Neuro

Question 1

Prosopagnosia (inability to recognize faces) is most often caused by a lesions where; which artery is involved?

Answer 1

• Right inferior temporal lobe, specifically the fusiform gyrus
• Posterior Cerebral Artery

Question 2

A decrease in which NT is associated with a reduction in REM sleep, total sleep time, and delta sleep?

Answer 2

↓ Acetylcholine

Question 3

Which 2 NT’s promote arousal and wakefulness?

Answer 3

Dopamine and Norepinephrine

Question 4

How is Trisomy 18 (Edward syndrome) distinguished from Trisomy 13 (Patau syndrome)?

Answer 4

• Both share the rocker-bottom feet, congenital heart defects,andsevere intellectual disability
• Trisomy 18 is distinguished by micrognhtahia (small jaw), low-set ears, and clenched fists w/ overlapping digits

Question 5

What are the 4 primary symptoms of Gerstmann syndrome?

Answer 5

• Agraphia: inability to write
• Acalculia: inability to calculate
• Finger agnosia: inability to identify fingers
• Left-right disorientation

Question 6

Which paired brainstem nucleus is located in the posterior rostral pons near the lateral floor of the 4th ventricle and what NT does it secrete?

Answer 6

Locus ceruleus —> NE

Question 7

Most of the external auditory canal, including the external portion of the tympanic membrane is innervated by which nerve?

Answer 7

Mandibular division of trigeminal nerve (CN V3) via auriculotemporal branch

Question 8

Leptin acts in the arcuate nucleus of the hypothalamus to inhibit and stimulate what?

Answer 8

• Inhibit production of neuropeptide Y –> decreasing appetite
• Stimulate producting of alpha-MSH –> increasing satiety

Question 9

Where do the ventral posterior lateral (VPL) and ventral posterior medial (VPM) nuclei of the thalamus receive input from?

Answer 9

• VPL receives input from spinothalamic tract and dorsal columns
• VPM receives input from the trigeminal pathway

Question 10

What is believed to be the primary cause of lacunar infarcts?

Answer 10

Lipohyalinosis and Microatheromas

Question 11

Expanding space occupying lesions within the temporal lobe can cause elevated ICP with transtentorial herniation of the uncus causing compression of what structure and producing what sx?

Answer 11

Ipsilateral CN III —> oculomotor palsy w/ fixed dilated pupil

Question 12

Patients with medically intractable sx’s of Parkinson disease may benefit from high-frequency deep brain stimulation of which structures in the basal ganglia?

Answer 12

Globus pallidus internus or Subthalamic nucleus

Question 13

High frequency stimulation of which thalamic nucleus may reduce thalamic excitation and lessen excessive movements in pt’s with medically intractable essential tremor?

Answer 13

Ventral intermediate nucelus

Question 14

Fractures to the orbital floor can result in damage to which nerve with what sx’s?

Answer 14

• Infraorbital n. = continuation of maxillary n. (V2)
• Numbness and paresthesia of upper cheek, upper lip, and upper gingiva

Question 15

Aneurysms leading to CN III palsy most often involve which artery?

Answer 15

Posterior Communicating A. (PCA) - Medial Midbrain

Question 16

>95% of glioblastomas are associated with the overexpression of what?

Answer 16

EGFR

Question 17

Where is the largest concentration of ACh producing neuron in the brain?

Answer 17

Amygdala in nucleus basalis of Meynert

Question 18

Pt’s with an internal capsule stroke commonly present how?

Answer 18

• Pure motor weakness affecting the contralateral arm, leg, and lower face
• Contralateral spasticity or increased tone, hyperreflexia, and a (+) Babinkski sign are also present
• “Clasp-knife” spasticity

Question 19

What sx’s occur do to damage of the external vs. internal segment of the globus pallidus?

Answer 19

• External: results in decreased motion/movement
• Internal: results in excessive motion/movement

Question 20

Fractures at the Pterion risk lacerating which artery; where does it branch from?

Answer 20

• Middle Meningeal a. —> enters at foramen spinosum (epidural hematoma)
• Branch of the Maxillary a. (a terminal branch of the external carotid a.)