lolernie's version from 2016-05-04 06:28


Question Answer
Sound localization begins in theSuperior Olivary Nuclei (SON
Superior olivary nuclie receives bilater input from:cochlear nucleus
E.COLI-MA MnemonicCentral auditory pathway - Eighth CN, coch, oliv, lat lemniscus, inferior coliculus of dorsal midbrain, medial geniculate nucleus of thalamus
Tonotopy?Tones close to each other in terms of frequency are represented in topologically neighbouring regions in the brain. - Preserved throughout central auditory pathway
Central auditory pathway synapses where:Synapse in the primary auditory cortex (PAC) in the superior temporal and Heschl’s gyri
Unilateral PAC (primary auditory cortex) lesion causes whatlarge lesion can affect CONTRALATERAL sound localization, though both PACs 'hear' both sides.
Cochliar nuclei (Receive input from ipsilateral spiral ganglion (PNS) via CN VIII) blood supply:AICA
What structure Receives direct input from both the cochlear nuclei and the SON via the lateral lemniscusInferior colliculus of dorsal midbrain
Weber’s Test (hearing)Tuning fork on skull
Left ear hearing loss, weber's test shows loud left earhearing loss is CONDUCTIVE (air conduction is reduced in left ear.. sound travels through solid better)
Left ear hearing loss, weber's test shows loud right earhearing loss is sensorineural, sound lateralizes to unaffected ear
Rinne's TestTurning fork on mastoid process, then move next to outer ear
Positive Rinne TestTuning fork is louder in AIR than against mastoid. Means normal hearing or sensorineural loss
Negative Rinne TestTuning form is louder on bone than against mastoid, means hearing loss is conductive
The saccule and utricle respond to linear acceleration of the head and gravity
The three semicircular canals respond to angular acceleration of the head
Scarpa's ganglion recieves input from otolith organs and semicircular canals
Scarpa's ganglion sends output to the CN8 via..Vestribular nerve (part of CN VIII [vestibulocochliar nerve])
What cranial nerve originates in labyrinth of ear and synapses on flocculonodular cerebellar lobe.CN8 (vesticulocochlear)
Vestibulo-Ocular Reflex (VOR)Moves eyes to compensate for rapid head movement during fixed gaze (stare, head left, eyes go right)
Oculocephalic (Doll’s Eye) Maneuver tests...Vestibulo-Ocular Reflex (VOR)
an absent Vestibulo-Ocular Reflex (VOR) indicates what type of lesioninfratentorial (aka... brainstem)
When is Oculocephalic maneuver test best used on a patientUnconscious patient. (conscious patient can suppress it)
Caloric testing of VOR tests forbrainstem AND supratentorial lesion.
Saccadic return of eyes to midposition in VOR caloric testing is done by...frontal eye fields (supratentorial)
Benign Paroxysmal Positional Vertigo (BPPV)Otoliths in utricle become dislodged and migrate to semicircular canals - Fleeting (< 30 s) positional vertigo brought on by movements of the head, nausea vomit possible
Otitis interna aka labyrinthitis/vestibular neuronitis is usually caused by.. name 2 signsUnilateral. Usual virus caused. Hearing loss/tinnitus and vertigo/nausea/nystagmus
Otitis interna treatment..Usually subsides over weeks.
Left beating nystagmus involves rapid saccade to which directionLeft. Inition slow VOR is to the right followed by rapid left saccade
Cold water caloric VOR test in left ear should cause...right saccade (COWS)
Ménière’s DiseaseIdiopathic disruption of endolymph circulation, increasing labyrinthine pressure
Violent, sudden attacks of nausea, vomiting, sweating.. stuffiness in ear prior to attack... variable nystagmusMénière’s Disease
Vestibular SchwannomaBenign tumor of myelin insulating CN VIII within the cerebellopontine angle
Signs of Vestibular Schwannomaipsilateral hearing loss/tinnitus, vertigo/nausea/nystagmus, and possible Bell's paulsy from compression of CNVII and trigeminal signs CNV if tumor expands
Resting tremor, visual hallucinations, forgetful, REM sleep problemsLewy Body Dementia - Think parkinson's lewy body
Loss of cholinergic neurons in the basal forebraina part of alzheimer's
Younger dementia (45-64) with personality/language/behavior changesFrontotemporal dementia
Rapid deterioration (months) of dementia with myoclonic jerkscreuzfelt-jacobs prion
Right parietal lobe damage can result in left hemineglect - what blood supply?right ACA/PCA
What is Gerstmann syndromeLoss of ability to read and write caused by left posterior parietal cortex damage (alexia/agraphia)
Anosognosia caused by damage to right posterior parietal cortexdenial of existence of right limb
Bilateral posterior parietal cortex lesionBalint syndrome, inability to attend to more than one object in visual field
apraxia and UMN signs suggest damage wherespanning motor cortices
Ideomotor and ideational apraxiaIdeomotor is inability to translate idea into movement, ideational apraxia is the inability to conceptualize movements
Dorsal stream vs ventral streamDorsal = where (object is in relation to viewer) Ventral = What (identification)
Dorsal or ventral stream terminates in posterior parietal cortexdorsal stream - 'where' pathway, consists of angular & supramarginal gyri
Syndrome associated with PPC/dorsal stream lesionGerstman syndrome, finger agnosia, can't read write or calculate
Damage to ventral stream can cause whatVisual agnosia (can see but not recognize)
Bilateral damage to lingual gyrus (part of ventral stream) causes whatcerebral achromatopsia (non-retinal color blindness)
Bilateral damage to inferior temporal/fusiform gyri (part of ventral stream) can cause whatprosopagnosia, face-blindness
What part of brain causes emotional/social pain and social cognitionanterior cingulate cortex
Parahippocampal gyri, subcallosal gyri, and cigulate cortex comprice thelimbic association region
Frontal release signsprimitive reflexes (grasp, snout, sucling) signs of PFC damage particularly in dementia
Simple vs complex siezureSimple = no impairment of consciousness, complex causes impairment.
Tonic-clonic seizures are akagrand mal
Jacksonian march is part of simple or complex partial seizures?Simple partial, which is focal (complex partial is also focal)
Only seizure with auracomplex partial
Decorticate posturing (rubrospinal takeover) as pain response causes what limb because of damage to where?Bilateral CST
What if rubrospinal is lesioned too and vestibulo and reticulospinal tract takeover?arm extension aka decerebrete posturing
Mydriasis from lesion tomidbrain or CN3
Pinpoint, non-reactive pupils from lesion topons
What cranial nerves can get damaged from treating hypernatremia too quickly?ventral pons, generally CN4 abducens
Locked in syndrome caused bypons damage, generally treating hyponatremia too fast
locus coeruleusnorepinephrine
raphe nucleus5-ht (serotonin)
substantia nigradopamine
Cheyne–Stokes respirationabnormal breathing characterized by progressively deeper sometimes faster breathing, followed by gradual decrease and then apnea.
Coma, cheyne-stokes, decorticate posturing, + (normal) oculocephalic, absent saccadeCerebrum damage
Coma, cheyne-stokes, decorticate posturing, SMALL REACTIVE PUPILS, + (normal) oculocephalic, absent saccadediencephalon
Coma, cheyne-stokes, decerebrate posturing, LARGE UNREACTIVE PUPILS, - (abnormal) oculocephalic, absent saccade/VORmidbrain
Coma, cheyne-stokes, decerebrate posturing, PINPOINT PUPILS, - (abnormal) oculocephalic, absent saccade/VORpons
Coma, ataxic breathing, flaccid posturing, LARGE UNREACTIVE PUPILS, - (abnormal) oculocephalic, absent saccade/VORMedulla
Degeneration of periaquaductal grey/amygdala/anterior nucleus of thalamus caused byvernicke-korsakoff ->alcohol, gait problems
bilateral damage to anterior temporal lobes (hippocampus) (result from alzheim, herpes, infarction, oxidative stress) can cause..Anterograde amnesia
Which hippocampal lesion affects spatial memoryRight
Amygdala lesion can causeincreased rage or eliminate unconscious response to emotional stimuli
Where are major cholinergic nuclei that supply limbic/cortical structures?Basal forebrain/septum, degenerates in alzheim
Bacterial CFS is cloudy, while tuberculous CSF isn't. Tuberculous is associated with..outside the country
Atony (no muscle tone) is a sign ofLMN damage
Cranial nerve lesion for hoarsness/gag/dysphagiaIX or X
Fasciculations/fibrillations vs. clasp-knife/babinski signLMN vs UMN
Cranial nerves are PNS or CNS? Ipsilateral or contralateral signs?PNS, Ipsilateral
Cranial motor nerves that are NOT innervated bilaterally?Left CN7 = Right LOWER FACE probz (upper face is fine because bilateral) & CNXII
The corticobulbar tract is composed of the upper motor neurons ofthe cranial nerves.
Posterior cerebral artery and superior cerebellor arteries, surround what CN?CN3, occulomotor
Cranial nerve most sensitive to intracranial pressure raise?CN6, can't abduct eyes
Bitemporal hemianopsia/tunnel vission associated with what aneurism?ACA (CN2)
Trigeminal nucleus is medial or lateral medulla and pons? Blood supply?Lateral. PICA/VA
Anterior and medial blood supply of rostral medulla?ASpA, would effect medial lemniscus aka DCML (fine touch, vibration, proprioception), ipsilateral direction tongue deviation b/c hypoglossal nuclei
UMN (motor cortex, genu) damage to effecting tongue causes tongue to deviating..CONTRAlateral. b/c lack of UMN input in that direction. Would be ipsilateral if LMN damage (aka hypoglossal nerve)
4th ventricle is wherebetween pons/rostral medulla and cerebellum
Blood supply to midbrainPCA
Contralateral parkinsons signs from lesions to..Rostral midbrain.. contrateral
Down and out eyes, mydriasis, ptosisdamage to occulomotor (CN3)
Cerebral aquaduct is in the..midbrain
Multiple sclerosis effectsrandom white matter
What disease affects midline of cerebellum (vermis) causing wobbliness (from trunk problems)Wernicke's
Raphe nucleiSerotonin, near dcml
Striatum degeneration is known asHuntington's disease
Guillan Beret affects PNS or CNS?Only PNS demyelination (hence no visual problems since Optic CN2 is the only CNS cranial nerve)
Multiple sclerosis affects PNS or CNS?Only CNS demyelination
Lhermitte's sign for MSMultiple sclerosis, electricy like sensation down arms upon neck flexion
Unthoff's phenomenon for MSHigh temperatures cause worse symptoms
Lambert-eaton vs myasthenia gravis muscle exertionMuscle exertion makes lambert eaton feel better, myasthenia gravis feel worse
Muscarinic receptors are associated with which part of Autonomic nervous system?PNS
Nicotinic receptors are associated with which part of Autonomic nervous system?ANS
Cut off signal from Pontine micturition center causesspastic bladder, partial involuntary emptying with some retention
MiosisPathological pupillary CONSTRICTION
MydriasisPathalogical pupillary DILATION (blown pupil)
Pupillary constriction (miosis), anhydrosis, PtosisHorner syndrome, damage to lateral brainstem, cervical damage
Multiple System AtropyParkinsonism (that L-Dopa doesn't fix), Ataxia, Autonomic dysregulation - All caused by degeneration of basal ganglia, cerebellum, and sympathetic preganglionic neurons
The reticular activating system (RAS) is found bilaterally in the DORSAL portion of the brainstem from the level ofthe midbrain to the mid-pons.
Central pontine myelinolysis CT appearanceNote the sombrero- or pig snout-shaped pattern on pons scan
Complex partial seizures usually involve what lobetemporal
LEFT Angular gyrus is part of...Posterior partietal cortex, associated with gerstman syndrome
All postganglionic neuron somata, whether sympathetic or parasympathetic, express what NT receptors?nAChRs
During micturition, ____ (<--ANS) stimulation causes the detrusor muscle to contract and the internal urethral sphincter to relax.parasympathetic
Injuries to the spinal cord below ___ can give rise to chronic flaccid bladderT12
Fasciculations and atrophyLMN signs
Lesioning the a primarily sympathetic pathway (the dorsal longitudinal fasciculus) that runs throughout the lateral brainstemUnilateral horner syndrome
Apex of cochlea..Wide and floppy, transduces low sounds. Base=High Apex=Low
Why high frequency hairs in cochlea go first?Those hair cells are the first to get hit by the sound wave.
The lateral lemnisci carry outputs from, among other things, the superior olivary nuclei, where _____ first occurs.sound localization
A lesion to the cochlear nuclei unilaterally would result in unilateral hearing loss. Part of midbrain?Caudal pons
the saccules transduce...vertical acceleration
The ultricles transduce..horizontal acceleration
spiral ganglia are associated with..auditory pathway
scarpa gangla associated withvestibular pathway
patients with vertigo tends to fall towardsthe side of the lesion
Menieres.. endolymph.. scalamedia
NEGATIVE rinne's test means...abnormal result
Agranular cortex with large layer VMotor
Granular cortex with large layer IVSensory
Splenium of corpus callosum connects the two..Visual cortex (reading)
body of corpus callosum connects the two..parietal
Hummingbird sign and can't look up/downPSP (progressive supranuclear palsy)
Temporal lobe pressing/passing tentorial notch herniaUncal (mydriasis, down and out eye)
Down and out eyeocculomotor nerve palsy
Duret hemorrhageFrom central herniation.. basilar artery burst, usually fatal
central herniationTemporal and diencephalon through tentorium