USMLE 1 Neuroscience

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Where are skeletal motor neurons and preganglionic autonomic neurons derived?: Neural Tube
What form postganglionic autonomic neurons and sensory neurons?: Neural Crest cells
What do all ganglia contain? (2): Sensory neurons

or

Postganglionic autonomic neurons

(both from neural crest cells)
Neural crest cells which migrate to the Adrenal Medulla to form postganglionic sympathetic neurons?: Chromaffin cells
What type of defect in development causes an increase in Alpha-feto protein?: Neural tube defect
Aside from the epidermis, hair and nails, what else does the Surface Ectoderm make? (5)*: A PILE:

Anterior Pituitary

Parotid gland

Inner ear

Lens of the eye

Enamel of teeth
Germ layer that forms the retina, CNS and pineal gland?: Neuroectoderm

(Neural tube)
What (3) systems are formed by the Mesoderm? What organs from other systems? (3): Musculoskeletal
(all bone and muscle);
Cardiovascular
(heart, blood, lymph, vessels);
Reproductive organs

Organs:
Spleen;
Adrenal cortex;
Kidney and ureter
What part of the thyroid is formed by the Neural crest cells?: Parafollicular (C) cells
What germ layer forms every organ aside from the neurological, integumentary, musculoskeletal, reproductive and CV systems (and the spleen, adrenal and kidney)?: Endoderm

(every individual organ aside from those mentioned)
What germ layer makes the dura?: Mesoderm

(others from Neural crest)
Where are the preganglionic neuron cell bodies?: in the CNS

(postganglionic cell bodies are in the ganglion = PNS)
What drives all sympathetic preganglionic neurons?: Hypothalamic fibers
Which is Preganglionic versus Postganglionic: White rami or gray rami?: Pre = White

Post = Gray
The Otic ganglion supplies what nerve to where?: CN-9

to Parotid gland
What ganglion supplies CN-3 to the ciliary muscle and the pupillary sphinctor?: Ciliary ganglion
What are the parasympathetic preganglionic neurons? (7): CN-3;
CN-7;
CN-9;
CN-10

S-2;
S-3;
S-4
What are the (5)* secondary vesicles and their adult derivatives from top to bottom?: Todd Detests STYs:

Telencephalon = Cerebral Hemispheres;

Diencephalon = Thalamus;

meSencephalon = Midbrain

meTencephalon = Pons / Cerebellum*;

mYelencephalon = Medulla
The (4) parts of the Ventricles are derived from which vesicles?: Telencephalon = Lateral

Diencephalon = Third

Mesencephalon = Aqueduct

Metencephalon = Fourth (top)

Myelencephalon = Fourth (bottom)
(3) Differential Dx of ailments that affect the axon in Retrograde Transport: Herpes virus;

Polio;

Tetnus toxin
In Spina Bifida, where is the defect? What prevents this?: Vertebral arches

prevents it:
Folic Acid
difference b/t Meningocele and Meningomyelocele?: Meningocele = meninges only

Meningomyelocele = meninges and cord
which spinal formation defect is the most severe?: Spina bifida w/ Myeloschisis

(neural tube is open on the back--not covered w/ skin)

also called Rahischosis
Muscular demyelinating dz that affects only the Optic nerve in the CNS?: Multiple Sclerosis
Which CN exits dorsally?: CN-4

Trochlear nerve
CNS cell: physical support and repair; maintains BBB what is the cellular marker?: Astrocyte

marker:
GFAP
CNS cell: lines the ventricles: Ependymal cells
CNS cell: only supportive CNS cell from the Mesoderm what is its action?: Microglia

(phagocytosis)
CNS cell: most common type of glial cell in white matter: Oligodendroglia
CNS cell: cell associated w/ acoustic neuroma: Schwann cell
Sensory cell: Light discriminatory touch on hairless skin (palms, soles, fingers): Meissner's corpuscles
Sensory cell: deep cell involved in pressure, coarse touch, vibration and tension: Pacinian corpuscle
Sensory cell: in dermis of fingertips, hair follicles and hard palate for light, crude touch: Merkel's corpuscles
which peripheral nerve layer is the permeability barrier and must be rejoined in microsurgery for limb attachment?: Perineurium
What cells make the CSF?: Choroid plexus
What is the path of CSF to the Subarachnoid space? (8): LM3 S4 LMS:
Lateral ventricle ->
Monroe (foramen) -> Third ventricle ->
Sylvius Aqueduct -> Fourth Ventricle ->
Luschka and Magendie foramen ->
Subarachnoid space
Which is always abnormal in CSF: Monocytes Lymphocytes PMNs: PMNs

(bacterial meningitis)
Dx: Excessive dilation of ventricles: Hydrocephalus
At what level does the spinal cord end? Subarachnoid space? Where is lumbar puncture performed?: Cord ends: L2

meninges end: S2

puncture: L3 - L5
which part of the spinal cord is sensory versus motor?: Dorsal = Sensory

Ventral = Motor
in the spinal cord, where are the ascending and descending tracts versus the cell bodies?: White matter = Tracts

Gray = Cell bodies
Which horn of the spinal cord participates in reflexes?: Dorsal horn
Where is pressure, vibration, touch and proprioception in the spinal cord?: Dorsal columns
Where is the voluntary motor section of the spinal cord?: Lateral corticospinal tract
Where is the pain and temperature section of the spinal cord?: Spinothalamic tract

(anterior to the ventral horns)
Where are the cell bodies of an Upper Motor Neuron?: UMN = Brain stem and Cerebral Cortex
What connects the two hemispheres?: Corpus Callosum
Where is it in cortex? Vision: Occipital lobe
Where is it in cortex? Hearing: Temporal lobe
Where is it in cortex? Taste: Insula

(below postcentral gyrus)
Where is it in cortex? Reading and writing: Angular gyrus
Where is it in cortex? Primary Motor: Precentral gyrus
Where is it in cortex? Primary Sensory: Postcentral gyrus
Where is it in cortex? Wernicke's area: Temporal lobe, superior gyrus
Where is it in cortex? Broca's area: Frontal lobe near lateral fissure
What structures does the needle go thru in a lumbar puncture? (7): Skin -> Ligaments -> Epidural space -> Dura mater -> Subdural space -> Arachnoid -> Subarachnoid space (for CSF)
What is different if a lesion on the corticospinal tract occurs above versus below the pyramidal decussation (medulla)?: Above = Contralateral side weakness

Below = Ipsilateral side weakness
If you ask a patient to place their feet together and close their eyes, and the patient sways (positive Romberg sign), where is the lesion?: Dorsal columns

(if swaying w/ eyes open = cerebellar damage)
where does neuron 1 end in the Dorsal column-medial lemniscus pathway?: Ipsilateral nucleus cuneatus or gracilis in Medulla
Which of the major tracts crosses at the level of the entering first neuron?: Spinothalamic tract
where is the lesion anywhere along the spinothalamic tract in the cord or brainstem?: Contralateral to signs
where is the first synapse in the spinothalamic tract? where does the second neuron cross?: Ipsilateral Dorsal gray matter at the entry level of the neuron

Second neuron crosses on the same level in the white commissure and ascend laterally
What is the Babinski sign?: Dorsiflexion of big toe and fanning of the others
Landmark for a pudendal nerve block: Ischial spine
Landmark for lumbar puncture: Iliac crest
CN responsible for: movement of the face muscles: CN-7

Facial
CN responsible for: sensation of the face: CN-5

Trigeminal
CN responsible for: taste from anterior 2/3 or tongue: CN-7

Facial
CN responsible for: taste from posterior 1/3 or tongue: CN-9

Glossopharyngeal
CN responsible for: Tongue movement: CN-12

Hypoglossal
CN responsible for: Mastication: CN-5

Trigeminal
CN responsible for: Crying: CN-7

Facial
Exit from the skull of the 3 parts of the Trigeminal nerve: Standing Room Only:

V-1: Superior Orbital Fissure

V-2: Rotundum (foramen)

V-3: Ovale (foramen)
Which cross-section of the spinal cord has: 1. greatest amount of Gray matter 2. Lateral horns: 1. Lumbar

2. Thoracic
Dx: LMN symptoms bilaterally, including flaccid paralysis: Polio
Dx: lesion in white matter of cervical spine due to demyelination; scanning speech, intention tremor, Nystagmus: Multiple sclerosis

its a SIN to have MS:
Scanning speech,
Intention tremor;
Nystagmus
Dx: Bilateral dorsal column signs below lesion; positive Romberg; locomotive ataxia; reactive to accomodation but not light; shooting pain: Tabes Dorsalis

(syphillis)

(accomodation but not light = Argyll Robertson pupils)
Dx: Everything gone except the dorsal columns: Ventral Artery occlusion

(Anterior Spinal Artery)
Dx: Bilateral loss of pain and temp in upper extremities but still has touch: Syringomyelia

(enlargement of central canal of spinal cord)
Dx: Combined upper and lower motor neuron deficits w/o any sensory deficit: ALS

(Amylotrophic Lateral Sclerosis)
Dx: demyelination of dorsal columns, lateral corticospinal tract; ataxic gait; hyperreflexia; impaired position and vibration: Vitamin B-12 neuropathy

(Friedrich's ataxia)
Dx: Non-fluent aphasia w/ intact comprehension: Broca's aphasia

(BROken speech)

(Nonfluent/Expressive/Motor)
Dx: Fluent aphasia w/ impaired comprehension: Wernicke's aphasia

(Wordy; Wernickies = "What?")

(Fluent/Receptive/Sensory)
Dx: Sudden flailing of one arm where is lesion?: Hemiballismus

lesion:
Contralateral Subthalamic Nucleus
Dx: Slow, writhing movements, especially in fingers where is lesion?: Athetosis

lesion:
Basal Ganglia
Dx: Sudden jerky purposeless movements where is lesion?: Chorea

lesion:
Basal Ganglia
(7)* functions of the Hypothalamus: TAN HATS:
Thirst and water balance;
Adenohypophysis;
Neurohypophysis;
Hunger;
Autonomic regulation / Circadian rhythm;
Temperature;
Sexual urges and emotions
Nucleus in Hypothalamus: Thirst and water balance: Supraoptic

(holding a pee makes you feel water up past your eyeballs)
Nucleus in Hypothalamus: Destruction leads to Anorexia: Lateral

(destroying "Lateral" makes you thin)
Nucleus in Hypothalamus: Destruction leads to hyperphagia and Obesity: Ventromedial

(destroying makes you grow ventrally and medially)
portion of Hypothalamus: Regulates Parasympathetics what else does it regulate?: Anterior

also: Cooling when hot

[Wear a CAP when you are hot]
(Cooling - Anterior - Parasymp)
portion of Hypothalamus: Regulates Sympathetics what else does it regulate?: Posterior

also: Heat when cold
Nucleus in Hypothalamus: Destruction leads to Rage; normally leads to pleasure: Septal nucleus

(Septal = Sexual urges)
Which nucleus for ADH and Oxytocin?: ADH = Supraoptic

Oxytocin = Paraventricular
Portion of Thalamus: Visual: Lateral Geniculate Nucleus
(LGN)

(Lateral for Light)
Portion of Thalamus: Auditory: Medial Geniculate Nucleus
(MGN)

(Medial for Music)
Portion of Thalamus: Body sensations - pressure, touch, vibration: Ventral Posterior Lateral
(VPL)

V = Vibration
P = Pressure
L = Light touch
Portion of Thalamus: Facial sensation: Ventral Posterior Medial
(VPM)

[Very Pleasant Mug (face)]
Portion of Thalamus: Motor: Ventral Lateral/Anterior nuclei
(VL/VA)

[Volumes of Lifting and Aerobics]
Major relay for ascending sensory info that ultimately reaches the cortex: Thalamus
Portion of the brain responsible for Feeding, Fighting, Feeling, Flight and F-cking: Using "LIMBS" for all 5 F's:

Limbic system
Portion of the brain tha is important for voluntary movements and making postural adjustments: Basal Ganglia
Where does the Direct and Indirect pathway of DA from Substantia Nigra go to first? Second? Third?: First:
both to Putamen

Second:
Direct (+) = Globus Pallidus Internal (GPi)
Indirect (-) = GPe

Third:
GPi -> Thalamus or Pedunculopontine nucleus in spine
GPe -> GPi or Subthalamic Nucleus (to GPi)
Numbered areas of Brain: 1. 1,2,3 2. 4 3. 6 4. 8: 1. Sensory

2. Motor

3. Premotor

4. Frontal eye fields
Numbered areas of Brain: 1. 17 2. 22 3. 41, 42 4. 44, 45: 1. Principal Visual cortex (occipital)

2. Assoc Auditory (Wernicke)

3. Primary Auditory

4. Motor Speech (Broca)
Lesion: lack of social judgement: Frontal lobe
Brain Vessel: Leg and foot area of the motor and sensory cortices; medial surface of the brain: Anterior Cerebral artery
Brain Vessel: supplies the trunk, arm and face of the motor and sensory cortices; Wernicke and Broca's areas; Lateral aspect of the brain: Medial Cerebral artery
Brain Vessel: may cause visual field defects; most common Circle of Willis aneurysm: Anterior Communicating artery
Brain Vessel: causes CN-3 palsy: Posterior Communicating artery
Brain Vessel: division of middle cerebral artery; "arteries of stroke"; supply internal capsule, caudate, putamen, globus pallidus: Lateral Striate
what would a stroke in the anterior part of the circle of willis give?: sensory and motor dysfunction;
aphasia
How would a stroke in the posterior part of the circle of willis present? (3): cranial nerve deficits, coma, ataxia
Main vein return of the CSF: Superior Sagittal sinus
what protects a clavical fracture from a brachial plexus injury?: Subclavius muscle
Initial sign of an acute appendicitis appears in what dermatome?: T-10

(at the belly butTEN)
what nerve refers gall bladder pain to the right shoulder?: Phrenic nerve
dermatome for the Inguinal Ligament: L1 = IL
what monitors muscle length? muscle tension?: Length = muscle Spindles

Tension = Golgi Tendon organs
What are the Thenar and Hypothenar muscles? (3 each): Thenar = Thumb
OAF (Oppose, Abduct, Flex)
POLLICIS

Hypothenar is pinky
OAF
DIGITI MINIMI
(4)* muscles that the Radial nerve innervates: BEST ("great extensor nerve"):

Brachioradialis;

Extensors of wrist and fingers;

Supinator;

Triceps
(3) Vagal Nuclei and their function (and any assoc CN): nucleus Solitarius = Sensory of viscera (incl taste)
CN-7, 9, 10

nucleus aMbiguus = Motor of pharynx and esophagus
CN-9, 10, 11

Dorsal Motor = Parasymp to heart, lungs and UGI
What cranial nerves have exits through the sphenoid bone?: CN-2 to CN-6
what cranial nerves pass through the Cavernous Sinus? (5): eye muscle nerves (CN-3, 4, 6)

and

V-1 and V-2
What vessel passes through the cavernous sinus? Which is the only "free floating" cranial nerve in the cavernous sinus?: Internal carotid

CN-6
Definition: takes venous blood from the eyes and superficial cortex to the internal jugular; also houses the pituitary: Cavernous sinus
(3) muscles that close the jaw: M = Munch:

Masseter;

teMoralis;

Medial pterygoid
muscle that lowers the jaw what are all muscles of mastication innervated by?: Lowers = Lateral pterygoid

Innervated: V-3
What are the "glossus" muscles innervated by?: all except PALATOglossus are innervated by the hypoGLOSSal nerve (Palat = vagus)

Palat = vagus
-glossus = hypoglossal
What are the "palat" muscles innervated by?: all except Tensor veli Palatini are innervated by the Vagus (Tensor = V-3)

Palat = Vagus

TENSor was too TENSE and is V-3
what innervates each of the eye muscles?: LR6 SO4 R3:

Lateral Rectus = CN-6

Superior Oblique = CN-4

Rest = CN-3
Movement of following eye muscles: 1. Superior Oblique 2. Superior Rectus 3. Inferior Oblique 4. Inferior Rectus: 1. DOWN nasal
2. up lateral
3. UP nasal
4. down lateral

Rectus = Lateral (like LR)
Oblique = Opposite direction
CN and nuclei involved in a normal pupillary light reflex: CN-3 -> Pretectile nuclei ->

Edinger-Westphal nuclei
Sounds and CN used to test: 1. palate elevation 2. tongue 3. lips: 1. Kuh-kuh (CN-10)

2. La-la (CN-12)

3. Mi-mi (CN-7)
Extraocular eye movements during REM is due to what area of the brain?: Paramedian Pontine Reticular Formation
(PPRF)
Aphasia w/ poor repitition and good comprehension; fluent speech: Arcuate Fasciculus

(connects Wernicke to Broca)
Dx: Hyperorality, hypersexuality, disinhibited behavior where is lesion?: Kluver-Bucy syndrome

lesion:
bilateral Amygdala
Where is lesion? Spacial neglect syndrome: Right parietal lobe
Where is lesion? Tremor at rest, chorea, athtosis: Basal Ganglia
Where is lesion? Truncal ataxia, dysarthria: Cerebellar Vermis

(Vermis is central and affects Central part of body)
Where is lesion? Coma: Reticular Activating system
what type of amyloid is w/ alzheimers? what chromosome/allele w/ familial form? (2): Beta-amyloid

Chrom 1, 14, 19 - APOE4 allele

Chrom 21 - p-App gene
Dx: dementia, aphasia, parkinsonian aspects what is sign/protein problem? where is problem in brain (lobes)?: Pick's Dz

Pick bodies = TAU protein

Frontal or temporal lobes only
MCC of dementia in elderly? 2nd MCC?: MCC = Alzheimers

2nd MCC = Multi-infarct dementia
Dx: chorea, dementia what part of brain is atrophied? what chromosome problem? what NT problem?: Huntington's Dz

CAG repeats on chrom 4 =
Caudate (C) loses ACh (A) and GABA (G)
Dx: Tremor at rest, Rigidity, Akinesia, Postural instability what is sign in brain?: Parkinson's
(TRAPped in body)

sign: Lewy Bodies
Dx: "floppy baby", tongue fasciculations, median age of death is 7 months where is problem?: Werding-Hoffmann Dz

prob: degeneration of Anterior horns
Dx: CSF has lymphocytic pleocytosis w/ slight protein elevation. Virus is recovered from stool or throat: Poliovirus
classic triad of Multiple Sclerosis: SIN:

Scanning speech;

Intention tremor / Incontinence

Nystagmus
Tx for MS: Beta-interferon
Dx: demyelinating dz seen w/ AIDS what virus?: Progressive Multifocal Leukoencephalopathy
(PML)

virus: JC virus
Dx: symmetric ascending muscle weakness due to demyelination of PNS; diplegia, CV irregularities; papilledema Causes (2): Gullian-Barre syndrome

causes:
Herpesvirus;
Campylobacter infection
Tx for Gullian-Barre (2): First line:
Respiratory support

also:
plasmapheresis
Seziure type: Consciousness intact: Simple Partial
Seziure type: Blank stare: Absent (Petite mal)
Seizure type: Quick, repetitive jerks: Myoclonic
Seizure type: Alternating stiffening and movement: Tonic-Clonic (Grand mal)
Seizure type: Stiffening: Tonic
Seizure type: "drop" seizures: Atonic
Intracranial hemorrhage: CT shows "biconcave disk" not crossing suture lines: Epidural hematoma

(middle meningeal artery)
Intracranial hemorrhage: CT shows crescent-shaped hemorrhage that crosses suture lines: Subdural hematoma

(bridging veins)
Intracranial hemorrhage: "worst HA of life", bloody spinal tap: Subarachnoid hemorrhage

(berry aneurysm)
(3) Dx assoc w/ berry aneurysms: APKD;

Ehlers-Danlos;

Marfan's
what are clinical presentations of brain tumors due to?: Mass effects

(seizures, dementia, etc)
MCC brain tumor in adult: Glioblastoma multiforme
Dx: "butterfly glioma" - can cross the corpus callosum: Glioblastoma Multiforme
Dx: "Pseudopalisading" tumor cells boarder the areas of necrosis and hemorrhage: Glioblastoma Multiforme
Dx: spindle cells concentrically arranged in whorled pattern of this brain tumor; psammoma bodies; arises from arachnoid cells; on surface: Meningioma
Dx: "fried egg" cells - round nuclei w/ clear cytoplasm in frontal lobes: Oligodendroglioma
Dx: childhood brain tumor; diffusely infiltrating; posterior fossa; Rosenthal fibers - eosinophilic corkscrew appearance: Pilocytic Astrocytoma
Dx: childhood brain tumor; rosettes or pseudorosettes; radiosensitive; neuroectodermal origin: Medulloblastoma
Dx: perivascular pseudorosettes; rod-shaped blepharoplasts; MC in ventricles: Ependymoma
Dx: childhood brain tumor w/ foamy cells and high vascularity what is it assoc with? what is the ectopic production?: Hemangioblastoma

assoc w: Von Hippel-Lindau

ectopic: EPO -> polycythemia
Dx: benign childhood tumor from Rathke's pouch and can cause bitemporal hemianopsia: Craniopharyngioma
Dx: Ipsilateral loss of all sensation; contralateral loss of pain and temp: Brown-Sequard syndrome
Dx: Ptosis, anhidrosis, miosis of face Can be associated w/ spinal cord lesion above what level?: Horners syndrome

(PAM is Horny)

w/ spine above T-1
Nerve w/ site of injury: Shaft of humerus: Radial
Nerve w/ site of injury: Supracondyle of humerus: Median
Nerve w/ site of injury: Medial epicondyle: Ulnar
Nerve w/ site of injury: Surgical neck of humerus: Axillary
Dx: loss of triceps brachii, brachioradialis, extensor carpi radialis longus: Radial nerve injury

(Radial = wRist drop)
Dx: no loss of power in any arm muscles; loss of forearm pronation, wrist flexion, finger flexion, several thumb movements, thenar atrophy: Median nerve injury

("Pope's Blessing" = cross in the median)
Dx: impaired wrist flexion and adduction, and impaired adduction of the thumb and last two fingers: Ulnar nerve injury

(Claw hand)
Dx: Anterior shoulder dislocation; loss of deltoid action: Axillary nerve injury
Dx: difficulty flexing elbow; loss of function of coracobrachialis, biceps, and brachialis muscles (and biceps reflex): Musculocutaneous nerve injury
Bracial plexus is assoc w/ what 5 spinal nerves?: C5, C6, C7, C8, T1
what is the order of the (5)* main nerves as they come off the brachial plexus (top to bottom)?: CAMel RUn:
musculoCutaneous;
Axillary;
Median;
Radial;
Ulna
Dx: limb hangs at side, medially rotated and forearm is pronated where is problem? what is common cause?: Erb-Duchenne Palsy
("Waiter's Tip")

C5 and C6 (upper trunk) injury

occurs as delivery trauma
What innervates the lateral and anterior foot?: PED = Peroneal Everts and Dorsiflexes

Deep Peroneal = Anterior

Superficial Peroneal = Lateral
What innervates the posterior foot and plantar flexes?: TIP = Tibial Inverts and Plantarflexes

(can't stand on TIPtoes)
what nerve corresponds to L3-L4?: Femoral
Dx: delivery causes atrophy of thenar, hypothenar and interosseous muscles, sensory deficit on medial forearm, dissapearance of radial pulse w/ movement of head to opposite side what is compressed? (2): Thoracic Outlet Syndrome

(Subclavian artery and inferior Trunk (C8, T1) of brachial plexus)
Which is the only sympathetic that secretes ACh?: Sweat gland
How do you tell where a CN-12 lesion is? (3 steps): 1. have person stick tongue out to determine if flaccid or spastic paralysis

2. look to which side it deviates

3. LMN (flaccid) deviates toward side of lesion; UMN (spastic) deviates away from side of lesion

(Lmn = Lick your wound (same side))
what/where is Deviation of CN-5 lesion?: Jaw towards lesion side
Test for unilateral lesion of cerebellum?: Rhomberg - patient falls Toward side of lesion
Deviation of CN-10?: Uvula deviates AWAY from side of lesion
Deviation of CN-11? (2): Shoulder droop on side of lesion

weakness on turning head to contralateral side
what (2) CN have UMN and LMN symptoms if there is a lesion?: CN-7

CN-12
which CN problem? Palatal sagging and vocal cord paralysis: CN-10
(4) nuclei associated w/ CN-9 which deals w/ the gag reflex?: Spinal V

Solitarius (tongue)

Inf. Salvitory (Parotid)

Ambiguus (gag reflex)
A tumor of the internal jugular at the petrosus temporal bone would have an effect on what CN?: CN-9, 10, 11
what ganglion / nerve does a right turn inside the skull?: Geniculate ganglion of the Facial nerve
Dx: brain tumor causing truncal ataxia, wide-based gait, projectile vomiting: Meduloblastoma
in a Webber hearing test, how do you tell what type of problem it is if the sound localizes to one side?: Ipsilateral = Conduction loss

Contralateral = Sensorineural loss
what is the specific ganglia for the tear-producing part of CN-7?: Pterygopalatine ganglion

(spit = submandibular gang)

(all 3 originally from Superior salivary nuclei)
how do you know if patient has UMN or LMN CN-7 lesion?: UMN - contralateral LOWER face only

LMN - Ipsilateral UPPER and LOWER face
(Bells Palsy)
what Dx can you see Bell's Palsy? (5)*: ALexander BELL w/ STD
AIDS;
Lyme dz;
Sarcoid;
Tumors;
Diabetes
Herniation syndromes: can compress cerebral artery: Cingulate herniation

(under falx)
Herniation syndromes: Coma and death can result when it compresses brainstem: Central Transtentorial herniation
Herniation syndromes: medial, temporal lobe herniation: Uncal
Herniation syndromes: herniates into foramen magnum: Cerebellar tonsillar
Dx: contrlateral hemiparesis, ipsilateral dilated pupil, ipsilateral gaze preference, caudal displacement of brainstem (Duret hemorrhages): Uncal herniation
where is lesion for a Left homonymous hemianopia: right optic tract
Where is the substantia nigra and VTA located?: Midbrain
how can you tell if CN-4 lesion is on the nerve or the nucleus?: Nerve = head-tilt away from lesion

Nucleus = head-tilt towards lesion
Dx: small irregular pupil that does not react to light but does to accomodation what to Dx is it seen in?: Argyll-Robertson the diabetic hooker w/ syphillis:

"Accomodates but does not react"

seen in:
Diabetes;
Syphillis
visual field defect: right temporal lobe lesion or Meyer's loop: Left upper quadrantic anopsia
visual field defect: right upper (cuneate) calcarine fissure: Left lower quadrantic anopsia
(w/ macular sparing)
visual field defect: right occipital lesion: Left hemianopia w/ macular sparing
Dx: person cannot move right eye to left lateral but can converge both eyes to center what muscle and CN involved? what Dx is it commonly seen in?: lesion of Medial Longitudinal Fasciculus (MLF)

(medial rectus palsy, normal w/ convergence; CN-3, CN-4)

MLF w/ MS
NT changes: Anxiety (3): Inc NE

Dec GABA

Dec 5-HT
NT changes: Depression (2): Dec NE

Dec 5-HT
NT changes: Alzheimer's: Dec ACh
NT changes: Huntington's Dz (2): Dec GABA

Dec ACh
If you shine a light in patient's right eye and both pupils constrict, then shine it in left eye and they both dilate, where is the lesion?: Left Retinal outflow tract of Optic nerve
Difference b/t MRI T1 and T2: T1 = Black water

T2 = white water
Order of deep cerebellar nuclei from lateral to midline (4)*: Dont Eat Greesy Food

D
E
G
F
In the cerebellum: where are the parallel fibers? Dendrites of Purkinje cells?: Parallel = Granular layer

Dendrites of Purkinje = Molecular layer
Bridge b/t thinking brain and emotional brain: Cingulate
regulates placement and memory: Hippocampus
Regulates reward system; important in drug addiction: Nucleus Accumbens
where is the most likely place of a lesion for Aphasia?: Temporal lobe
What is the electrolyte flow for depolarization of hair cells in the cochlea?: K+ into the cell depolarizes
What receptor measures steady pressure on the skin?: Ruffini endings
What receptor measures vibration on the skin?: Pacinian corpuscle
what tracts are in the Inferior (3), Middle (1) and Superior (2) cerebellar peduncles?*: DIBs On TVS in the PM:

Inferior - Dorsal (cord); vestiBulocerebellar; Olive

Superior - Tectocerebellar; Ventral

Middle - Pontocerebellar
when a person moves his head to the right, what happens in the semicircular canal? (2): both (R and L) bend away from the Kinocilium;

Cupula moves to opposite side
when light strikes the eye, what are the steps? (6): Light -> CIS changes to TRANS ->
Inc Rhodopsin -> Inc Transducin ->
Dec cGMP -> Dec Na+ -> Hyperpolarization
if nystagmus is a symptom of a cerebellar lesion, where is the lesion?: Flocculonodular lobe
what is the equation for intensity of hearing?: Intensity = 20 x log (sound/threshold)
what are two places in the ear that hear high-frequency sounds? example of a low-frequency place?: Base:

Oval window

Round window

(Apex - Helicotrema - hears low sounds)
what occurs with the biceps and triceps regarding Ia and Ib fibers when flexing the biceps?: Flex biceps:

Bicep -
Ia Dec firing (compressed);
Ib Inc firing (tension/contract);

Triceps -
Ia Inc firing (stretched);
Ib has no change

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Deck Info

Number of cards 243