Terms in this set (90)
Myelinate multiple CNS axons, damaged in multiple sclerosis
Form multinucleated giant cells when infected with HIV
Myelinates one PNS axon, damaged in Guillain-Barré
Cells of BBB
Supraoptic (hypothalamic nucleus)
Function: Makes ADH, passes it to posterior pituitary for release
Paraventricular (hypothalamic nucleus)
Function: Makes Oxytocin, passes it to posterior pituitary for release
Lateral area (hypothalamic nucleus)
Function: Hunger (inhibited by leptin)
Destruction: Anorexia, FTT
Ventromedial area (hypothalamic nucleus)
Function: Satiety (stimulated by leptin)
Destruction: Hyperphagia, obesity
Anterior (hypothalamic nucleus)
Function: Cooling, parasympathetic
Posterior (hypothalamic nucleus)
Function: Heating, sympathetic
Suprachiasmatic (hypothalamic nucleus)
Function: Circadian rhythm
EEG waveform in Stage N1 sleep
EEG waveform in Stage N2 sleep
Sleep spindles and K complexes
EEG waveform in Stage N3 sleep
Delta waves (lowest frequency, highest amplitude; "slow wave sleep")
EEG waveform in REM sleep
Beta waves (highest frequency, lowest amplitude)
What drugs shorten Stage N3 sleep?
Rapid transition to REM sleep, can --> cataplexy
In what stage of sleep do enuresis, night terrors and sleep walking occur?
Which cranial nerves have their nuclei located in the medulla?
CN IX, X, XII
Which cranial nerves have their nuclei located in the pons?
CN V, VI, VII, VIII
Which cranial nerves have their nuclei located in the midbrain?
CN III, IV
Unilateral facial drooping involving the forehead
Bell's Palsy (lesion CN VII)
What cranial nerves traverse the cavernus sinus?
CN III, IV, V1 + V2, VI
Right homonomous hemianopsia -- where is the lesion?
Left optic tract
What abnormalities are found with a Chiari I malformation?
Cerebral tonsillar herniation --> syringomyelia
What abnormalities are found with a Chiari II malformation?
Significant herniation of cerebellar tonsils and vermis thru foramen magnum --> aqueductal stenosis and hydrocephalus
Compression of crossing fibers of the spinothalamic tract --> cape-like distribution of bilateral loss of pain and temperature sensation in the upper extremities; can extend laterally --> compression of anterior horn --> weakness and atrophy of the hands
From which pharyngeal pouch do the middle ear and eustachian tubes develop?
From which pharyngeal pouch do the superior parathyroids develop?
From which pharyngeal pouch do the inferior parathyroids and thymus develop?
From which pharyngeal pouch does the epithelial lining of the palatine tonsil develop?
Lesion to Non-dominant parietal lobe (R side in most people)
Lesion to Arcuate fasciculus
Dysarthria and truncal ataxia
Lesion to cerebellar vermis
Agraphia and acalculia
Lesion to dominant parietal lobe (L side in most people), Gerstmann syndrome.
Hyperorality, hypersexuality, disinhibited behavior
Bilateral amygdala lesion (Kluver-Bucy syndrome)
Typical cause of lesion to mammillary bodies
Thiamine (B1) deficiency
Broca or Wernicke aphasia
Unilateral lower extremity sensory and/or motor loss
Unilateral facial and arm sensory and/or motor loss
What artery supplies the medial lemniscus and medullary pyramids of the medulla?
Anterior spinal artery
Where does the corticospinal tract decussate in the brainstem?
Caudal medulla, prior to the medullary pyramids then descends
Where does the dorsal column medical lemniscus pathway decussate?
Medulla, then ascends as medial lemniscus
What artery supplies the following medullary structures: spinothalamic tract, inferior cerebellar peduncle, nucleus ambiguous, lateral spinothalamic tract
How can a stroke of the facial motor cortex be distinguished from Bell's Palsy?
Stroke to facial motor cortex will spare motor fxn of the upper face
Leftward deviation of the tongue on protrusion and right sided spastic paralysis, where is the lesion?
Medulla prior to the decussation of the corticospinal tract. The left hypoglossal nucleus and the corticospinal tract are in close proximity in the rostral medulla.
Signs of Weber syndrome
Contralateral spastic paralysis or hemiparesis
CN III palsy (eye looks down and out)
Signs of Wallenberg syndrome
Contralateral loss of pain and temperature on the body and ipsilateral loss of pain and temperature on the face
Hoarse voice, difficulty swallowing, loss of gag reflex
Ipsilateral Horner syndrome
Vertigo, nystagmus, nausea/vomiting
Ipsilateral cerebellar defects
Inability to abduct eye on lateral gaze and difficulty smiling, where is the lesion?
Pons. Here, CN VI (abducens) and VII (facial) are affected. Pons contains nuclei of CN V, VI, VII, VIII.
What is the lesion in "locked in" syndrome?
Basilar artery. Supplies pons, medulla, lower midbrain, corticospinal and corticobulbar tracts, ocular cranial nerve nuclei, PPRF.
What's the most common site of berry aneurysms and what conditions are associated with berry aneurysms?
Anterior communicating artery
Subdural hematoma, cause
Rupture of bridging veins, common in elderly
Recent onset stroke symptoms, first steps
Consider tPA, CT of the head w/o contrast
Lucid interval following head trauma
Most common cause of epidural hematoma
Middle meningeal artery rupture
What information is communicated at the Nucleus Soltarius?
Sensory information like taste, baroreceptors, sensation of gut distension
What information is communicated at the Nucleus Ambiguous?
Motor innervation to the pharynx, larynx and upper esophagus
What information is communicated at the Dorsal Motor Nucleus
Autonomic information to the heart, lungs, upper GI tract
Where is CSF generated, where is it reabsorbed?
CSF is made in the ependymal cells of the choroid plexus (lines ventricles)
It is reabsorbed by arachnoid granulations in the superior sagittal sinus
Communicating vs. non-communicating hydrocephalus
Communicating: decreased absorption of CSF
Non-communicating: physical obstruction
Clinical features of normal pressure hydrocephalus
Urinary incontinence (wet)
Which type of collagen is abnormal in Alports syndrome?
Which type of collagen is abnormal in Ehlers Danlos?
Vascular = Type III
Classic - Type I and Type V
Meningioma - 2nd most common primary brain tumor in adults (more common in women)
Pediatric brain tumor
4th ventricle compression
Ependymoma - 3rd most common primary brain tumor in kids (poor prognosis)
a/w CN VIII
a/w Neurofibromatosis type 2
Derived from Rathke's pouch
Most common pediatric supratentorial tumor
Amenorrhea, decreased libido
Stains with GFAP
Most common primary brain tumor in adults
Most common primary brain tumor in kids
4th ventricle compression
von Hippel-Lindau syndrome
VHL --> risk of bilateral renal cell CA
Perinuclear cytoplasmic clearing
IV, a/w hallucinations and bad dreams
PCP analog, blocks NMDA receptors, increases cerebral blood flow.
IV, most common drug used for conscious sedation (e.g. endoscopy)
Increases frequency of Cl- channel opening, provides anterograde amnesia, can reverse with flumazenil.
Inhaled, side effect of hepatotoxicity
Slow onset (high blood solubility), high potency (high lipid solubility)
IV, used for rapid anesthesia induction and short duration of action
Potentiates GABA-A, can use IV drip to maintain anesthesia. High TG content, increases risk of pancreatitis with long-term use (>2 days).
IV, decreases cerebral blood flow (useful for brain surgery)
Barbituates (like thiopental).
Increase duration of Cl- channel opening.
Opioid that does not indue histamine release
Mechanism of action of Dantrolene
Prevents Ca2+ release from sarcoplasmic reticulum of skeletal muscle, preventing contraction.
Used for malignant hyperthermia and neuroleptic malignant syndrome.
MOA of local anesthetics
Block Na+ channels.
Small myelinated > small unmyelinated > large myelinated > large unmyelinated
What drugs can be used to reverse neuromuscular blockade
Cholinesterase inhibitors like Neostigmine.
Used for non-depolarizing neuromuscular blockers (tubocurarine, vercuronium).
Most common causes of seizures in children
Developmental etiologies, infectious/febrile, trauma, metabolic
Treatment for absence seizures
Drugs that cause Stevens-Johnson syndrome
Seizure drugs: Ethosuximide, lamotrigine, carbamazepine, phenytoin, phenobarbital
Unique side effects of phenytoin
Fetal hydantoin syndrome
Drug induced lupus
Stevens Johnson syndrome
What drug regenerates AchE after organophosphate poisoning?
Treatment for organophosphate poisoning
Atropine (and pralidoxime)
Which anticholinesterases are used in the treatment of Alzheimers
Artery and nerve at risk for injury with anterior shoulder dislocation
Posterior circumflex artery