoma is often found in what
condition?
neurofibromatosis type 2
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.
Oligodendroma
Q0758:On pathology this tumor has "fried egg" cells-round
nucleii with clear cytoplasm. They are often calcified.
Oligodendroma
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)
pituitary adenoma
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.
Pilocytic (low grade) astrocytoma)
Q0761:On pathology this primary brain tumor shows
Rosenthal fibers (eosinophilic; corkscrew fibers)
Pilocytic (low grade )astrocytoma
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.
Medulloblastoma
Q0763:On pathology this tumor shows Rosettes or
perivascular pseudorosette pattern of cells
medulloblastoma
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.
ependymoma
Q0765:On pathology this tumor has characteristic
perivascular pseudorosettes. Rod shaped blepharoplasts
(basal ciliary bodies) found near the nucleus
ependymoma
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.
Hemangioblastoma
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.
Craniopharyngioma
Q0768:Sign of UMN or LMN lesion or both?;Weakness
Both;mneu: LOWER MN= everything is LOWERED (less
mm mass; less mm tone; less reflexes; downgoing toes.
UPPER MN= everything UP (tone; DTRs; toes)
Q0769:Sign of UMN or LMN lesion or both?;Atrophy
LMN;mneu: LOWER MN= everything is LOWERED (less
mm mass; less mm tone; less reflexes; downgoing toes.
UPPER MN= everything UP (tone; DTRs; toes)
Q0770:Sign of UMN or LMN lesion or both?;Fasciculation
LMN;mneu: LOWER MN= everything is LOWERED (less
mm mass; less mm tone; less reflexes; downgoing toes.
UPPER MN= everything UP (tone; DTRs; toes)
Q0771:Sign of UMN or LMN lesion or both?;Increased
Reflexes?;Decreased Reflexes?
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)
Q0772:Sign of UMN or LMN lesion or both?;Increased
tone?;Decreased tone?
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)
Q0773:Sign of UMN or LMN lesion or both?;Babinski?
UMN;mneu: LOWER MN= everything is LOWERED (less
mm mass; less mm tone; less reflexes; downgoing toes.
UPPER MN= everything UP (tone; DTRs; toes)
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]
Poliomyelitis & Werdinig Hoffman dz
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]
MS
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]
Poliomyelitis & Werdinig Hoffman dz
Q0777:This dz involves combined UMN and LMN deficits
with no sensory deficit. Pt often presents with both UMN &
LMN neuron signs [pic]
ALS
Q0778:When this happpens the only thing spared are the
dorsal columns and tract of Lissauer[pic]
complete occlusion of ventral artery
Q0779:This results in degeneration of the dorsal roots and
dorsal columns. Pt presents with impared proprioception and
locomotor ataxia.
Tabes dorsalis (tertiary syphilis)
Q0780:This resultswhen the crossing fibers of the
corticospinal tract are damaged. Pt presents with bilateral loss
of pain and temperature sensation
syringomyelia
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
vit B neuropathy and Friedreich's ataxia
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.
Syringomyelia
Q0783:Syringomyelia often presents with this congenital
malformation.
Arnold-Chiari malformation
Q0784:Syringomyelia is most common at this spinal level
C8-T1
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
Tabes dorsalis
Q0786:Brown Sequard syndrome is a complete hemisection
of the spinal cord. Give the findings.
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
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?
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
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
_________
Horner's syndrome
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)
Radial nn
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
_________
Horner's syndrome
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.
ulnar
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.
Axillary
Q0793:What nerve was injured?;Pt presents with a loss of
function of biceps; coracobrachialis; and brachialis muscle. He
has no biceps reflex?
musculocutaneous
Q0794:This nerve passes through the supinator
radial
Q0795:this nerve passes through the pronator teres
median
Q0796:this nerve passes through the flexor carpi ulnaris
ulnar
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?
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.
Q0798:What nerve was injured?;Pt presents with loss of
dorsiflexion resulting in "foot drop"
Common peroneal nerve (L4-S2);PED= Peroneal Everts &
Dorsiflexes; if injured; foot is dropPED
Q0799:Deep peroneal nn innervates _______
compartment;Superficial peroneal nn innervates _______
compartment
anterior;lateral
Q0800:What nn is injured?;pt presents with loss of plantar
flexion.
Tibial (L4-S3);TIP=Tibial Inverts & Plantarflexes; if injured;
cant stand on TIPtoes.
Q0801:What nn is damaged?;Pt presents with loss of knee
extension and deminished pateller reflex.
Femoral (L2-L4)
Q0802:What nn is injured?;Pt presents with a loss of hip
adduction?
Obturator
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?
Thoraci outlet syndrome (Klumpke's palsy);Compression of
subclavian aa and inferior trunk of brachial plexus (C8;T1)
Q0804:In a LMN lesion of CN XII the tongue will deviate
_____ (away or towards) the side of the lesion?
towards;mneu: lick your wounds
Q0805:In a CN V motor lesion the jaw deviates ______
(towards or away) the side of the lesion
towards
Q0806:in a CN X lesion the uvula will deviate _______
(towards or away) of the side of the lesion.
away
Q0807:In a unilateral lesion of the cerebellum the pt tends to
fall _______ (towards or away) the side of the lesion.
towards
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
contralateral;ipsilateral
Q0809:pt presents with paralysis of the lower half his face
only. What do you suspect.
contralateral UMN lesion ;(either of motor cortex or
connection between cortex and facial nucleus)
Q0810:pt presents with paralysis of one side of his entire
face (upper and lower). What do you suspect?
ipsilater LMN lesion of CN VII
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
Bell's palsy
Q0812:Give some diseases in which Bell's palsy is often seen
as a complicaion.
Aids; Lyme dz; Sarcoidosis; Tumors; Diabetes;mneu:
ALexander BELL with STD: AIDS; Lyme; Sarcoid; Tumors;
Diabetes
Q0813:This herniation syndrome can compress the anterior
cerebral aa
Cingulate herniation under falx cerebri
Q0814:These 3 herniation syndrome can result in coma and
death if brain stem is compressed.
1)downward transtentoral (central herniation;2) Uncal
herniation (Uncus=medial temporal lobe);3)Cerebellar
tonsillar herniation into the foramen magnum
Q0815:In the case of an uncal herniation you may see
ipsilateral dilated pupil/ptosis. This is due to what?
Stretching of CN III
Q0816:In the case of an uncal herniation you may see
contralateral homonymous hemianopia. This is due to what?
compression of ipsilateral posterior cerebral aa
Q0817:In the case of an uncal herniation you may see
ipsilateral paresis. This is due to what?
compression of contralateral crus cerebri (Kernohan's notch)
Q0818:In the case of an uncal herniation you may see Duret
hemorrhages (paramedian artery rupture). This is due to
caudal displacement of the brain stem
Q0819:Pt can't see at all out of his right eye (right anopia)
Where is the lesion?
Right optic nn
Q0820:Pts has bilateral temporal visual field defects
(bitemporal hemianopia) Where is the lesion?
Optic chiasm
Q0821:Pt can't see the left visual field in either eye (Left
homonymous hemianopia) Where is the lesion?
Right Optic Tract
Q0822:Pt has Left upper quadratic anopsia (cant see up and
to the right on both sides) Where is the lesion?
Right Temporal Lesion (Meyer's loop)
Q0823:Pt has left lower quandrantic anopia (can't see down
and to the left in either eye) Where is the lesion?
Right Parietal lesion ;(Dorsal optic radiation)
Q0824:Pt has left hemianopia with macular sparing??
???visual cortex??
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.
Internuclear opthalmoplegia (MLF syndrome);mneu:
MLF=MS
Q0826:explain the pathology of Internuclear opthalmoplegia
(Medial longitudinal fasciculus [MLF] syndrome)[pic]
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.
Q0827:give the dz indicated by the following neurotransmitter
changes;increased NE;decreased GABA;decreased 5HT
Anxiety
Q0828:give the dz indicated by the following neurotransmitter
changes;decreased NE & decreased 5HT
depression
Q0829:give the dz indicated by the following neurotransmitter
changes;decreased ACh
Alzheimer's dementia
Q0830:give the dz indicated by the following neurotransmitter
changes;decreased GABA;decreased ACh
Huntington's dz
Q0831:give the dz indicated by the following neurotransmitter
changes;increased Dopamine
Schizophrenia
Q0832:give the dz indicated by the following neurotransmitter
changes;decreased Dopamine
Parkinson's dz
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?
1st-time;2nd-place;last-person
Q0834:what is anosognosia?
unawareness that one is ill
Q0835:what is autotopagnosia
inability to locate one's own body parts
Q0836:what is depersonalization
body seems unreal or dissociated
Q0837:what is ANTEROgrade amnesia?
inability to remember things that occurred afte a CNS
insult;mneu: antero=after
Q0838:what is RETROgrade amnesia?
inability to remember things that occurred before a CNS
insult;mneu: retro=before
Q0839:what is substance dependance?
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
Q0840:What is substance abuse
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
Q0841:intoxication of this drug results in disinhibition;
emotional lability; slurred speech; ataxia; coma; blackouts.
alcohol
Q0842:gamma glutamyltransferase (GGT) is a sensitive
indicator of this drugs use
alcohol
Q0843:withdrawal from this drug results in tremor
tachycardia; hypertension; malaise; nausea; seizures; delerium
tremens (DTs); tremulousness; agitation; hallucinations
alcohol
Q0844:intoxication of this substance results in CNS
depression; nausea and vomiting; constipation; pupillary
constriction (pinpoint pupils); seizures;*overdose is life
threatening
opiods
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
opiods
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
amphetamines
Q0847:withdrawal from this substance results in post use
"crash"; including depression; lethargy; headache; stomach
cramps; hunger; hypersomnolence
amphetamines
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
cocaine
Q0849:withdrawal from this substance results in a post-use
"crash"; including severe depression and suicidality;
hypersomnolence; fatigue; malaise; and severe psychological
craving
cocaine
Q0850:intoxication with this substance results in belligerence;
impulsiveness; fever; psychomotor agitation; vertical and
horizontal nystagmus; tachycardia; ataxia; homicidality;
psychosis; delirium
PCP
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
PCP
Q0852:intoxication with this substance can result in marked
anxiety or depression; delusions; visual hallucinations;
flashbacks; and pupil dilation
LSD
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
Marijuana
Q0854:Intoxication with this drug is dangerous because of its
low safety margin. higher doses result in respiratory
depression
barbituates
Q0855:withdrawal from this substance results in anxiety;
seizures; delerium; and life-threatening cardiovascular collapse
barbiturates
Q0856:These medications have a greater safety margin than
barbituates. Intoxication can result in amnesia; ataxia;
somnolence; minor respiratory depression.
benzodiazepines
Q0857:these drugs have an additive effect with alcohol
benzodiazepines
Q0858:withdrawal from these drugs results in rebound
anxiety; seizures; tremor; and insomnia
benzodiazepines
Q0859:excessive use of this drug results in restlessness;
insomnia; increased diuresis; muscle twitching; and cardiac
arrhythmias
caffeine
Q0860:withdrawal from this drug results in headache;
lethargy; depression; and weight gain
caffiene
Q0861:use of this drug results in restlessness; insomnia;
anxiety; and arrhythmias-no increased diuresis
nicotine
Q0862:withdrawal from this drug results in irritability;
headache; anxiety; weight gain; and extreme cravings
nicotine
Q0863:use of this drug results in restlessness; insomnia;
anxiety; and arrhythmias-no increased diuresis
nicotine
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.
Alcoholism
Q0865:What is a drug used in treatment of alcoholism
disulfiram
Q0866:describe the metabolism and effects of ethenaol
image p. 360
Q0867:When do DTs usually appear in alcoholics?
2-5D after last drink.
Q0868:In alcoholics in withdrawal what occurs 1st--
autonomic system hyperactivity (tachycardia; tremors;
anxiety) or psychotic symptoms (hallucinations; delusions)
1st-autonomic hyperactivity;2nd-psychotic symptoms
Q0869:How do you treat DTs in alcholics going through
withdrawal?
benzodiazpenes
Q0870:Long-term alcohol use leads to this involving
micronodular cirrhosis with accompaning symptoms of
jaundice; hypoalbuminemia; coagulation factor deficiencies;
and portal hypertension.
alcoholic cirrhosis
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.
Wernicke-Korsakoff syndrome
Q0872:What is the tx of Wernicke-Korsakoff syndrome
IV vitamine B1 (thiamine)
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.
Mallory-Weiss syndrome
Q0874:Heroine is a schedule __ drug
schedule I (not perscribable)
Q0875:addicts of this drug are at increase risk of hepatitis;
abscesses; overdose; hemorrhoids; AIDS; and right sided
endocarditis.
heroine
Q0876:These drugs can competatively inhibit opiods
Naloxone (narcan) and naltrexone
Q0877:This long acting oral opiate is used for heroine
detoxification or long term maitenance
methadone
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.
delerium;mneu: deliRIUM=changes in sensoRIUM
Q0879:this is the most common psychiatric illness on medical
and surgical floors.
delerium
Q0880:delerium is often iatrogenic and reversable. Look at pts
meds for ones with this effect.
anticholenergic
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.
Dementia;mneu: DeMEMtia is characterized by MEMory
loss. Commonly irreversable.
Q0882:In elderly pts this disease can often present like
dementia.
depression
Q0883:DSM Criteria of Major depressive episode
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
Q0884:Lifetime prevalence of a major depressive episode is
_____ for males and _____ for females
5-12% - males;10-25% - females
Q0885:This variation on Major depressive disorders invoves
2 or more major depressive episodes with a symptom free
interval of 2 months
RRECURRENT Major Depressive Disorder
Q0886:This disorder is a milder form of depression that lasts
at least 2 years
dysthymia
Q0887:Pts with depression typically have the follwing 3
changes in their sleep stages.
1)decreased slow wave sleep;2)decreased REM latency;3)
Early-morning awakening (important screening question
Q0888:Risk factors for suicide completion
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
Q0889:ECT is a treatment option when?
MDD refractory to other treatment
Q0890:Major adverse effects of ECT
anterograde and retrograde amnesia; and confusion
Q0891:T or F: ECT is painful.
F
Q0892:This psychiatric disorder is characterized by a period
of abnormally and persistantly elevated; expansive; or irritable
mood lasting at least one week.
Manic episode
Q0893:Describe the DSM criteria for a manic episode.
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
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
Hypomanic episode
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)
malingering
Q0896:Drug of choice for bipolar disorder
lithium
Q0897:what is cyclothymic disorder?
a milder form of bipolar disorder lasting at least 2 years
Q0898:In this disorder the pt conciously creates symptoms in
order to assume the "sick role" and to get medical attention.
factitious disorder
Q0899:This form of factitious disorder is manifested by a
chronic history of multiple hospital admissions and
willingness to receive invasive procedures.
Munchausen's syndrome
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.
Muchausen's syndrome by proxy
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.
Somatoform disorders
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
Conversion disorder
Q0903:Type of somatoform disorder in which pt presents
with prolonged pain that is not explained completely by an
illness.
Somatoform pain disorder
Q0904:Type of somatoform disorder in which pt presents
with preoccupation with and fear of having a serious illness in
spite of medical reassurance
hypochondriasis
Q0905:Type of somatoform disorder in which pt presents
with a variety of complaints in multiple organ sytems with no
identifiable underlying physical findings
Somatization disorder
Q0906:Type of somatoform disorder in which pt presents
with preoccupation with minor or imagined physical flaws.
Pts often seek cosmetic surgery
Body dysmorhic disorder
Q0907:Type of somatoform disorder in which pt presents
with false belief of being pregnant associated with objective
physical signs of pregnancy
pseudocyesis
Q0908:What type of gain: primary; secondary; tertiary?;What
the symmptom does for the patients internal psychic
economy
primary gain
Q0909:What type of gain: primary; secondary; tertiary?;What
the symptom gets the patient (sympathy; attention)
secondary gain
Q0910:What type of gain: primary; secondary; tertiary?;What
the caretaker gets (like an doctor on an interesting case)
tertiary
Q0911:Describe DSM characterization of panic disorder
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)
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.
specific phobia
Q0913:what form of psychotherapy works well for specific
phobias
systematic desensitation
Q0914:gamophobia
fear of marrage
Q0915:algophobia
fear of pain
Q0916:acrophobia
fear of heights
Q0917:agoraphobia
fear of open spaces
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.
Post-traumatic stress disorder
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
Adjustment disorder
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.
generalized anxiety disorder
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.
Autistic disorder
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.
Asperger disorder
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.
Rett disorder
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.
Attention Deficit Hyperactivity Disorder (ADHD)
Q0925:What is the treatment of ADHD
methylphenidate
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.
Conduct disorder
Q0927:This psychiatric disorder of childhood is characterized
by noncompliance in the absence of criminality.
Oppositional defiant disorder.
Q0928:This psychiatric disorder of childhood is characterized
by motor/vocal tics and involuntary profanity. Onset is <18
y/o.
Tourette's syndrome
Q0929:What is the treatment for Tourette's syndrome
haloperidol
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.
Seperation anxiety disorder.
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.
Anerexia nervosa
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.
Bulimia nervosa
Q0933:Hallucinations v. Illusion v. Delusions;______ are
perceptions in the absense of external stimuli
Hallucinations
Q0934:Hallucinations v. Illusion v. Delusions;__________ are
misinterpretations of actual external stimuli
illusions
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
Delusions
Q0936:Delusions v. Loose associations;a _____ is a disorder
in the CONTENT of the thought (the actual idea)
delusion
Q0937:Delusions v. Loose associations;a _____ is a disorder
in the FORM of the thought (the way the ideas are tied
together)
loose association
Q0938:hallucination types;______ and _____ hallucinations
are common in schizophrenia
auditory and visual
Q0939:hallucination types;_____ hallucination often occurs
as an aura of a psychomotor siezure
olfactory
Q0940:hallucination types;_____ hallucinations are rare
gustatory
Q0941:hallucination types;_____ hallucinations are common
in DTs. Also seen in cocaine abusers ("cocaine bugs")
tactile hallucination
Q0942:formication
sensation of ants crawling on one's skin
Q0943:by definition hypnagogic hallucinations occur when?
going to sleep;mneu: hypnaGOgic hallucination occurs while
GOing to sleep
Q0944:by definition hypnopompic hallucinations occur
when?
while waking from sleep
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.
sleep apnea
Q0946:In this subcagegory of sleep apnea; the pt shows no
respiratory effort
central sleep apnea
Q0947:In this subcagegory of sleep apnea; the pt shows
respiratory effort against airway obstruction
obstructive sleep apnea
Q0948:This diagnosis is categorizecd by disordered sleep-
wake cycles. It may include hypnagogic (just before sleep) or
hypnopompic (just before waking) hallucinations. The
person's sleep episodes start off with REM sleep.
narcolepsy
Q0949:This form of narcolepsy involves a loss of all muscle
tone follwing a strong emotional stimulus.
cataplexy
Q0950:Tx for narcolepsy
ampetamines
Q0951:This psychiatric illness is characterized by periods of
psychosis and disturbed behavior with adecline in functioning
lasting >6months.
schizophrenia
Q0952:Give the DSM criterial for schizophrenia.
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.
Q0953:What is the most common type of hallucination in
schizophrenia
auditory
Q0954:in schizophrenia; disorganized thought often takes the
form of ______
loose associations
Q0955:in the etiology of schizophrenia; what is more
important; genetic or enviornmental factors
genetic
Q0956:Symptoms of schizophrenia that last 1-6 mo
schizophreniform disorder
Q0957:Symptoms of schizophrenia that last <1 mo
brief psychotic disorder (usually stress related)
Q0958:Lifetime prevelence of schizophrenia
1.50%
Q0959:schizophrenia typically presents earlier in _______
(males or females)
males
Q0960:this psychiatric condition involves a combination of
schizophrenia and a mood disorder
schizoaffective disorder
Q0961:What are the 5 subtypes of schizophrenia
1)disorganized;2) catatonic;3)paranoid;4)undifferentiated;5)
residual
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.
personality trait
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.
personality disorders
Q0964:This cluster of personality disorders usually present
as "odd" or "eccentric. They cannot develop meaningful social
relationships. Give cluster and types.
Cluster A "Wierd";1)Paranoid;2)Schizoid;3) Schizotypal
Q0965:This cluster of personality disorders shows no
psychosis but there is a genetic association with
schizophrenia.
Cluster A "Wierd";1)Paranoid;2)Schizoid;3) Schizotypal
Q0966:personality disorder characterized by distrust and
suspiciousness
paranoid personality disorder
Q0967:main defence mechonism exiped by those with
paranoid personality disorder
projection
Q0968:personality disorder characterized by voluntary social
withdrawal and limited emotional expression
schizoid
Q0969:personality disorder characterized by interpersonal
awkwardness; odd beliefs or magical thinking. Often eccentric
in appearance.
Schizotypal
Q0970:This cluster of personality disorders is dramatic;
emotiona; and eratic;Give the cluster and the subtypes
Cluster B: "Wild";1)Antisocial;2) Borderline;3)
Histrionic;4)Narcissistic
Q0971:This cluster of personality disorders has a genetic
associateion with mood disorders and subsance abuse.
Cluster B: "Wild";1)Antisocial;2) Borderline;3)
Histrionic;4)Narcissistic
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
antisocial personality diosrder
Q0973:personality disorder characterized by unstable mood
and interpersonal relationships; impulsiveness; sense of
emptiness. Effects females more than males
Borderline
Q0974:personality disorder characterized by excessive
emotionality; attention seeking; sexually provocative
histrionic
Q0975:personality disorder characterized by grandiosity &
sense of entitlement. May react to criticism with rage.
Narcissistic
Q0976:This cluster of personality disorders is charicterized
by anxiety and fear. Give the cluster and the types.
Cluster C: "Worried";1)avoidant;2)obsessive-
compulsive;3)dependant
Q0977:This cluster of personality disorders has a genetic
association with anxiety diosrders.
Cluster C: "Worried";1)avoidant;2)obsessive-
compulsive;3)dependant
Q0978:personality disorder characterized by sensitivity to
rejection; socially inhibited; timid; feelings of inadequacy
avoidant
Q0979:personality disorder characterized by preocupation
with order; perfectionism; and control
obsessive-compulsive
Q0980:personality disorder characterized by submissive and
clinging behavior. They have an excessive need to be taken
care of and low self confidence.
dependant
Q0981:This dz is due to a loss of dopaminergic neurons and
excess cholinergic activity
parkinsonism
Q0982:The treatments for parkinson's dz can be summarized
by the mneumonic BALSA. What does this stand for
Bromocriptine;Amantadine;Levodopa (w/ carbidopa);Selegine
(&COMT inhibitors);Antimuscarinics
Q0983:This drug is an erogot alkaloid an a partial dopamine
agonist. The strategy behind this drug is to antagonize
dopamine receptors.
bromocriptine
Q0984:This drug may increase dopamine release.
Amantadine
Q0985:This drug is converted to dopamine in the CNS
L-dopa/carbidopa
Q0986:This drug is a selective MAO type B ihibitor. The
strategy of this Parkensons drug is that it prevents dopamine
breakdown.
Selegiline
Q0987:This drug is a COMT ihibitor. The strategy of these
Parkensons drugs is that it prevents dopamine breakdown.
entacapone & tolcapone
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
Benzotropine
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
L-dopa (levvodopa)/carbidopa
Q0990:What is the most common toxicity of L-dopa
arrhthmias from peripheral conversion to dopamine
Q0991:Why is carbidopa given with levodopa.
carbidopa is a peripheral decarboxylase inhibitor. It is given
with L-dopa inorder to limit the peripheral side effects.
Q0992:Long term use of ______ can lead to the of dyskinesia
follwing administraiton; and akinesia between doses.
L-dopa
Q0993:This parkinsons drug acts by selectively inhibiting
MAO-B; therby increased the availabilty of dopamine.
Selegine
Q0994:This drug is a 5-HT (1D) agonist. It causes
vasoconstriction and is used for acute migrane or cluster
headache attacks.
Sumatriptan
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
Sumatriptan
Q0996:This drug is 1st line for tonic clonic siezures and
status epilepticus prophylaxis. It acts by increased Na+
channel inactivation
phenytoin
Q0997:This drug is first line for tonic clonic siexures and
trigeminal neuralgia. It acts by increased Na+ channel
inactivation.
Carbazepine
Q0998:This siezure medication blocks voltage gaited Na+
channels; but has no effect on GABA release
Lamotrigine
Q0999:This epilepsy medication acts to increased GABA
release. It is also used for peripheral neuropathy
Gabapentin
Q1000:This epilepsy medication acts to block Na+ channels
and increased GABA release.
topiramate
Q1001:This epilepsy medication acts to increased GABA
action. It is 1st line in pregnant women & children
phenobarbital
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.
valproic acid
Q1003:This epilepsy medication is 1st line for absence
seizures. It acts by blocking the thalamic T-type Ca++
channesls.
ethsuximide
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)
Benzodiazepines;(diazepam or lorazepam)
Q1005:Give the epilepsy drug associated with the following
toxicities;sedation; tolerance; dependence
benzodiazepines
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.
Carbamazepine
Q1007:Give the epilepsy drug associated with the following
toxicities;GI distress; lethargy; headache; uticaria; Stevens-
Johnson syndrome
Ethosuximide
Q1008:Give the epilepsy drug associated with the following
toxicities;Sedation; tolerance; dependance; induction of
cytocrome P-450.
Phenobarbital
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.
Phenytoin
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.
Valproic acid
Q1011:Give the epilepsy drug associated with the following
toxicities;Stevens-Johnson syndrome
Lamotrigine
Q1012:Give the epilepsy drug associated with the following
toxicities;Sedation; ataxia
Gabapentin
Q1013:Give the epilepsy drug associated with the following
toxicities;Sedation; mental dulling; kidney stones; weight loss
Topiramate
Q1014:The mechanism of this drug is blockade of Na+
channels; inhibition of glutamate release from exitatory
presynaptic neurons
phenytoin
Q1015:This drug is 1st line for tonic clonic siezures and for
prophylaxis of status epilepticus. It is also a class IB
antiarrhythmic.
phenytoin
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.
phenytoin
Q1017:This drug acts by facilitating GABA action by
increased duration of Cl- channel opening; thus decreased
neuron firing
barbituates (phenobarbital; pentobarbital; thiopental;
secobarbital);mneu: BarbiDURATe (increased DURATion)
Q1018:This group of drugs is used as a sedative for anxiety;
siezures; insomnia; induction of anesthesia
barbituates (phenobarbital; pentobarbital; thiopental;
secobarbital)
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)
barbituates (phenobarbital; pentobarbital; thiopental;
secobarbital)
Q1020:this type of drugs is contraindicated in porphyria
barbituates (phenobarbital; pentobarbital; thiopental;
secobarbital)
Q1021:What do you do if someone ODs on barbituates?
symptom management (assist respiration; manage BP)
Q1022:The mechanism of this drug is to facilitate GABA
action by increased frequency of Cl- channel opening
Benzodiazepines (Diazepam; lorazepam; triazolam;
temazepam; oxazepam; midazolam; chlordiazepoxide;
alprazolam);mneu: FREnzodiazepenes (increased
FREquency)
Q1023:Most benzodiazepines have long half-lives and active
metabolites. The short acting ones are what? (3)
Triazolam; Oxazepam; Midazolam;mneu: TOM Thumb
Q1024:These drugs are used to treat anxiety; spasticity;
status epilepticus; detoxification (esp etoh w/drawl[DTs]);
night terrors; & sleep walking.
Benzodiazepines (diazepam; lorazepam; triazolam;
temazepam; oxazepam; midazolam; chlordiazepoxide;
alprazolam)
Q1025:Toxicity of this drug includes dependence; additive
CNS depression effects with alcohol. Less risk of respiratory
depressiona nd coma than with barbituates.
Benzodiazepines (diazepam; lorazepam; triazolam;
temazepam; oxazepam; midazolam; chlordiazepoxide;
alprazolam)
Q1026:Treat Benzodiazepine overdose with ________
Flumazenil (competitive antagonist at GABA receptor)
Q1027:These drugs are used to treat anxiety; spasticity;
status epilepticus; detoxification (esp etoh w/drawl[DTs]);
night terrors; & sleep walking.
Benzodiazepines (diazepam; lorazepam; triazolam;
temazepam; oxazepam; midazolam; chlordiazepoxide;
alprazolam)
Q1028:phenobarbital; pentobarbital; thiopental; secobarbital
are ________
barbituates
Q1029:diazepam; lorazepam; triazolam; temazepam;
oxazepam; midazolam; chlordiazepoxide; alprazolam are
_______ (drug category)
Benzodiazepines
Q1030:Thioridazine; haloperidol; fluphenazine;
chlorpromazine are all _______ (drug category)
Antipsychotics (neuroleptics)
Q1031:This drug acts to block dopamine (D2) receptors
antipsychotics (neuroleptics
Q1032:This drug category is used to treat psychosis; acute
mania; and tourettes syndrome
antipsychotics
Q1033:Toxicies of this group of drugs include extrapyramidal
system (EPS side effects)
antipsychotics
Q1034:Toxicies of this group of drugs include endocrine side
effects (e.g; dopamine receptor antagonism →
hyperprolactinemia→gynomastia)
antipsychotics
Q1035:Toxicies of this group of drugs include side effects
arising from muscarinic block (dry mouth &constipation);
alpha receptors (hypotension) and histamine receptors
(sedation)
antipsychotics
Q1036:This toxicity of antipsychotic involves symptoms
that include rigidity; myoglobinuria; autonomic instability;
hyperpyrexia.
Neuroleptic malignant syndrome
Q1037:How do you treat Neuroleptic malignant syndrome
(antipsychotic toxicity)
dandrolene and dopamine agonists)
Q1038:This antipsychotic toxicity includes stereotypic oral-
facal movements; probably due to dopamine receptor
sensitization; which results from long term antipsychotic use.
Tarditive dyskinesia
Q1039:Evelution of EPs side effects with antipsychotic use:
4 h acute dystonia;4 d akinesia;4 wk akathisia;4 mo tarditive
dykinesia;(often reversible)
Q1040:The drugs clozapine; olanzapine; risperidone are of the
category _________
Atypical antipsychotis;mneu: i'ts not ATYPICAL for OLd
CLOsets to RISPER
Q1041:This group of drugs acts by blocking 5-HT2 and
dopamine receptors
Atypical Antipsychotics
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.
Atypical antipsychotics
Q1043:This atypical antipsychotic is also used for OCD;
anxiety disorder; depression; mania; and tourettes syndrome
Olanzapine
Q1044:This atypical antipsychotic may cause
agranulocytosis and requires weekly WBC monitoring
Clozapine
Q1045:The mechanism of this drug is not established. It is
possibly related to an inhibition of the phosphoinositol
cascade.
Lithium
Q1046:This drug is used as a mood stabilizer for bipolar
affective disorder. It blocks relapse and acute manic events.
Lithium
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.
lithium;mneu: LMNOP;Lithium side effects;Movement
(tremor);Nephrogenic dbts
insipidus;hypOthyroidism;Pregnancy problems
Q1048:ANTIDEPRESSANTS [image]p.371
--
Q1049:The drugs Fluoxetine; sertraline ; paroxetine; and
citalopram belong to this category of drugs
Serotonin-specific reuptake Inhibitors (SSRI)
Q1050:This drug is indicated for endogenous depression; and
obsessive compulsive disorder
SSRIs
Q1051:This drug boast fewer toxicities than TCAs but has
been associated with GI distress; sexual dysfuncion
(anorgasmia).
SSRIs
Q1052:When used with MAO inhibitors; SSRIs can cause
"serotonin syndrome." What three things does this involve.
hyperthermia; muscle rigidity; CV collapse
Q1053:The drugs Imipramine; amitriptyline; desipramine;
nortriptyline; clomipramine; and doxepin are of this
medication category
Tricyclic antidepressants
Q1054:These drugs act to block the reuptake of NE and
serotonin
tricyclic antidepressants
Q1055:These drugs are indicated for major depression that
does not respond to SSRIs
tricyclic antidepressants
Q1056:This tricyclic antidepressant is indicated for
bedwetting
imipramine
Q1057:This is the only tricyclic antidepressant indicated for
OCD
clomipramine
Q1058:The side effects of these drugs include sedation; alpha
blocking effects (hypotension); atropine like (anticholinergic)
side effects (tachycardia; urinary retention)
tricyclic antidepressants
Q1059:Secondary TCAs like ______ have less anticholinergic
side effects than do tertiary TCAs like amitriptyline
nortriptyline
Q1060:This TCA is the least sedating.
desipramine
Q1061:The side effects of these drugs include sedation; alpha
blocking effects (hypotension); atropine like (anticholinergic)
side effects (tachycardia; urinary retention)
tricyclic antidepressants
Q1062:Give the 3 Cs of Tricyclic antidepressant toxicity
Convulsions; Coma; Cadiotoxicity (arrhythmias);also can
have respiratory depression & hyperpyrexia?
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?
This could be due to the anticholinergic side effects of TCAs.
Use nortriptyline.
Q1064:Bupropion; Venlafaxine; Mirtazapine; Maprotiline;
Trazodone belong to what drug category
heterocyclic antidepressents;mneu: You need BUtane in your
VEiNs to MURder for a MAP of AlcaTRAZ
Q1065:These are 2nd and 3rd generation antidepressante with
varied and mixed mechanisms of action. They are used to treat
major depession.
heterocyclic antidepressants
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.
Buproprion
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.
Venlafaxine
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.
Mirtazapine
Q1069:This heterocyclic antidepressant blocks NE reuptake.
Toxicity includes sedation and orthostatic hypotension.
Maprotiline
Q1070:This heterocyclic antidepressant acts primarily to
inhibit seratonin reuptake. Toxicity includes sedation; nausea;
priaprism; and postural hypotension
Trazodone
Q1071:The drugs Phenelzine & tranylcypromine are of this
catigory
Monoamine oxidase Inhibitors (MAOIs)
Q1072:This drug acts by non-selectively inhibiting
Monoamine oxidase (MAO)→increased levels of amine
neurotransmitters
Monoamine oxidase inhibiters (MAOIs)
Q1073:These drugs are used for atypical depression (i.e; with
psychotic or phobic features; anxiety; and hypochondriasis.
Monoamine oxidase inhibiters (MAOIs)
Q1074:These drugs can cause a hypertensive crisis with
tyramine ingestion (wine & cheese) and merperidine. They
also can cause CNS stimulation.
Monoamine oxidase inhibiters (MAOIs)
Q1075:These drugs are contraindicated with SSRIs or Beta
agonists (to prevent seratonin syndrome)
Monoamine oxidase inhibiters (MAOIs)
Q1076:CNS anesthetics must be ______ soluable in order to
cross teh blood-brain barrier
lipid
Q1077:anesthetics with decreased solubility in blood have
____ induction and recovery times
rapid
Q1078:anesthetics with increased solubility in lipids have
______ potency
increased
Q1079:relative potency of inhalation anesthetics is indicated
by what index
Minimal anesthetic concentration
Q1080:Minimal anesthetic concentration is ________
(proportional or inversely proportional) to potency
inversely proportional;potency =1/MAC
Q1081:Fill in the blanks regarding general principles of
anesthesia;increased solubility in ______ = ;increased
Potency =1/MAC
lipids
Q1082:N2O has low blood and lipid solubility. What is the
rate of induction and what is the potency?
fast;low
Q1083:Halothane has increased lipid and blood solubility;
and thus ____ potency and ____ induction
high;slow
Q1084:anesthetics with decreased solubility in blood have
____ induction and recovery times
rapid
Q1085:anesthetics with increased solubility in lipids have
______ potency
increased
Q1086:halothane; enflurane; isoflurane; sevoflurane;
methoxyflurane; and nitrous oxide are all this type of
anesthetic
inhaled anesthetics
Q1087:These drugs result in myocardial & respiratory
depression; nausea/emesis; and increased cerebral blood and
decreased cerebral metabolic demand.
inhaled anesthetics
Q1088:This inhaled anesthetic has a toxicity of hepatotoxicity
halothane
Q1089:This inhaled anesthetic has a toxicity of
nephrotoxicity
methoxyflurane
Q1090:This inhaled anesthetic has a toxicity of seizures.
enflurane
Q1091:This is a rare but very dangerous toxicity of inhaled
anesthetics
malignant hyperthermia
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.
Thiopental
Q1093:This benzodiazepine given IV is the most common
anesthetic used for endoscopy. It may cause severe
postoperative respiratory depression; decreased BP; and
amnesia.
Midazolam
Q1094:You give your pt Midazolam for his endoscopy.
Postoperatively he developse hypotension. What drug do you
give him?
flumazenil
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.
Arylcyclohexamines (Ketamine)
Q1096:These opiates are given IV with other CNS
depressants during general anesthesia
morphine; fentanyl
Q1097:This IV anesthetic is used for rapid anesthesia
induction and short procedures. It has less postoperative
nausea than thiopental.
Propofol
Q1098:What are the IV anesthetics?
Barbituates;Benzodiazepines;Ketamine;Opiates;Propofol;mne
u: B.B. King on OPIATES PROPOses FOOLishly
Q1099:This drug is used in the treatment of malignant
hyperthermia and neuroleptic malignant syndrome.
dantrolene
Q1100:This condition can be caused by the concomitant use
of inhalation anesthetics (except N2O) and succinylcholine.
Malignant hyperthermiia
Q1101:The drugs procaine; cocaine; tetracaine; lidocaine;
mepivacaine; pubivacaine are in this category
local anestetics
Q1102:Procaine; cocaine; tetracaine; are considered this type
of local anesthetics.
esters
Q1103:lidocaine; mepivacaine; pubivacaine are considered this
type of local anesthetics.
amides;mneu: amIdes all have 2 "I"s in their names
Q1104:This group of drugs acts by blocking Na+ channels in
nerves by binding to secific receptors on the inner portion of
the channel
local anesthetics
Q1105:Your pt has infected tissue that needs to be
anesthetized. Do you need more or less local anesthetic?
More-infected tissue is acidic and therefore charged. The
charged anesthetics will have trouble penetrating the
membrane effectively.
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
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
Q1107:What is the order of loss in sensation upon
administration of a local anesthetic;touch;pain;pressure; temp
pain>temp>touch>pressure
Q1108:Local anesthetics are usually given with this to
enhance local action--decreased bleeding; increased anesthesia
by decreased systemic concentration.
epinephrine (or another vasoconstrictor)
Q1109:These drugs are used for minor surgical procedures and
as spinal anesthesia.
local anesthetics
Q1110:You want to give you're pt a local anesthetic but she is
allergic to esters. Name an amide you can give her.
lidocaine; mepivacaine; bupivancaine
Q1111:a toxicity of this local anesthetic is CV toxicity
bupivacaine
Q1112:a toxicity of this local anesthetic is arrhythmias
cocaine
Q1113:general side effects of local anesthetics may include?
CNS exitation; hypertension; hypotension
Q1114:These drugs are used for muscle paralysis in surgery
or mechanical ventilation. They are selective for the motor (v.
autonomic) nicotinic receptor
neuromuscular blocking drug
Q1115:The depolarizing neuromuscular blocking drug is
__________
succinylcholine
Q1116:The drugs tubocurarine; atracurium; mivacurium;
pancuronium; vecuronium; rapacuronium are of this category
of neuromuscular blocking drugs
nondepolarizing
Q1117:Nondepolarizing neuromuscular blocking drugs
compete with ____ for receptors
ACh
Q1118:In order to reverse the blockade of nondepolarizing
blocking agents you can use __________
any cholinesterase inhibitor;e.g; neostigmine; edrophonium
Q1119:With depolarizing neuromuscular blocking drugs phase
I is known as the ___________ phase
prolonged depolarization phase
Q1120:With depolarizing neuromuscular blocking drugs phase
I -prolonged depolarization - is potentiated by what?
cholinesterase inhibitors
Q1121:With depolarizing neuromuscular blocking drugs phase
II is known as the ___________ phase
repolarized but blocked phase
Q1122:after initiating paralysis with a depolarizing
neuromuscular blocking drugs; is it possible to reverse the
effects.
During phase II (repolarized but blocked phase) only-- the
antidote consists of cholinesterase inhibitors (e.g;
neostigmine)
Q1123:name two diseases that affect the CEREBRAL
CORTEX
1) Alzheimer's disease 2) Pick's disease
Q1124:name two diseases that affect BASAL GANGLIA &
BRAIN STEM:
1) Huntington's disease 2) Parkinson disease
Q1125:in the spinal cord;name 3 degenerative MOTOR
NEURON diseases;Name 3 degenerative
SPINOCEREBELLAR diseases
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]
Q1126:what is the most common cause of elderly dementia?
Alzheimer's
Q1127:name two pathological findings characteristic of
Alzheimer's
1) senile plaques = intracytoplasmic inclusion bodies 2)
neurofibrillary tangles (abnormally phosphorylated tau
protein)
Q1128:what is the 2nd most common cause of dementia in
elderly?
multi-infarct dementia in elderly\\
Q1129:How can Alzheimer also affect intracranial
vasculature?
amyloid angiopathy --> intracranial hemorrhage
Q1130:The familial form of Alzheimer's is associated with
what chromosomes and (name the allele's name in 2 of the 4)
chromosome 1; 14; 19 (APO-E4 allele); 21 (p-App gene)
Q1131:What is pathognemomic with Pick's disease upon
histology?
Pick bodies = intra-cytoplasmic inclusion bodies
Q1132:What cortical areas does Pick's disease affect
Frontal and temporal lobes (remember; sharp; atrophic
appearance of gross specimen)
Q1133:What is the inheritance pattern of Huntington's
Auto Dominant
Q1134:What are some symptoms of Huntingtons?
1) chorea 2) dementia
Q1135:Huntington's is due to atrophy of _____ what?
atrophy of caudate nucleus = loss of GABA-nergic neurons
Q1136:what is the genetic abnormality of Huntington's?
1) Chr. 4 - expansion of CAG repeats
Q1137:Parkinson disease is associated with what pathology
findings?
1) Lewy bodies 2) depigmentation of substantia nigra (loss of
dopaminergic neurons)
Q1138:rare cases of Parkinson's have been linked to what
contaminant of certain illicit drugs?
MPTP = contaminant to street drug
Q1139:Parkinson's can make you feel in a "TRAP" = ?
T = tremor at rest; R = cogwheel rigidity; A = akinesia ;
Postural instability
Q1140:ALS = Lou Gehrig's disease (the Iron Horse of the
Yankees; hero of Joe DiMaggio) = what signs is ALS
associated with?
Both UMN and LMN deficits
Q1141:Werdnig-Hoffman disease - presents as birth as?
1) floppy baby syndrome 2) note tongue fasciculations as
well (also seen in ALS)
Q1142:for Polio; what kind of signs to you see?
predominantly LMN deficits.
Q1143:name 4 types of cranial related hemorrhages (think of
layers that could possibly be involved)
1) epidural hemorrhage 2) subdural h 3) subarachnoid h 4)
parenchymal h
Q1144:what is a common site of epidural
hematoma/hemorrhage
1) rupture of MMA: middle meningeal artery; often 2ndary to
fracture of temporal bone
Q1145:what does CT show for epidural h?
biconcave disc NOT crossing suture lines
Q1146:what else do you see in epidural hematoma?
lucid interval
Q1147:How do subdural h. most often occur?
rupture of bridging veins (think; elderly being jolted in roller
coaster)
Q1148:subdural hematoma is venous bleeding so how would
this influence symptomatic findings?
venous = less pressure = delayed onset of symptoms
Q1149:what types of people do you see subdural h.?
1) elderly; 2) alcoholics 3) blunt trauma/sudden change in
velocity injuries
Q1150:for SUBDURALs what do you see upon CT?
1) crescent-shaped hemorrhage instead 2) YES IT does cross
the suture lines
Q1151:subarachnoid hemorrhage is often seen where (name 2
types
rupture of 1) aneurysm (usually Berry aneurysm) or an
2)AVM
Q1152:symptoms of subarachnoid hemorrhage?
the worst headache of my life
Q1153:since its subarachnoid (hemorrhage); what do you see
on what test?
bloody or xanthochromic CSF on spinal tap
Q1154:name 4 risk factors for parenchymal hematoma
1) HTN 2) amyloid angiopathy 3) diabetes mellitus 4) tumor
Q1155:most common site for Berry aneurysms
bifurcation of the anterior communicating artery (Circle of
Willis)
Q1156:berry aneurysms are associated with which genetic
diseases
adult polycystic disease; Ehlers-Danlos s; and marfan's
Q1157:Classic triad of Multiple Sclerosis
SIN: Scanning speech; intention tremor; nystagmus (affect
woman 20-30s)
Q1158:Prevalence of MS
increase prevalence w/ increased distance from the equator
Q1159:Clinical s/s of MS; labs; pathology.
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)
Q1160:Progressive multifocal leukoencephalopathy (PML) is
associated w/
JC virus and seen in 2-4 % of AIDS pts (reactivation or latent
infect)
Q1161:pathogenesis of Guillian-Barre syndrome
Inflammation and demyelination of peripheral nerves and
motor fibers of the ventral roots (sensory effec less severe
than motor)
Q1162:s/s of Guillian-Barre syndrome; lab findings
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 ("albumino-
cytologic dissociation") elevated protein may lead to
papilledema
Q1163:association between G-B syndrome and…
herpesvirus or camplobacter jejuni infection; inoculations; and
stress but no definitive link to a pathogen
Q1164:organism causing polio and mechanism of action
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
Q1165:s/s of polio
malaise; HA; fever; nausea; abd. Pain; sore throats; signs of
LMN signs
Q1166:lab findings of polio
csf w/ lymphocytic pleocytosis w/ slight elevation of protein;
virus recovered from stool or throat
Q1167:describe Broca's (expressive) aphasia
confluent aphasia w/ intact comprehension broca's is broken
speech
Q1168:describe Wernicke's (aphasia)
Fluent aphasia w/ impaired concentration Wernick's ="What?"
W area located in superior temperal gyrus
Q1169:describe two types of partial seizures
1.simple partial (awareness is intact)--motor; sensory;
autonomic; psychic 2.Complex partial (impaired awareness)
Q1170:describe types of Generalized seizure ( diffuse)
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
Q1171:what are the causes of seizures in children?
genetic; infection; trauma; congenital; metabolic
Q1172:what are the causes of seizures in adults?
tumors; trauma; stroke; infection
Q1173:what are the causes of seizures in elderly?
stroke; tumor; trauma; metabolic; infection
Q1174:what is Horner's syndrome?
sympathectomy of face (lesion above T1) 1.Ptosis
2.anhidrosis and flushing of affected side 3.miosis [PAM is
horny]
Q1175:Horner's syndrome is associated w/ what type of
tumor?
pancoast tumor
Q1176:what is syringomyelia?
enlargement of the central canal of the S.C. Crossing fibers of
spinothalamic tract are damaged.
Q1177:what are the s/s of syringomyelia?
b/l loss of pain and temp sensation in the upper extremities w/
the touch sensation. Most common at C8-T1
Q1178:syringomyelia commonly seen in what pts?
pts w/ Arnold-Chiari malformation
Q1179:Tabes dorsalis what infection is tabes dorsalis
associated w/?
teriary syphilis
Q1180:Tabes dorsalis what happens in the CNS?
degeneration of dorsal columns and dorsal root
Q1181:Tabes dorsalis dorsalis also is associated with what
s/s?
charcot's joint; shooting (lightning) pain; Argyll Robertson
pupils; and absence of DTRs
Q1182:Where are skeletal motor neurons and preganglionic
autonomic neurons derived?
Neural Tube
Q1183:What form postganglionic autonomic neurons and
sensory neurons?
Neural Crest cells
Q1184:What do all ganglia contain?;(2)
Sensory neurons;or;Postganglionic autonomic neurons;(both
from neural crest cells)
Q1185:Neural crest cells which migrate to the Adrenal
Medulla to form postganglionic sympathetic neurons?
Chromaffin cells
Q1186:What type of defect in development causes an increase
in ;Alpha-feto protein?
Neural tube defect
Q1187:Aside from the epidermis; hair and nails; what else
does the Surface Ectoderm make?;(5)*
A PILE;Anterior Pituitary;Parotid gland;Inner ear;Lens of the
eye;Enamel of teeth
Q1188:Germ layer that forms the retina; CNS and pineal
gland?
Neuroectoderm;(Neural tube)
Q1189:What (3) systems are formed by the Mesoderm?;What
organs from other systems?;(3)
Musculoskeletal ;(all bone and muscle);Cardiovascular;(heart;
blood; lymph; vessels);Reproductive
organs;Organs;Spleen;Adrenal cortex;Kidney and ureter
Q1190:What part of the thyroid is formed by the Neural crest
cells?
Parafollicular (C) cells
Q1191:What germ layer forms every organ aside from the
neurological; integumentary; musculoskeletal; reproductive
and CV systems (and the spleen; adrenal and kidney)?
Endoderm;(every individual organ aside from those
mentioned)
Q1192:What germ layer makes the dura?
Mesoderm;(others from Neural crest)
Q1193:Where are the preganglionic neuron cell bodies?
in the CNS;(postganglionic cell bodies are in the ganglion =
PNS)
Q1194:What drives all sympathetic preganglionic neurons?
Hypothalamic fibers
Q1195:Which is Preganglionic versus Postganglionic: White
rami or gray rami?
Pre = White;Post = Gray
Q1196:The Otic ganglion supplies what nerve to where?
CN-9;to Parotid gland
Q1197:What ganglion supplies CN-3 to the ciliary muscle and
the pupillary sphinctor?
Ciliary ganglion
Q1198:What are the parasympathetic preganglionic
neurons?;(7)
CN-3;CN-7;CN-9;CN-10;S-2;S-3;S-4
Q1199:What are the (5)* secondary vesicles and their adult
derivatives from top to bottom?
Todd Detests STYs;Telencephalon = Cerebral
Hemispheres;;Diencephalon = Thalamus;;meSencephalon =
Midbrain;meTencephalon = Pons /
Cerebellum*;;mYelencephalon = Medulla
Q1200:The (4) parts of the Ventricles are derived from which
vesicles?
Telencephalon = Lateral;Diencephalon =
Third;Mesencephalon = Aqueduct;Metencephalon = Fourth
(top);Myelencephalon = Fourth (bottom)
Q1201:(3) Differential Dx of ailments that affect the axon in
Retrograde Transport
Herpes virus;;Polio;;Tetnus toxin
Q1202:In Spina Bifida; where is the defect?;What prevents
this?
Vertebral arches;prevents it;Folic Acid
Q1203:difference b/t Meningocele and Meningomyelocele?
Meningocele = meninges only;Meningomyelocele = meninges
and cord
Q1204:which spinal formation defect is the most severe?
Spina bifida w/ Myeloschisis;(neural tube is open on the
back--not covered w/ skin);also called Rahischosis
Q1205:Muscular demyelinating dz that affects only the Optic
nerve in the CNS?
Multiple Sclerosis
Q1206:Which CN exits dorsally?
CN-4;Trochlear nerve
Q1207:CNS cell;physical support and repair; maintains
BBB;what is the cellular marker?
Astrocyte;;marker;GFAP
Q1208:CNS cell;lines the ventricles
Ependymal cells
Q1209:CNS cell;only supportive CNS cell from the
Mesoderm;what is its action?
Microglia;(phagocytosis)
Q1210:CNS cell;most common type of glial cell in white
matter
Oligodendroglia
Q1211:CNS cell;cell associated w/ acoustic neuroma
Schwann cell
Q1212:Sensory cell;Light discriminatory touch on hairless
skin (palms; soles; fingers)
Meissner's corpuscles
Q1213:Sensory cell;deep cell involved in pressure; coarse
touch; vibration and tension
Pacinian corpuscle
Q1214:Sensory cell;in dermis of fingertips; hair follicles and
hard palate for light; crude touch
Merkel's corpuscles
Q1215:which peripheral nerve layer is the permeability
barrier and must be rejoined in microsurgery for limb
attachment?
Perineurium
Q1216:What cells make the CSF?
Choroid plexus
Q1217:What is the path of CSF to the Subarachnoid
space?;(8)
LM3 S4 LMS;Lateral ventricle ->;Monroe (foramen) -> Third
ventricle ->;Sylvius Aqueduct -> Fourth Ventricle ->;Luschka
and Magendie foramen ->;Subarachnoid space
Q1218:Which is always abnormal in
CSF;Monocytes;Lymphocytes;PMNs
PMNs;(bacterial meningitis)
Q1219:Dx;Excessive dilation of ventricles
Hydrocephalus
Q1220:At what level does the spinal cord end?;Subarachnoid
space?;Where is lumbar puncture performed?
Cord ends: L2;meninges end: S2;puncture: L3 - L5
Q1221:which part of the spinal cord is sensory versus motor?
Dorsal = Sensory;Ventral = Motor
Q1222:in the spinal cord; where are the ascending and
descending tracts versus the cell bodies?
White matter = Tracts;Gray = Cell bodies
Q1223:Which horn of the spinal cord participates in reflexes?
Dorsal horn
Q1224:Where is pressure; vibration; touch and
proprioception in the spinal cord?
Dorsal columns
Q1225:Where is the voluntary motor section of the spinal
cord?
Lateral corticospinal tract
Q1226:Where is the pain and temperature section of the
spinal cord?
Spinothalamic tract;(anterior to the ventral horns)
Q1227:Where are the cell bodies of an Upper Motor Neuron?
UMN = Brain stem and Cerebral Cortex
Q1228:What connects the two hemispheres?
Corpus Callosum
Q1229:Where is it in cortex?;Vision
Occipital lobe
Q1230:Where is it in cortex?;Hearing
Temporal lobe
Q1231:Where is it in cortex?;Taste
Insula;(below postcentral gyrus)
Q1232:Where is it in cortex?;Reading and writing
Angular gyrus
Q1233:Where is it in cortex?;Primary Motor
Precentral gyrus
Q1234:Where is it in cortex?;Primary Sensory
Postcentral gyrus
Q1235:Where is it in cortex?;Wernicke's area
Temporal lobe; superior gyrus
Q1236:Where is it in cortex?;Broca's area
Frontal lobe near lateral fissure
Q1237:What structures does the needle go thru in a lumbar
puncture?;(7)
Skin -> Ligaments -> Epidural space -> Dura mater ->
Subdural space -> Arachnoid -> Subarachnoid space (for CSF)
Q1238:What is different if a lesion on the corticospinal tract
occurs above versus below the pyramidal decussation
(medulla)?
Above = Contralateral side weakness;;Below = Ipsilateral side
weakness
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?
Dorsal columns;(if swaying w/ eyes open = cerebellar damage)
Q1240:where does neuron 1 end in the Dorsal column-medial
lemniscus pathway?
Ipsilateral nucleus cuneatus or gracilis in Medulla
Q1241:Which of the major tracts crosses at the level of the
entering first neuron?
Spinothalamic tract
Q1242:where is the lesion anywhere along the spinothalamic
tract in the cord or brainstem?
Contralateral to signs
Q1243:where is the first synapse in the spinothalamic
tract?;where does the second neuron cross?
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
Q1244:What is the Babinski sign?
Dorsiflexion of big toe and fanning of the others
Q1245:Landmark for a pudendal nerve block
Ischial spine
Q1246:Landmark for lumbar puncture
Iliac crest
Q1247:CN responsible for;movement of the face muscles
CN-7;Facial
Q1248:CN responsible for;sensation of the face
CN-5;Trigeminal
Q1249:CN responsible for;taste from anterior 2/3 or tongue
CN-7;Facial
Q1250:CN responsible for;taste from posterior 1/3 or tongue
CN-9;Glossopharyngeal
Q1251:CN responsible for;Tongue movement
CN-12;Hypoglossal
Q1252:CN responsible for;Mastication
CN-5;Trigeminal
Q1253:CN responsible for;Crying
CN-7;Facial
Q1254:Exit from the skull of the 3 parts of the Trigeminal
nerve
Standing Room Only;V-1: Superior Orbital Fissure;V-2:
Rotundum (foramen);V-3: Ovale (foramen)
Q1255:Which cross-section of the spinal cord has;1. greatest
amount of Gray matter;2. Lateral horns
1. Lumbar;;2. Thoracic
Q1256:Dx;LMN symptoms bilaterally; including flaccid
paralysis
Polio
Q1257:Dx;lesion in white matter of cervical spine due to
demyelination; scanning speech; intention tremor; Nystagmus
Multiple sclerosis;its a SIN to have MS;Scanning
speech;Intention tremor;Nystagmus
Q1258:Dx;Bilateral dorsal column signs below lesion; positive
Romberg; locomotive ataxia; reactive to accomodation but not
light; shooting pain
Tabes Dorsalis;(syphillis);(accomodation but not light =
Argyll Robertson pupils)
Q1259:Dx;Everything gone except the dorsal columns
Ventral Artery occlusion;(Anterior Spinal Artery)
Q1260:Dx;Bilateral loss of pain and temp in upper extremities
but still has touch
Syringomyelia;(enlargement of central canal of spinal cord)
Q1261:Dx;Combined upper and lower motor neuron deficits
w/o any sensory deficit
ALS;(Amylotrophic Lateral Sclerosis)
Q1262:Dx;demyelination of dorsal columns; lateral
corticospinal tract; ataxic gait; hyperreflexia; impaired
position and vibration
Vitamin B-12 neuropathy;(Friedrich's ataxia)
Q1263:Dx;Non-fluent aphasia w/ intact comprehension
Broca's aphasia;(BROken
speech);(Nonfluent/Expressive/Motor)
Q1264:Dx;Fluent aphasia w/ impaired comprehension
Wernicke's aphasia;(Wordy; Wernickies =
"What?");(Fluent/Receptive/Sensory)
Q1265:Dx;Sudden flailing of one arm;where is lesion?
Hemiballismus;lesion;Contralateral Subthalamic Nucleus
Q1266:Dx;Slow; writhing movements; especially in
fingers;where is lesion?
Athetosis;lesion;Basal Ganglia
Q1267:Dx;Sudden jerky purposeless movements;where is
lesion?
Chorea;lesion;Basal Ganglia
Q1268:(7)* functions of the Hypothalamus
TAN HATS;Thirst and water
balance;Adenohypophysis;Neurohypophysis;Hunger;Autono
mic regulation / Circadian rhythm;Temperature;Sexual urges
and emotions
Q1269:Nucleus in Hypothalamus;Thirst and water balance
Supraoptic;;(holding a pee makes you feel water up past your
eyeballs)
Q1270:Nucleus in Hypothalamus;Destruction leads to
Anorexia
Lateral;(destroying "Lateral" makes you thin)
Q1271:Nucleus in Hypothalamus;Destruction leads to
hyperphagia and Obesity
Ventromedial;(destroying makes you grow ventrally and
medially)
Q1272:portion of Hypothalamus;Regulates
Parasympathetics;what else does it regulate?
Anterior;also: Cooling when hot;[Wear a CAP when you are
hot];(Cooling - Anterior - Parasymp)
Q1273:portion of Hypothalamus;Regulates
Sympathetics;what else does it regulate?
Posterior;;also: Heat when cold
Q1274:Nucleus in Hypothalamus;Destruction leads to
Rage;normally leads to pleasure
Septal nucleus;(Septal = Sexual urges)
Q1275:Which nucleus for ADH and Oxytocin?
ADH = Supraoptic;Oxytocin = Paraventricular
Q1276:Portion of Thalamus;Visual
Lateral Geniculate Nucleus;(LGN);(Lateral for Light)
Q1277:Portion of Thalamus;Auditory
Medial Geniculate Nucleus;(MGN);(Medial for Music)
Q1278:Portion of Thalamus;Body sensations - pressure;
touch; vibration
Ventral Posterior Lateral;(VPL);V = Vibration;P = Pressure;L
= Light touch
Q1279:Portion of Thalamus;Facial sensation
Ventral Posterior Medial;(VPM);[Very Pleasant Mug (face)]
Q1280:Portion of Thalamus;Motor
Ventral Lateral/Anterior nuclei ;(VL/VA);[Volumes of Lifting
and Aerobics]
Q1281:Major relay for ascending sensory info that ultimately
reaches the cortex
Thalamus
Q1282:Portion of the brain responsible for Feeding; Fighting;
Feeling; Flight and F-cking
Using "LIMBS" for all 5 F's;Limbic system
Q1283:Portion of the brain tha is important for voluntary
movements and making postural adjustments
Basal Ganglia
Q1284:Where does the Direct and Indirect pathway of DA
from Substantia Nigra go to first?;Second?;Third?
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)
Q1285:Numbered areas of Brain;1. 1;2;3;2. 4;3. 6;4. 8
1. Sensory;2. Motor;3. Premotor;4. Frontal eye fields
Q1286:Numbered areas of Brain;1. 17;2. 22;3. 41; 42;4. 44; 45
1. Principal Visual cortex (occipital);2. Assoc Auditory
(Wernicke);3. Primary Auditory;4. Motor Speech (Broca)
Q1287:Lesion;lack of social judgement
Frontal lobe
Q1288:Brain Vessel;Leg and foot area of the motor and
sensory cortices; medial surface of the brain
Anterior Cerebral artery
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
Medial Cerebral artery
Q1290:Brain Vessel;may cause visual field defects; most
common Circle of Willis aneurysm
Anterior Communicating artery
Q1291:Brain Vessel;causes CN-3 palsy
Posterior Communicating artery
Q1292:Brain Vessel;division of middle cerebral artery;
"arteries of stroke"; supply internal capsule; caudate;
putamen; globus pallidus
Lateral Striate
Q1293:what would a stroke in the anterior part of the circle of
willis give?
sensory and motor dysfunction;aphasia
Q1294:How would a stroke in the posterior part of the circle
of willis present?;(3)
cranial nerve deficits; coma; ataxia
Q1295:Main vein return of the CSF
Superior Sagittal sinus
Q1296:what protects a clavical fracture from a brachial plexus
injury?
Subclavius muscle
Q1297:Initial sign of an acute appendicitis appears in what
dermatome?
T-10;(at the belly butTEN)
Q1298:what nerve refers gall bladder pain to the right
shoulder?
Phrenic nerve
Q1299:dermatome for the Inguinal Ligament
L1 = IL
Q1300:what monitors muscle length?;muscle tension?
Length = muscle Spindles;Tension = Golgi Tendon organs
Q1301:What are the Thenar and Hypothenar muscles?;(3
each)
Thenar = Thumb;OAF (Oppose; Abduct;
Flex);POLLICIS;Hypothenar is pinky;OAF ;DIGITI
MINIMI
Q1302:(4)* muscles that the Radial nerve innervates
BEST ("great extensor nerve");Brachioradialis;;Extensors of
wrist and fingers;;Supinator;;Triceps
Q1303:(3) Vagal Nuclei and their function (and any assoc CN)
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
Q1304:What cranial nerves have exits through the sphenoid
bone?
CN-2 to CN-6
Q1305:what cranial nerves pass through the Cavernous
Sinus?;(5)
eye muscle nerves (CN-3; 4; 6);and ;V-1 and V-2
Q1306:What vessel passes through the cavernous
sinus?;Which is the only "free floating" cranial nerve in the
cavernous sinus?
Internal carotid;;CN-6
Q1307:Definition;takes venous blood from the eyes and
superficial cortex to the internal jugular; also houses the
pituitary
Cavernous sinus
Q1308:(3) muscles that close the jaw
M = Munch;Masseter;;teMoralis;;Medial pterygoid
Q1309:muscle that lowers the jaw;what are all muscles of
mastication innervated by?
Lowers = Lateral pterygoid;;Innervated: V-3
Q1310:What are the "glossus" muscles innervated by?
all except PALATOglossus are innervated by the
hypoGLOSSal nerve (Palat = vagus);Palat = vagus;-glossus =
hypoglossal
Q1311:What are the "palat" muscles innervated by?
all except Tensor veli Palatini are innervated by the Vagus
(Tensor = V-3);Palat = Vagus;TENSor was too TENSE and is
V-3
Q1312:what innervates each of the eye muscles?
LR6 SO4 R3;Lateral Rectus = CN-6;Superior Oblique = CN-
4;Rest = CN-3
Q1313:Movement of following eye muscles;1. Superior
Oblique;2. Superior Rectus;3. Inferior Oblique;4. Inferior
Rectus
1. DOWN nasal;2. up lateral;3. UP nasal;4. down
lateral;Rectus = Lateral (like LR);Oblique = Opposite
direction
Q1314:CN and nuclei involved in a normal pupillary light
reflex
CN-3 -> Pretectile nuclei ->;Edinger-Westphal nuclei
Q1315:Sounds and CN used to test;1. palate elevation;2.
tongue;3. lips
1. Kuh-kuh (CN-10);2. La-la (CN-12);3. Mi-mi (CN-7)
Q1316:Extraocular eye movements during REM is due to
what area of the brain?
Paramedian Pontine Reticular Formation;(PPRF)
Q1317:Aphasia w/ poor repitition and good comprehension;
fluent speech
Arcuate Fasciculus;(connects Wernicke to Broca)
Q1318:Dx;Hyperorality; hypersexuality; disinhibited
behavior;where is lesion?
Kluver-Bucy syndrome;lesion;bilateral Amygdala
Q1319:Where is lesion?;Spacial neglect syndrome
Right parietal lobe
Q1320:Where is lesion?;Tremor at rest; chorea; athtosis
Basal Ganglia
Q1321:Where is lesion?;Truncal ataxia; dysarthria
Cerebellar Vermis;(Vermis is central and affects Central part
of body)
Q1322:Where is lesion?;Coma
Reticular Activating system
Q1323:what type of amyloid is w/ alzheimers?;what
chromosome/allele w/ familial form?;(2)
Beta-amyloid;Chrom 1; 14; 19 - APOE4 allele;Chrom 21 - p-
App gene
Q1324:Dx;dementia; aphasia; parkinsonian aspects;what is
sign/protein problem?;where is problem in brain (lobes)?
Pick's Dz;Pick bodies = TAU protein;Frontal or temporal
lobes only
Q1325:MCC of dementia in elderly?;2nd MCC?
MCC = Alzheimers;2nd MCC = Multi-infarct dementia
Q1326:Dx;chorea; dementia;what part of brain is
atrophied?;what chromosome problem?;what NT problem?
Huntington's Dz;CAG repeats on chrom 4 =;Caudate (C)
loses ACh (A) and GABA (G)
Q1327:Dx;Tremor at rest; Rigidity; Akinesia; Postural
instability;what is sign in brain?
Parkinson's;(TRAPped in body);sign: Lewy Bodies
Q1328:Dx;"floppy baby"; tongue fasciculations; median age
of death is 7 months;where is problem?
Werding-Hoffmann Dz;prob: degeneration of Anterior horns
Q1329:Dx;CSF has lymphocytic pleocytosis w/ slight protein
elevation. Virus is recovered from stool or throat
Poliovirus
Q1330:classic triad of Multiple Sclerosis
SIN;Scanning speech;;Intention tremor /
Incontinence;Nystagmus
Q1331:Tx for MS
Beta-interferon
Q1332:Dx;demyelinating dz seen w/ AIDS;what virus?
Progressive Multifocal Leukoencephalopathy;(PML);virus:
JC virus
Q1333:Dx;symmetric ascending muscle weakness due to
demyelination of PNS; diplegia; CV irregularities;
papilledema;Causes (2)
Gullian-Barre syndrome;causes;Herpesvirus;Campylobacter
infection
Q1334:Tx for Gullian-Barre;(2)
First line;Respiratory support;also;plasmapheresis
Q1335:Seziure type;Consciousness intact
Simple Partial
Q1336:Seziure type;Blank stare
Absent (Petite mal)
Q1337:Seizure type;Quick; repetitive jerks
Myoclonic
Q1338:Seizure type;Alternating stiffening and movement
Tonic-Clonic (Grand mal)
Q1339:Seizure type;Stiffening
Tonic
Q1340:Seizure type;"drop" seizures
Atonic
Q1341:Intracranial hemorrhage;CT shows "biconcave disk"
not crossing suture lines
Epidural hematoma;(middle meningeal artery)
Q1342:Intracranial hemorrhage;CT shows crescent-shaped
hemorrhage that crosses suture lines
Subdural hematoma;(bridging veins)
Q1343:Intracranial hemorrhage;"worst HA of life"; bloody
spinal tap
Subarachnoid hemorrhage;(berry aneurysm)
Q1344:(3) Dx assoc w/ berry aneurysms
APKD;;Ehlers-Danlos;;Marfan's
Q1345:what are clinical presentations of brain tumors due to?
Mass effects;(seizures; dementia; etc)
Q1346:MCC brain tumor in adult
Glioblastoma multiforme
Q1347:Dx;"butterfly glioma" - can cross the corpus callosum
Glioblastoma Multiforme
Q1348:Dx;"Pseudopalisading" tumor cells boarder the areas of
necrosis and hemorrhage
Glioblastoma Multiforme
Q1349:Dx;spindle cells concentrically arranged in whorled
pattern of this brain tumor; psammoma bodies; arises from
arachnoid cells; on surface
Meningioma
Q1350:Dx;"fried egg" cells - round nuclei w/ clear cytoplasm
in frontal lobes
Oligodendroglioma
Q1351:Dx;childhood brain tumor; diffusely infiltrating;
posterior fossa; Rosenthal fibers - eosinophilic corkscrew
appearance
Pilocytic Astrocytoma
Q1352:Dx;childhood brain tumor; rosettes or pseudorosettes;
radiosensitive; neuroectodermal origin
Medulloblastoma
Q1353:Dx;perivascular pseudorosettes; rod-shaped
blepharoplasts; MC in ventricles
Ependymoma
Q1354:Dx;childhood brain tumor w/ foamy cells and high
vascularity;what is it assoc with?;what is the ectopic
production?
Hemangioblastoma;assoc w: Von Hippel-Lindau;ectopic: EPO
-> polycythemia
Q1355:Dx;benign childhood tumor from Rathke's pouch and
can cause bitemporal hemianopsia
Craniopharyngioma
Q1356:Dx;Ipsilateral loss of all sensation; contralateral loss of
pain and temp
Brown-Sequard syndrome
Q1357:Dx;Ptosis; anhidrosis; miosis of face;Can be associated
w/ spinal cord lesion above what level?
Horners syndrome;(PAM is Horny);w/ spine above T-1
Q1358:Nerve w/ site of injury;Shaft of humerus
Radial
Q1359:Nerve w/ site of injury;Supracondyle of humerus
Median
Q1360:Nerve w/ site of injury;Medial epicondyle
Ulnar
Q1361:Nerve w/ site of injury;Surgical neck of humerus
Axillary
Q1362:Dx;loss of triceps brachii; brachioradialis; extensor
carpi radialis longus
Radial nerve injury;(Radial = wRist drop)
Q1363:Dx;no loss of power in any arm muscles; loss of
forearm pronation; wrist flexion; finger flexion; several thumb
movements; thenar atrophy
Median nerve injury;("Pope's Blessing" = cross in the median)
Q1364:Dx;impaired wrist flexion and adduction; and impaired
adduction of the thumb and last two fingers
Ulnar nerve injury;(Claw hand)
Q1365:Dx;Anterior shoulder dislocation; loss of deltoid action
Axillary nerve injury
Q1366:Dx;difficulty flexing elbow; loss of function of
coracobrachialis; biceps; and brachialis muscles (and biceps
reflex)
Musculocutaneous nerve injury
Q1367:Bracial plexus is assoc w/ what 5 spinal nerves?
C5; C6; C7; C8; T1
Q1368:what is the order of the (5)* main nerves as they come
off the brachial plexus (top to bottom)?
CAMel RUn;musculoCutaneous;Axillary;Median;Radial;Ulna
Q1369:Dx;limb hangs at side; medially rotated and forearm is
pronated;where is problem?;what is common cause?
Erb-Duchenne Palsy;("Waiter's Tip");C5 and C6 (upper
trunk) injury;occurs as delivery trauma
Q1370:What innervates the lateral and anterior foot?
PED = Peroneal Everts and Dorsiflexes;Deep Peroneal =
Anterior;Superficial Peroneal = Lateral
Q1371:What innervates the posterior foot and plantar flexes?
TIP = Tibial Inverts and Plantarflexes;(can't stand on
TIPtoes)
Q1372:what nerve corresponds to L3-L4?
Femoral
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)
Thoracic Outlet Syndrome;(Subclavian artery and inferior
Trunk (C8; T1) of brachial plexus)
Q1374:Which is the only sympathetic that secretes ACh?
Sweat gland
Q1375:How do you tell where a CN-12 lesion is?;(3 steps)
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))
Q1376:what/where is Deviation of CN-5 lesion?
Jaw towards lesion side
Q1377:Test for unilateral lesion of cerebellum?
Rhomberg - patient falls Toward side of lesion
Q1378:Deviation of CN-10?
Uvula deviates AWAY from side of lesion
Q1379:Deviation of CN-11?;(2)
Shoulder droop on side of lesion;weakness on turning head to
contralateral side
Q1380:what (2) CN have UMN and LMN symptoms if there
is a lesion?
CN-7;CN-12
Q1381:which CN problem?;Palatal sagging and vocal cord
paralysis
CN-10
Q1382:(4) nuclei associated w/ CN-9;which deals w/ the gag
reflex?
Spinal V;Solitarius (tongue);Inf. Salvitory (Parotid);Ambiguus
(gag reflex)
Q1383:A tumor of the internal jugular at the petrosus
temporal bone would have an effect on what CN?
CN-9; 10; 11
Q1384:what ganglion / nerve does a right turn inside the skull?
Geniculate ganglion of the Facial nerve
Q1385:Dx;brain tumor causing truncal ataxia; wide-based gait;
projectile vomiting
Meduloblastoma
Q1386:in a Webber hearing test; how do you tell what type of
problem it is if the sound localizes to one side?
Ipsilateral = Conduction loss;Contralateral = Sensorineural
loss
Q1387:what is the specific ganglia for the tear-producing part
of CN-7?
Pterygopalatine ganglion;;(spit = submandibular gang);(all 3
originally from Superior salivary nuclei)
Q1388:how do you know if patient has UMN or LMN CN-7
lesion?
UMN - contralateral LOWER face only;LMN - Ipsilateral
UPPER and LOWER face;(Bells Palsy)
Q1389:what Dx can you see Bell's Palsy?;(5)*
ALexander BELL w/ STD;AIDS;Lyme
dz;Sarcoid;Tumors;Diabetes
Q1390:Herniation syndromes;can compress cerebral artery
Cingulate herniation;(under falx)
Q1391:Herniation syndromes;Coma and death can result
when it compresses brainstem
Central Transtentorial herniation
Q1392:Herniation syndromes;medial; temporal lobe
herniation
Uncal
Q1393:Herniation syndromes;herniates into foramen magnum
Cerebellar tonsillar
Q1394:Dx;contrlateral hemiparesis; ipsilateral dilated pupil;
ipsilateral gaze preference; caudal displacement of brainstem
(Duret hemorrhages)
Uncal herniation
Q1395:where is lesion for a Left homonymous hemianopia
right optic tract
Q1396:Where is the substantia nigra and VTA located?
Midbrain
Q1397:how can you tell if CN-4 lesion is on the nerve or the
nucleus?
Nerve = head-tilt away from lesion;;Nucleus = head-tilt
towards lesion
Q1398:Dx;small irregular pupil that does not react to light but
does to accomodation;what to Dx is it seen in?
Argyll-Robertson the diabetic hooker w/
syphillis;"Accomodates but does not react";seen
in;Diabetes;Syphillis
Q1399:visual field defect;right temporal lobe lesion or
Meyer's loop
Left upper quadrantic anopsia
Q1400:visual field defect;right upper (cuneate) calcarine
fissure
Left lower quadrantic anopsia;(w/ macular sparing)
Q1401:visual field defect;right occipital lesion
Left hemianopia w/ macular sparing
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?
lesion of Medial Longitudinal Fasciculus (MLF);(medial
rectus palsy; normal w/ convergence; CN-3; CN-4);MLF w/
MS
Q1403:NT changes;Anxiety;(3)
Inc NE;Dec GABA;Dec 5-HT
Q1404:NT changes;Depression;(2)
Dec NE;Dec 5-HT
Q1405:NT changes;Alzheimer's
Dec ACh
Q1406:NT changes;Huntington's Dz;(2)
Dec GABA;Dec ACh
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?
Left Retinal outflow tract of Optic nerve
Q1408:Difference b/t MRI T1 and T2
T1 = Black water;T2 = white water
Q1409:Order of deep cerebellar nuclei from lateral to
midline;(4)*
Dont Eat Greesy Food;D;E;G;F
Q1410:In the cerebellum;where are the parallel
fibers?;Dendrites of Purkinje cells?
Parallel = Granular layer;Dendrites of Purkinje = Molecular
layer
Q1411:Bridge b/t thinking brain and emotional brain
Cingulate
Q1412:regulates placement and memory
Hippocampus
Q1413:Regulates reward system; important in drug addiction
Nucleus Accumbens
Q1414:where is the most likely place of a lesion for Aphasia?
Temporal lobe
Q1415:What is the electrolyte flow for depolarization of hair
cells in the cochlea?
K+ into the cell depolarizes
Q1416:What receptor measures steady pressure on the skin?
Ruffini endings
Q1417:What receptor measures vibration on the skin?
Pacinian corpuscle
Q1418:what tracts are in the Inferior (3); Middle (1) and
Superior (2) cerebellar peduncles?*
DIBs On TVS in the PM;Inferior - Dorsal (cord);
vestiBulocerebellar; Olive;Superior - Tectocerebellar;
Ventral;Middle - Pontocerebellar
Q1419:when a person moves his head to the right; what
happens in the semicircular canal?;(2)
both (R and L) bend away from the Kinocilium;;Cupula
moves to opposite side
Q1420:when light strikes the eye; what are the steps?;(6)
Light -> CIS changes to TRANS ->;Inc Rhodopsin -> Inc
Transducin ->;Dec cGMP -> Dec Na+ -> Hyperpolarization
Q1421:if nystagmus is a symptom of a cerebellar lesion;
where is the lesion?
Flocculonodular lobe
Q1422:what is the equation for intensity of hearing?
Intensity = 20 x log (sound/threshold)
Q1423:what are two places in the ear that hear high-frequency
sounds?;example of a low-frequency place?
Base;Oval window;Round window;(Apex - Helicotrema -
hears low sounds)
Q1424:what occurs with the biceps and triceps regarding Ia
and Ib fibers when flexing the biceps?
Flex biceps;Bicep - ;Ia Dec firing (compressed);Ib Inc firing
(tension/contract);;Triceps - ;Ia Inc firing (stretched);Ib has no
change