Create
Learn
Share

USMLE Neurology 2

rename
fluff's version from 2017-04-12 01:47

Cerebellar Anatomy

ZoneAnswerQuestion
Anterior lobeAntigravity/postureControls
Posterior lobeFine motor coordinationControls
Flocculonodular lobeBalance/eye movementsControls
Medial zone/midline vermisAxial/proximal musculatureControls
Intermediate zone/medial lateral cerebellar hemisphereDistal musculatureControls
Lateral zone/lateral lateral cerebellar hemispherePlanning movementControls
Anterior vermis syndromeTrunk/leg/gait ataxiaSx
Anterior vermis syndromeAlcoholismCause
Anterior vermis syndromeAnterior lobeLobe
Posterior vermis syndromeFlocculonodular lobeLobe
Posterior vermis syndromeTruncal ataxiaSx
Posterior vermis syndromeChilhood medulloblastoma/ependymomaCause
Superior cerebellar peduncleVL/VA nuclei of thalamusOutput
Superior cerebellar peduncleVentral spinocerebellar tractInput
Middle cerebellar pedunclePontocerebellar tractOutput
Inferior cerebellar peduncleOlivocerebellar tract/cuneocerebellar tract/dorsal spinocerebellar tractOutput
memorize

Hypothalamus

AreaFunctionLesion
Supraoptic/paraventricularThirst/waterADH
LateralHunger/inhibited by leptinAnorexia
VentromedialSatiety/stimulated by leptinHyperphagia
Anterior hypothalamusCooling-parasympatheticA/C cooling
Posterior hypothalamusHeating-sympatheticPosterior poikilotherm (cold blooded)
Suprachiasmatic nucleusCircadian rhythmSleep to be charismatic
memorize

Thalamus

RegionAnswerQuestionNumber
VPLSpinothalamic/medial lemniscus (dorsal columns) from bodyInput2
VPMSpinothalamic/medial lemniscus (trigeminal)/gustatory pathwaysInput2
LGNOptic tractInput1
MGNSuperior olive/brachium of inferior colliculus of tectumInput2
VABasal ganglia>cerebellumInput2
VLCerebellum>basal gangliaInput2
VPLPain/temp/pressure/touch/vibration/proprioception of bodyInfo6
VPMFace sensation/tasteInfo2/makeup goes on face
LGNVisionInfo1/lateral-light
MGNHearingInfo1/medial-music
VAMotorInfo1
VLMotorInfo1
VPLPrimary somatosensory cortexOutput1
VPMPrimary somatosensory cortexOutput1
LGNCalcarine sulcus of the occipital lobeOutput1
MGNAuditory cortex of temporal lobeOutput1
VA/VLMotor cortexOutput1
PulvinarVisual attention/suppress irrelevant stimuli/utilizing info to initiate eye movementsInfo3
Anterior nuclear groupAffect/emotion/behaviorInfo3
Medial nuclear groupAffect/emotion/behaviorInfo3
Median dorsal nucleusMemory (Wernicke-Korsakoff)Info1
memorize

Movement Disorders

DisorderAnswerQuestion
HemiballismusSudden wild flailing of 1 arm +/- ipsilateral legSx
ChoreaSudden jerky purposeless movementsSx
AthetosisSlow writhing movements/fingersSx
MyoclonusSudden brief uncontrolled muscle contractionSx
DystoniaSustained involuntary contractionsSx
Essential/postural tremorAction tremor/exacerbated by holding position/postureSx
Resting tremorUncontrolled movement of distal appendages/alleviated by intentionSx
Intention tremorSlow zigzag motion when pointing-extending toward targetSx
HemiballismusContralateral STNLocation
ChoreaBasal gangliaLocation
AthetosisBasal gangliaLocation
Intention tremorCerebellarLocation
memorize

Spinal Cord Tracts

TractAnswerQuestion
Intermediate hornSympathetics T1-L2/3Info
Anterior spinothalamic tractCrude touch/pressureInfo
Anterior spinothalamic tractSacral-legs lateral/cervical-arms medialDistribution
Fasciculus cuneatusUpper body/extremitiesSource
Fasciculus gracilisLower body/extremitiesSource
Posterior column-medial lemniscusCaudal medullaDecussation
Posterior column-medial lemniscusPressure/vibration/touch/proprioceptionInfo
Posterior column-medial lemniscusFasciculi cuneatus (arms/lateral)/gracilis (legs/medial)Distribution
Posterior column-medial lemniscusDorsal root ganglia1st neuron
Posterior column-medial lemniscusNucleus gracilis/cuneatus2nd neuron
Posterior column-medial lemniscusVPL3rd neuron
Posterior column-medial lemniscusSensory cortex4th neuron
Lateral spinothalamic tractDorsal root ganglia1st neuron
Lateral spinothalamic tractPosterior horn2nd neuron
Lateral spinothalamic tractVPL3rd neuron
Lateral spinothalamic tractSensory cortex4th neuron
Lateral spinothalamic tractFew levels above rootDecussation
Lateral spinothalamic tractPain/tempInfo
Lateral corticospinal tractVoluntary motorInfo
Lateral corticospinal tractSacral-legs lateral/cervical-arms medialDistribution
Lateral corticospinal tractPyramidal decussationDecussation
Lateral corticospinal tractCortex/UMN1st neuron
Lateral corticospinal tractAnterior horn/LMN2nd neuron
memorize

Spinal Cord Lesions

DiseaseAnswerQuestionNumber
PolioLMN/anterior hornLocation2
Werdnig-HoffmanLMN/anterior hornLocation2
PolioFlaccid paralysisSx1
Werdnig-HoffmanFlaccid paralysisSx1
MSWhite matter of cervical region/random/asymmetricLocation2
MSScanning speech/intention tremor/nystagmusSx3
MSDemyelinationCause1
ALSUMN/LMN (anterior horn/lateral corticospinal tract)Location2
ALSSuperoxide dismutase 1Cause1
ALSFasciculations/atrophy/progressive-fatalSx3
ALSRiluzole (decreases presynaptic glutamate/increases survival)Treat1
Complete ASA occlusionAll but dorsal columns/Lissaeur's tract/upper thoracic (Adamkiewicz supplies ASA below T8)Location3
Tabes dorsalisDorsal columns/rootsLocation2
Tabes dorsalisLoss of sensation/proprioception/sensory ataxia (inability to sense/feel legs)Sx3
Tabes dorsalisTertiary syphilis/demyelinationCause2
Tabes dorsalisLoss of DTRs/Romberg+/Charcot's joints/Argyll Robertson pupilsPE4
SyringomyeliaAnterior white commisure of spinothalamic tract/usually C8-T1/can expand to other tractsLocation2
SyringomyeliaBilateral pain/temperatureSx2
B12/E deficiencyDorsal columns/lateral corticospinal tracts/spinocerebellar tractsLocation3
B12/E deficiencyAtaxic gait/paresthesia/impaired position/vibration senseSx4
B12/E deficiencyDemyelinationCause1
PolioPoliovirus destroys neuronsCause1
Werdnig-HoffmanCongenital degeneration of anterior hornsCause1
Brown-Sequard SyndromeIpsilateral UMN below lesion/Ipsilateral LMN at levelMotor Sx2
Brown-Sequard SyndromeIpsilateral all sensation at level/Ipsilateral tactile-vibration-proprioception below/Contralateral pain-temp belowSensation Sx3
memorize

Dermatomes

Question Answer
C2Posterior half of skull
C3Turtleneck
C4Low collar shirt
T4Nipple
T7Xiphoid
T10Umbilicus
L1Inguinal ligament
L4Kneecaps
S2/3/4Erection/sensation of penile/anal
memorize

Primitive reflexes

Question Answer
MoroAbduct/extend limbs when startled/then draw together
RootingMoves head toward one side if cheek or mouth is stroked/nipple seeking
SuckingSucking when roof of mouth is touched
PalmarCurling of fingers if palm stroked
PlantarDorsiflexion of large toe/fanning of other toes/like Babinski in adult/normal in baby
GalantStroke on one side of spine causes flexion toward that side
memorize

Cranial Nerve Reflexes

ReflexNerveIn/Out
CornealV1 opthalmic/nasociliary branchAfferent
LacrimationV1 (loss of reflex doesn't preclude emotional tears)Afferent
Jaw jerkV3 (sensory/muscle spindle from masseter)Afferent
PupillaryIIAfferent
GagIXAfferent
CornealVII (temporal/orbicularis oculi)Efferent
LacrimationVIIEfferent
Jaw jerkV3 (motor/masseter)Efferent
PupillaryIIIEfferent
GagXEfferent
memorize

Cranial Nerve Nuclei

NerveAnswerQuestion
IIIMidbrainLocation
IVMidbrainLocation
VPonsLocation
VIPonsLocation
VIILower ponsLocation
VIIIPonsLocation
IXMedullaLocation
XMedullaLocation
XISpinal cordLocation
XIIMedullaLocation
IIIMedial nuclei/motor/basal plateL-M/S-M
IVMedial nuclei/motor/basal plateL-M/S-M
VMedial and lateral/motor and sensory/basal and alar platesL-M/S-M
VIMedial nuclei/motor/basal plateL-M/S-M
VIIMedial and lateral/motor and sensory/basal and alar platesL-M/S-M
VIIILateral nuclei/sensory/alar plateL-M/S-M
IXMedial and lateral/motor and sensory/basal and alar platesL-M/S-M
XIMedial nuclei/motor/basal plateL-M/S-M
XIIMedial nuclei/motor/basal plateL-M/S-M
VII/IX/XNucleus solitarius/sensory (taste/baro/gut distention)L-M/S-M
IX/XNucleus ambiguus/motor (pharynx/larynx/upper esophagus)L-M/S-M
XDorsal motor nucleus/autonomic to heart/lungs/upper GIL-M/S-M
memorize

Exit Pathways

Nerve-VesselCranial FossaOrifice
IAnteriorCribriform plate
IIMiddleoptic canal
Opthalmic arteryMiddleoptic canal
Central retinal veinMiddleoptic canal
V1Middlesuperior orbital fissure
VIMiddlesuperior orbital fissure
Opthalmic veinMiddlesuperior orbital fissure
Optic sympathetic fibersMiddlesuperior orbital fissure
V2Middleforamen rotundum
V3Middleforamen ovale
Middle meningeal arteryMiddleforamen spinosum
VIIPosteriorinternal auditory meatus
VIIIPosteriorinternal auditory meatus
IXPosteriorjugular foramen
XPosteriorjugular foramen
XIPosteriorjugular foramen
Jugular veinPosteriorjugular foramen
XIIPosteriorhypoglossal canal
XI rootPosteriorforamen magnum
Brain stemPosteriorforamen magnum
Vertebral arteriesPosteriorforamen magnum
memorize

Visual defects

DefectLesion Location
Right anopiaRight optic nerve
Bitemporal hemianopiaLateral geniculate body/chiasm
Binasal hemianopiaInternal carotid calcification
Left homonymous hemianopiaRight optic tract
Left upper quadrantic anopiaRight Meyer's loop/temoral lobe/inferior retinal loops around inferior horn of lateral ventricle
Left lower quadrantic anopiaRight Dorsal optic radiation/parietal lobe/superior retina takes shortest path via internal capsule
Left hemianopia with macular sparingRight PCA infarct/occipital lobe
Central scotomaMacular degeneration
memorize

Aphasia

TypeFluency-Comprehension-Repetition
Broca'sNonfluent/good comp/poor rep
Transcortical motor (damage near Broca's)Nonfluent/good comp/good rep
Transcortical sensory (damage near Wernicke's)Fluent/poor comp/good rep
Wernicke'sFluent/poor comp/poor rep
ConductionFluent/good comp/poor rep
GlobalNonfluent/poor comp/poor rep
memorize

Hematomas

TypeAnswerQuestion
SubduralCrescent hematoma/concave/may cross suture linesCT
EpiduralLenticular/convex/less likely to cross suture linesCT
SubduralGradual signs/hours to daysTiming
EpiduralLucid interval/rapid compressionTiming
SubduralAbused/fallen (alcoholics/elderly)Associated causes
EpiduralSkull fractureAssociated causes
SubduralBridging vein bleedingCommon vessel
EpiduralMiddle meningeal artery lacerationCommon vessel
SubduralLess dense (CSF dilution)CT Density
EpiduralMore dense (no blood dilution)CT Density
memorize

Misc terms

TermDef
AlexiaReading/central language
AgraphiaWriting
AnosognosiaLack of awareness of illness/deficit/condition
AsomatognosiaLack of knowledge of body/hemineglect/denial of part of body belongs to them
Ganser syndromeDissociative disorder not otherwise specified
ApraxiaInability to carry out task upon comman/may be able to spontaneously
ProsopagnosiaInability to recognize faces
AnencephalyComplete failure of higher brain development/external head grossly deformed
EncephaloceleProtrusion of brain and meninges out of skull
HydranencephalyExternal head forms normally/cerebral hemispheres destroyed
PorencephalyCyst-cavity in brain that communicates with ventricles
HoloprosencephalopathyForebrain failure of development/external head grossly deformed
memorize

Laryngeal Anatomy

ABRelation
Aryepiglottic muscleRecurrent laryngealInnervation
Thyroepiglottic muscleRecurrent laryngealInnervation
CricothyroidExternal branch of superior laryngeal nerveInnervation
Lateral cricoarytenoidRecurrent laryngealInnervation
Posterior cricoarytenoidRecurrent laryngealInnervation
ThyroarytenoidRecurrent laryngealInnervation
VocalisRecurrent laryngealInnervation
CricothyroidStretches/adducts vocal ligamentFxn
Lateral cricoarytenoidAdducts vocal ligamentFxn
Posterior cricoarytenoidAbducts vocal ligamentFxn
ThyroarytenoidLoosens vocal ligamentFxn
VocalisTenses segments of vocal ligamentFxn
Laryngeal mucosa above vocal foldsInternal branch of superior laryngeal nerveInnervation
Laryngeal mucosa below vocal foldsRecurrent laryngealInnervation
Pharyngeal mucosaGlossopharyngealInnervation
Superior laryngeal arterySuperior thyroid arterySource
Superior laryngeal arteryInternal branch of superior laryngeal nerveAccompanies
Internal branch of superior laryngeal nerveSuperior laryngeal arteryAccompanies
Superior thyroid arteryExternal branch of superior laryngeal nerveAccompanies
External branch of superior laryngeal nerveSuperior thyroid arteryAccompanies
memorize

CSF Flow

SourceDestination
Lateral ventriclesForamina of Monro
Foramina of Monro3rd ventricle
3rd ventricleCerebral aqueduct of Sylvius
Cerebral aqueduct of Sylvius4th ventricle
4th ventricleLateral foramina of Luscka/median foramina of Magendie
Lateral foramina of Luscka/median foramina of MagendieSpinal subarachoid space
memorize

Misc Genes

ChromosomeGene NameDisease
3p25VHL/tumor suppressorVon Hippel-Lindau/RCC
11p13/11/15WT-1/2Wilms Tumor
13q14RbRetionblastoma/osteosarcoma
17p13.1p53Lung/breast/colon/etc
17p12-21BRCA1Hereditary breast/ovarian
13q12-13BRCA2Hereditary breast
5q21APCAdenomatous polyps/colonc cancer
18q21DCCColon cancer
17q11.2NF1Neurofibromas
22q12NF2Acoustic neuromas/meningiomas
22q11None/deletionCATCH-22/DiGerogre/Velocardiofacial
5p-None/deletionCri-du-chat
7 Phe 508 deletionCFTRCystic fibrosis
9TSC1/hamartin/regulates cell cycleTuberous Sclerosis
16TSC2/tuberin/GTPase activating-proliferationTuberous Sclerosis
4HuntingtonHuntington's Disease
16PKD1ADPKD
15None/deletion-inactivationPrader-Willi/Angelman's
memorize

 

USMLE Neurology Pharmacology