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Hi Yield 106.0 - 109.3

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mhewett's version from 2016-07-19 20:22

Section 106.0 Brainstem Lesions

Question Answer
What are the three components of the brainstem?(1) Midbrain (2) Pons (3) Medulla
What part of the brainstem is injured in Weber's syndrome? What is the most common cause?Medial midbrain; Occlusion of the posterior cerebral artery
What part of the brainstem is injured in AICA syndrome? What is the most common cause?Lateral inferior pons; Occlusion of the anterior inferior cerebellar artery
What is the cause of locked-in syndrome (pseudo coma)?Central pontine myelinolysis (which is caused by correcting a hyponatremic patient's serum sodium levels to quickly) or any cause that results in complete loss of function of the ventral (anterior) pons
What condition is characterized by a loss of all motor function except the ability to blink or move eyes vertically?Locked-in syndrome (pseudo coma)
memorize

 

Injury to what structure in the brainstem would cause weakness in the ipsilateral lower face, tongue, and palate? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Corticobulbar tract; Medial
Injury to what structure in the brainstem would cause contralateral hemiparesis of the entire trunk and extermities? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Corticospinal tract; Medial
Injury to what structure in the brainstem would cause contralateral loss of vibration sense and proprioception? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Medial lemniscus; Medial
Injury to what structure in the brainstem would cause eye abduction and depression? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Oculomotor nerve roots; Medial
Injury to what structure in the brainstem would cause dystaxia? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Cerebellar peduncles; Lateral
Injury to what structure in the brainstem would cause contralateral pain and temperature sensation loss from the trunk and limbs? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Spinothalmic tract; Lateral
Injury to what structure in the brainstem would cause ipsilateral Horner's syndrome? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Sympathetic tract; Lateral
Injury to what structure in the brainstem would cause ipsilateral loss of facial pain and temperature sensation? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Trigeminal nucleus; Lateral
Injury to what structure in the brainstem would cause ipsilateral ataxia and limb movement pathology? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Base of the pons; Medial
Injury to what structure in the brainstem would cause loss of gag reflex, dysphagia, and hoarsness? Would this lesion most likely be found on the lateral or medial aspect of the brainstem? Vestibular nucleus; Lateral
What spinal cord tract is associated with pain and temperature? Where does it crossover? Spinothalmic tract; Spinal cord
What spinal cord tract is associated with proprioception? Where does it crossover? Posterior columns; Branstem
What spinal cord tract is associated with motor function? Where does it crossover? Corticospinal tract; Brainstem
A patient status post motor vehicle accident is brought by EMS to the ER. There is spastic paralysis and loss of all sensory ability beginning near the level of the umbilicus and continuing all the way down the body bilaterally. There is increased patellar and achilles deep tendon reflexes bilaterally. What occured? Complete transection of the spinal cord at T10
A patient presents with complaints of "not being able to feel things like normal" throughout both his arms and across his shoulders, upper chest, and upper back. Examination reveals a patient with decreased light touch, proprioception, pain, and temperature sensation in a cape-like distribution over his upper body. What is the pathology? Syringomyelia
What cranial nerves are associated with the midbrain? Pons? Medulla? Midbrain: CN 3-4; Pons: CN 5-8; Medulla: CN 9-12
What cranial nerves are associated with the cerebellopotine angle? Inferior pontine sulcus? Middle cerebellar peduncle? CN 7-8; CN 6; CN 5
A patient presents with hemiplegia of the entire right side of the body. Where is the pathology? Left internal capsule
A patient presents with complaints of weakness of the hands and lower extremities. Muscle atrophy is evident in the feet and hands. Achilles deep tendon reflexes are increased. Brachioradialis reflexes are decreased. What is the likely diagnosis? ALS
A patient presents with right facial weakness and difficulties in moving eyes about voluntarily. On examination, she has a positive Romberg's sign. Babinski sign is present. Nystagmus is evident. She also complains of having had terrible difficulty seeing things a couple weeks ago out of her left eye? What is the likely diagnosis? Multiple sclerosis
A patient suffered acute onset sharp back pain that started yesterday. The pain continues today, but the patient also states that he has "pins and needle" feeling on the bottom of his right foot. Achilles reflex is 1/4. What is the likely neurologic problem? Impingement of the S1 nerve root by the L5 disk
A patient suffered a painful knee injury yesterday while playing in a basketball game. The pain continues today, but the patient also states that he has "pins and needle" feeling on the bottom of his right foot. Achilles reflex is 1/4. What is the likely neurologic problem? Impingement/damage to the tibial nerve (a branch of the sciatic nerve)
A patient with a long history of various sexually transmitted diseases now presents with complaints of difficulty walking along with complaints of lancinating pain in his legs. He walks about by slamming his feet on the ground. On examination, he demonstrates a positive Romberg sign and decreased proprioception bilaterally in both legs. What is the likely diagnosis? Tabes dorsalis (syphilitic myelopathy)
Parkinsonism, chorea, athentosis, and hemiballismus are all signs of disorders of the _____. Basal ganglia

Section 107.0 Skull Foramina

What runs through the cribiform plate? Olfactory nerve fibers
What runs through the optic canal? (1) Optic nerve (2) Opthalamic artery
What nerves run through the superior orbital fissure? (1) CN III (2) CN IV (3) CN VI (4) CN V (V1, opthalmic branch)
What runs through the foramen rotundum? CN V (V2, maxillary branch)
What runs through the foramen ovale? (1) CN V (V3, mandibular branch) (2) Accessory meningeal artery
What runs through the foramen spinosum? Middle meningeal artery
What runs through the carotid canal? Carotid artery
What runs through the internal auditory canal? (1) CN VII (2) CNVIII (3) Internal auditory artery
What nerves run through the jugular foramen? (1) CN IX (2) CN X (3) CN XI
What nerves run through the hypoglossal canal? CN XII
What runs through the foramen magnum? (1) Spinal cord (2) Vertebral arteries (3) Spinal arteries (anterior and posterior) (4) CN XI

Section 108.0 Dermatomes and DO CASES

What dermatome is associated with the lateral shoulder? Anus? C4; S5
What dermatome is associated with the medial upper arm? Knee and medial lower leg? T1; L4
What dermatome is associated with the umbilicus? Anterior thigh? T10; L1-3
What dermatome is associated with the lateral upper arm? Plantar foot? C5; S1
What dermatome is associated with the lateral ankle? Middle finger? S1; C7
What dermatome is associated with the dorsum of the foot? Lateral forearm? L5; C6
What dermatome is associated with the part of the lower leg below the knee and above the ankle? Medial forearm? L5; C8

Section 109.1 Cardiovascular Anatomy

Which of the coronary arteries usually supplies the SA node? AV node? Right coronary artery; Right coronary artery
What branch of the right coronary artery supplies the right ventricle? Marginal branch (acute marginal artery)
What branch of the right coronary artery supplies the inferior left ventricle 80% of the time? What artery supplies this region in the often 20% of patients? Posterior descending artery; Left circumflex artery
What branch of the right coronary artery supplies the posterior septum of the heart? Posterior descending artery
What branch of the left coronary artery supplies the anterior interventricular septum and the apex of the heart? Left anterior descending artery
What branch of the left coronary artery supplies the left ventricle of the heart? Left circumflex artery
What coronary artery is most common occluded? What is it a branch of? Left anterior descending artery (LAD); Left coronary artery
What coronary artery when stenosed is often refered to as the "widowmaker?" Left coronary artery
Which coronary artery supplies most of the left atrium and ventricle, and anterior portion of the septum? Left coronary artery
Which coronary artery supplies the right atrium and ventricle, plus sinus and AV nodes? Right coronary artery
The main coronary arteries are a branch of what major blood vessel? Aorta
Is blood flow greatest through the coronary arteries during diastole or systole? Lowest? Diastole; Systole
Where does parasympathetic innervation to the heart come from? Sympathetic innervations? Vagus n; T1-6
Does the SA node usually receive innervation from the left or right vagus? AV node? Right; Left
From what germ layer is the heart derived? Mesoderm
What EKG leads are associated with the anteroseptal region of the heart? What coronary vessels are associated with this region? V1-V3; Right coronary artery and/or left anterior descending artery
What EKG leads are associated with the anterior of the heart? What coronary vessels are associated with this region? V2-V4; Left anterior descending
What EKG leads are associated with the anteriorlateral region of the heart? What coronary vessels are associated with this region? V4-V6; Left coronary artery (widowmaker)
What EKG leads are associated with the lateral region of the heart? What coronary vessels are associated with this region? V5-V6: Left circumflex artery
What EKG leads are associated with the high lateral region of the heart? What coronary vessels are associated with this region? I and aVL; Left circumflex artery
What EKG leads are associated with the inferior region of the heart? What coronary vessels are associated with this region? II, III, aVF; Right coronary artery
What part of the EKG is represented by each letter? A: P wave; B: Q wave; C: R wave; D: S wave; E: T wave

Section 109.2-.3 Endocrine & Retroperitoneal Anatomy

What cells of the adrenal gland manage sympathetic responses by secreting epinephrine and norepinephrine? In what part of the adrenal gland would you find these cells? What is their embryologic origin? Chromaffin cells; Medulla; Neural crest
What part of the adrenal cortex manages sex (i.e. androgens)? Zona reticularis
What part of the adrenal cortex manages sugar and WBCs? Zona fasciculata
What part of the adrenal cortex manages salt (i.e. sodium and water)? Zona glomerulosa
What three arteries supply the adrenal gland? (1) Super suprarenal artery; (2) Middle suprarenal artery (3) Inferior suprarenal artery
Where does parasympathetic innervation to the cortex of the adrenal gland come from? Sympathetic innervations? Vagus n; T10-11
Where does innervation to the medulla of the adrenal gland come from? Celiac ganglion (T5-9)
From what germ layer is the cortex of the adrenal gland derived? Mesoderm
In the thyroid gland, _____ is absorbed from the blood to form, via the follicular epithelium, colloid. Iodine
Where is colloid/thyroglobulin stored/contained within the thyroid gland? Follicle
What are the two hormones produced by the thyroid gland? (1) Thyroxine (T4) (2) Triiodothyronine (T3)
What type of cells in the thyroid gland produce calcitonin? Parafollicular C cells
After removal of a thyroid gland tumor via surgery a man returns with complaints of dysphonia (impaired voice production). What nerve was most likely injured by this procedure? Right recurrent laryngeal nerve
What three arteries supply the thyroid gland? (1) Super thyroid artery (2) Inferior thyroid artery (3) Thyroid IMA artery (sometimes)
Where does parasympathetic innervation to the thyroid gland come from? Sympathetic innervations? Vagus n; T1-4
From what brachial arch are the follicular cells of the thyroid gland derived? From what germ layer? 2nd brachial arch; Endoderm
What is the embryologic origin of parafollicular C cells? Neural crest
The neurohypophysis is to the ______ as the adenohypophysis is to the _____. Posterior pituitary gland; Anterior pituitary gland
What are the three parts of the anterior pituitary gland? (1) Pars distalis (2) Pars tuberalis (3) Pars intermedia
The posterior pituitary is actually no glandular, it is a cluster of axons and nerve terminal originating from the _____. Hypothalamus
In what structure of the skull does the pituitary gland sit? In what bone would you find this structure? Sell turcica; Sphenoid bone
When the contents of granules destined for release in the pars nervosa are not immediately secreted, the granules can accumulate in groups as expansions or "lumps" along the axon; these expansions with accumulated numbers of granules within the axon are known as _____. Herring bodies
What hormones are produced by the posterior pituitary gland? Released? None; (1) Oxytocin (2) ADH
What hormones are produced by the posterior pituitary gland? Released? (1) Prolactin (2) ACTH (3) TSH (4) GH (5) FSH (6) LH; Same as previous questions
What are the acidophils of the anterior pituitary gland? What hormone is produced by each? (1) Somatotropes: Growth hormone (2) Lactrotropes: Prolactin
What are the basophils of the anterior pituitary gland? What hormone is produced by each? (1) Corticotropes: Pro-opiomelanocortin (catabolized to produce ACTH) (2) Gondatropes: FSH and LH (3) Thyrotropes: TSH
What two arteries supply the pituitary gland? What are they branches of? Superior hypophyseal artery (2) Inferior hypophyseal artery; Internal carotid artery
Where does sympathetic innervation to the anterior pituitary gland come from? T1-4
What embryologic structure is the anterior pituitary gland derived from? What germ layer? Rathkey's pouch; Ectoderm
What germ layer is the posterior pituitary gland derived from? Ectoderm
What are the retroperitoneal structures? MNEMONIC: SAD PUCKER (1) Suprerenal/Adrenal gland (2) Aorta (3) Inferior vena cava (4) Duodenum (5) Pancrease (not including tail) (6) Ureters (7) Colon (ascending and descending) (8) Kidneys (9) Esophagus (lower 2/3) (10) Rectum (upper 2/3)