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Neuro Flashcards

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1
Q

mesocortical pathway

A

ventral tegmental of midbrain–>cortex

result of blocking: increased negative symptoms of schizophrenia (social w/drawl, depression)

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2
Q

mesolimbic pathway

A

ventral tegmental of midbrain–>limbic system

result of blocking: relieves (+) symptoms of schizophrenia (target of antipyschotics)

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3
Q

nigrostriatal pathway

A

Basal ganglia
substantial nigra pars compacta–>neostratium

result of blocking: Parkinson disease

stimulation: extrapyramidal SE

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4
Q

tuberoinfundibular pathway

A

arcuate nucleus of hypothalamus–>pituitary

result of blocking: increase release of prolactin from anterior pituitary–>hypogonadism

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5
Q

structures running through cavernous sinus

A 
internal carotid
occulomotor nerve
trochlear nerve
abducens nerve
trigeminal nerve (opthalmic, maxillary)
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6
Q

Erb palsy

A
  • traction or tear of upper trunk (C5-C6 roots)
  • lateral traction on neck during delivery
  • deltoid, supraspinatus: abduction (arm hangs by side)
  • infraspinatus: lateral rotation (arm medially rotated)
  • biceps brachii: flexion, supination (arm extended and pronated)
  • “water’s tip”
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7
Q

Klumpke palsy

A
  • traction or tear of lower trunk C8-T1 root
  • upward force on arm during delivery, grabbing tree branch to break fall
  • intrinsic muscles affected (lumbricals, interossei, thenar, hypothenar
  • total claw hand: lumbricals normally flex MCP joints and extend DIP and PIP joints
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8
Q

thoracic outlet syndrome

A
  • compression of lower trunk and subclavian vessels
  • cervical rib injury, pancoast tumor
  • intrinsic muscles affected (lumbricals, interossei, thenar, hypothenar
  • atrophy of intrinsic hand muscles; ischemia, pain, and edema due to vascular compression
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9
Q

winged scapula

A
  • lesion of long thoracic nerve
  • axillary node dissection after mastectomy stab wound
  • serratus anterior: inability to anchor scapula to thoracic cage–>can’t abduct arm above horizontal position
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10
Q

axillary (C5-C6)

A
  • fractured surgical neck of humerus, anterior dislocation of humerus
  • flattened deltoid
  • loss of arm abduction at shoulder
  • loss of sensation over deltoid muscle and lateral arm
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11
Q

musculocutaneous (C5-C7)

A
  • upper trunk compression
  • loss of forearm flexion and supination
  • loss of sensation over lateral forearm
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12
Q

radial (C5-T1)

A
  • midshaft fracture of humerus, compression of axilla (crutches or “Saturday night palsy”)
  • wrist drop
  • decrease grip strength
  • loss of sensation over posterior arm/forearm and dorsal hand
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13
Q

median (C5-T1)

A
  • supracondylar fracture of humerus, carpal tunnel syndrome and wrist laceration
  • “ape hand” and “Pope’s blessing”
  • loss of wrist and lateral finger flexion, thumb opposition, lumbricals of 2nd and 3rd digits
  • loss of sensation over thenar eminence and dorsal and palmar aspects of lateral 3.5 fingers w/ proximal lesion
  • Tinel sign
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14
Q

ulnar (C8-T1)

A
  • fracture of medial epicondyle of humerus, fractured hook of hamate
  • “ulnar claw” on digit extension
  • radial deviation of wrist upon flexion (proximal lesion)
  • loss of flexion of wrist and medial fingers, abduction and adduction of fingers, actions of medial 2 lumbrical muscles
  • loss of sensation over medial 1.5 fingers including hypothenar eminence
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15
Q

recurrent branch of median nerve (C5-T1)

A
  • superficial laceration of palm
  • “ape hand”
  • loss of thenar muscle group: opposition abduction, flexion of thumb
  • NO loss of sensation
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16
Q

extending index and middle fingers at rest

A
  • “ulnar claw”

- distal ulnar nerve lesion

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17
Q

extending index and middle fingers when making fist

A
  • “Pope’s blessing”

- proximal median nerve

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18
Q

extending pinkie and ring fingers at rest

A
  • “median claw”

- distal median nerve

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19
Q

extending pinkie and ring fingers when making fist

A
  • “OK gesture”

- proximal ulnar nerve

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20
Q

atrophy of thenar eminence

A

“ape hand”–> unopposable thumb

-median nerve lesion

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21
Q

atrophy of hypothenar eminence

A

-ulnar nerve lesion

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22
Q

thenar muscles

A

Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

“OAF”

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23
Q

hypothenar muscles

A

Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minim brevis

“OAF”

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24
Q

Dorsal interosseous muscles

A

abduct fingers

DAB- dorsal abducts

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25
palmar interosseous muslces
adduct fingers | PAD-palmars adduct
26
lumbrical muscles
flex at the MCP joint, extend PIP and DIP joints
27
obturator (L2-L4)
- pelvic surgery - decreased thigh sensation (medial) - decreased adduction
28
femoral (L2-L4)
- pelvic fracture | - decreased thigh flexion and leg extension
29
common peroneal (L4-S2)
- trauma or compression of lateral aspect of leg; fibular neck fracture - foot drop: inverted and plantar flexed at rest, loss of eversion and dorsiflexion - "steppage gait" - loss of sensation of dorsum of foot "PED"-peroneal everts and dorsiflexes; if injured, foot dropPED
30
tibial (L4-S3)
- knee trauma, baker cyst, tarsal tunnel syndrome - inability to curl toes - loss of sensation on sole of foot - proximal lesions: foot everted at rest w/ loss of inversion and plantar flexion "TIP"-tibial inverts and plantarflexes; if injured, can't stand on TIPtoes
31
superior gluteal (L4-S1)
- posterior hip dislocates, polio - Trendelenburg sign/gait- pelvis tilts b/c weight-bearing leg can't maintain alignment of pelvis - innervates gluteus medius and minimus
32
inferior gluteal (L5-S2)
- posterior hip dislocation - difficulty climbing stairs, rising from seated position - loss of hip extension - innervates gluteus maximus
33
lateral area (hypothalamus)
- hunger - inhibited by leptin - "if you zap your lateral nucleus, you shrink lateral"
34
ventromedial area (hypothalamus)
- satiety - stimulated by leptin - "if you zap your ventromedial nucleus, you grow vertrally and medially"
35
anterior hypothalamus
- cooling, parasymathetic | - "A/C=anterior cooling"
36
posterior hypothalamus
-heating, sympathetic
37
suprachiasmatic nucleus
-circadian rhythm
38
supraoptic nucleus
-makes ADH
39
paraventricular nucleus
-makes oxytocin
40
VLP (thalamus nucleus)
- input: spinothalamic and dorsal columns/medial lemniscus - pain, temperature, pressure, touch, vibration, proprioception - destination: primary somatosensory cortex
41
VMP (thalamus nucleus)
-input: trigeminal and gustatory pathway -face sensation and taste -destination: primary somatosensory cortex "Makeup goes on the face"
42
LGN (thalamus nucleus)
-input: CN II -vision -destination: calcarine sulcus "Lateral=Light"
43
MGN
-input: superior olive and inferior colliculus of tectum -hearing -destination: cortex of temporal lobe "Medial=Music"
44
VL
- input: basal ganglia, cerebellum - motor - destination: motor cortex
45
MCA: area of lesion
motor cortex: upper limb and face sensory cortex: upper limb and face temporal lobe: Wernicke area frontal lobe: Broca area
46
MCA stroke symptoms
- contralateral paralysis of upper limb and face - contralateral loss of sensation of upper/lower limbs and face - aphasia if in dominant hemisphere - hemineglect if nondominant side
47
ACA area of lesion
- motor cortex: lower limb | - sensory cortex: lower limb
48
ACA stroke symptoms
- contralateral paralysis lower limbs | - contralateral loss of sensation of lower limbs
49
lenticulo-striate artery stroke
- striatum, internal capsule - contralateral hemiparesis/hemiplegia - common in unmanaged hypertension
50
ASA area of lesion
- lateral corticospinal tract - medial lemniscus - caudal medulla-hypoglossal nerve
51
ASA stroke symptoms
- contralateral hemiparesis-upper and lower limbs - decreased contralateral proprioception - ipsilateral hypoglossal dysfunction - Medial medullary syndrome: infarct of paramedian branches of ASA and vertebral arteries
52
PICA area of lesion
-lateral medulla: CN IX, X, XII; lateral spinothalamic tract
53
PICA stroke symptoms
- vomiting, vertigo, nystagmus - decreased pain/temp. sensation of ipsilateral face and contralateral body - dysphagia, hoarseness, decreased gag reflex - ipsilateral Horner syndrome; ataxia, dysmetria - Lateral medullary (Wallenberg) syndrome
54
AICA area of lesion
- lateral pons: CN V, VI, VII, VIII | - middle and inferior cerebellar peduncles
55
AICA stroke symptoms
- vomiting, vertigo, nystagmus - paralysis of face, decreased lacrimation/salvation, decreased taste of anterior 2/3 of tongue, decreased corneal reflex - decreased face pain and temp sensation - ipsilateral decrease in hearing - ipsilateral Horner syndrome - ataxia, dysmetria - Lateral pontine syndrome
56
PCA stroke
- occipital cortex, visual cortex | - contralateral hemianopia w/ macular sparing
57
Basilar artery stroke
- pons, medulla, lower midbrain: corticospinal and corticobulbar tracts, ocular nerve nuclei, PPRF - preserved consciousness and blinking, quadriplegia, loss of voluntary facial, mouth, and tongue movement - "locked-in syndrome"
58
ACom lesion
- aneurysm impinge cranial nerves - visual field defects - typically aneurysms, not strokes
59
PCom lesion
- saccular aneurysm - CN III palsy: eyes down and out w/ ptosis and pupil dilation - lesions typically aneurysms, not strokes
60
dorsal column
- ascending: pressure, vibration, fine touch, proprioception - decussates in medulla-->ascend contralaterally in medial lemniscus - synapse VPL--> sensory cortex
61
spinothalamic tract
- ascending: later-pain, temperature; anterior-crude touch, pressure - decussates at anterior white commissure-->ascends contralaterally - synapse VPL--> sensory cortex
62
lateral corticospinal tract
- descending: voluntary movement of contralateral limbs | - decussates at caudal medulla (pyrimidal decussation)--> descends contralaterally
63
nucleus solitarius
- visceral Sensory info - taste, baroreceptors, gut distention - CN VII, IX, X
64
nucleus ambiguus
- Motor innervation of pharynx, larynx, and upper esophagus - swallowing, palate elevation - CN IX, X, XI
65
dorsal motor nucleus
- autonomic (parasympathetic) fibers to heart, lungs, and upper GI - CN X
66
cribiform plate
CN I
67
middle cranial fossa: through sphenoid bone
CN II-VI
68
optic canal
- CN II - ophthalmic artery - central retinal vein
69
superior orbital fissure
- CN III, IV, V1, VI - ophthalmic vein - sympathetic fibers
70
foramen rotundum
CN V2
71
foramen ovale
CN V3
72
foramen spinosum
middle meningeal artery (ruptured in epidural hematoma)
73
posterior cranial fossa: through temporal or occipital bone
CN VII-XII
74
internal auditory meatus
CN VII, VIII
75
jugular foramen
CN IX, X, XI | jugular vein
76
hypoglossal canal
CN XII
77
foramen magnum
spinal roots of XI brain stem vertebral arteries
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