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397 Cards in this Set
- Front
- Back
Circle of Willis
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LOOK AT IT!!!!!
-Vertebral Arteries > Basilar Artery > Posterior Cerebral Arteries (Continue) > Posterior Communicating Arteries > Internal Cartoid Arteries > Anterior Cerebral Arteries -Anterior Communicating Artery - Joins Anterior Cerebral Arteries -Middle Cerebral Artery (Internal Carotid) -Anterior Spinal Artery (Basilar or Vertebrals) -Posterior Inferior Cerebellar Arteries (Vertebral) -Anterior Inferior Cerebellar Arteries (Basilar) -Superior Cerebellar Arteries (Basilar) |
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Which Artery supplies the Anterior Circulation of the Brain? What are the main arteries of the Anterior Circulation of the Brain?
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-Internal Carotid
-ACA and MCA |
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Which Arteries supply the Posterior Circulation of the Brain?
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Vertebral and Basilar Arteries
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Where do the Anterior and Posterior Circulations of the brain meet?
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Circle of Willis
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What types of Disturbances would we expect to see with an ACA Lesion? Why? Which side?
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-Leg and Foot
-Homunculus -Contralateral |
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What types of Sensory and Motor (Homuncli) Disturbances would we expect to see with an MCA Lesion? Why? Which side?
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-Hand, Arms, Face
-Homunculus -Contralateral |
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What types of Disturbances would we expect to see with an PCA Lesion? Why? Which side?
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-Visual Disturbances
-Affecting the Occipital Lobe -Contralateral |
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The artery that supplies the Somatosensory cortex near the superior sagittal fissure is fucked up. Which artery is this? What types of problems would you expect?
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-Anterior Cerebral Artery
-Sensory Impairment (Parathesia or Anesthesia) involving CONTRALATERAL foot |
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A patient is experiencing sensory problems on the right side of his face. You suspect it is a problem with blood supply. Which artery is likely involved? Which side?
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-Middle Cerebral Artery
-Left Side |
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What is Locked-In Syndrome? A Lesion to which artery can cause this?
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-Patient is aware and awake
-Cannot move or Communicate due to complete paralysis of nearly all voluntary muscles in the body except for the eyes -Basilar Artery |
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A patient has interruption of Basilar Artery flow. What syndrome might they present with? What happens in this syndrome?
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-Locked-In Syndrome
-Patient is aware and awake -Cannot move or Communicate due to complete paralysis of nearly all voluntary muscles in the body except for the eyes |
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What is the Internal Capsule? What does it contain?
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-Sheet of White Matter Lateral to the Thalamus
-Contains Axons from the Corticospinal Tract (CST) |
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Which artery is responsible for supplying the Internal Capsule?
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MCA
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What is the Genu of the Internal Capsule? What are its fibers responsible for?
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-Bend
-Face |
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What are the Posterior Limb Fibers of the Internal Capsule responsible for?
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Lower Body
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-Falx Cerebri
-Falx Cerebelli -Tentorium Cerebelli |
-Falx Cerebri
-Falx Cerebelli -Tentorium Cerebelli |
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Slide 19 - Imaging Vasculature
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Slide 19 - Imaging Vasculature
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What are some easy ways to recognize the MCA in an image?
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-Huge
-Coming off the Internal Carotids -Going Laterally |
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If an individual has a visual loss due to ischemia in the left occipital lobe, what major artery is likely compromised?
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Left PCA
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Slide 24 - Give the Arteries
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Slide 25 - Answers
-A - MCA -B - ACA -C - Internal Carotid -D - Basilar |
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Given an Image on the final, which side is right and which side is left?
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Flipped from normal
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MRI on Slide 26
-Identify Structures -DON'T BE LAZY, GO LOOK AT THIS YOU PIECE OF SHIT |
Answers on Slide 27
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Where is the VPL found? VPL damage results in what type of deficits?
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-Thalamus
-Interrupts Somatosensory Pathway and may lead to loss of conscious sensation of the contralateral side of the body |
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What is just medial to the Thalamus? Lateral?
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-3rd Ventricle
-Internal Capsule |
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A stroke involving a Thalamogeniculate Artery will result in what?
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-Loss of Sensation from the Opposite side of the Body
-Episodes of Spontaneous, Excruciating Pain on the Opposite Side |
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A patient comes in with Paralysis of his right leg and foot. He also has some sensory impairment of leg and foot. Ischemia from which artery could be the cause?
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Left ACA
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You are about to see a patient with Ischemia of his ACA. What types of symptoms would you expect to see?
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-Paraesis or Paralysis of the Contralateral Leg and Foot
-Sensory Impairment Involving the Contralateral Leg and Foot |
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You are told that a patient's motor cortex for his upper body is experiencing ischemia. Which artery supplies this? What about for the lower body?
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-Upper Body - MCA
-Lower Body - ACA |
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A patient comes in with Paralysis of his left face, hand, arm. He also has some sensory impairment in the same locations. Ischemia from which artery could be the cause?
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Right MCA
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If there is an Infarct in the Left Superior Division of the MCA, what can result?
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Broca's Aphasia
-Expressive Aphasia -Related to Speech Production |
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If there is an Infarct in the Left Inferior Division of the MCA, what can result?
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Wernicke's Aphasia
-Receptive Aphasia -Related to Interpretation of Speech |
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What is Broca's Aphasia? An Infarct in which artery can lead to Broca's Aphasia?
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-Expressive Aphasia
-Difficulty saying what you want to say -Dysarthria - Slow, Labored Speech -Superior Division of Left MCA |
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What is Wernicke's Aphasia? An Infarct in which artery can lead to Wernicke's Aphasia?
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-Receptive Aphasia
-Deficit of Auditory Comprehension -Cannot monitor their own conversation -Inferior Division of Left MCA |
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A patient comes in with slow, dysarticulated speech. Their words are slurred and they are aware of their problem. What's wrong? Infarct of what artery may have caused this?
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-Broca's (Expressive) Aphasia
-Superior Division of Left MCA |
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A patient comes in with a deficient of auditory comprehension. They cannot monitor their conversation and they are unaware of their problem. What's wrong? Infarct of what artery may have caused this?
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-Wernicke's (Receptive) Aphasia
-Inferior Division of Left MCA |
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What is Gerstmann's Syndrome? How does it result? Which artery is involved? Where in the brain? What are some symptoms?
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-Lesion to Dominant (usually Left) Posterior Association Area
-Left MCA -Parietal Lobe -Finger Agnosia -Agraphia (can't write) -Alexia (can't read) -Agnosia (can't synthesize, correlate, or recognize multisensory perceptions) -Dyscalculia (problems with numbers) |
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A patient has a lesion to their Left Posterior Association Area in their Parietal Lobe. They exhibit finger agnosia, agraphia, alexia, agnosia, and dyscalculia. How old is Tom.
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7
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A patient has a lesion to their Left Posterior Association Area in their Parietal Lobe. They exhibit finger agnosia, agraphia, alexia, agnosia, and dyscalculia. What syndrome might they have?
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Gerstmann's Syndrome
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If a patient has language problems, what artery is likely affected? On which side? Why?
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-MCA
-Dominant (Usually Left) -Dominant side contains Language association areas |
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What will damage to the Posterior Association of the Dominant side lead to? Nondominant side?
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-Gerstmann's Syndrome
-Hemineglect, Constructional Apraxia (drawing), Awareness of Body Image, Anosognosia (Denial or lack of awareness that there is anything wrong) |
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You are told that a patient has a Problem with their Posterior Assocation Area in their Parietal Lobe on their nondominant side. Which artery is likely involved? What symptoms might you see?
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-Right MCA
-Hemineglect -Constructional Apraxia -Disturbances in the Awareness of the Body Image -Anosognosia - Denial or lack of awareness that there is anything wrong |
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Which artery provides Blood Supply to the Pons?
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Superior Cerebellar Arteries
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Which arteries provide Blood Supply to the Medulla?
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-Anterior Spinal Artery
-Posterior Inferior Cerebellar Arteries |
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What does the Corticospinal Tract (CST) do? Above the Caudal Medulla, what side?
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-Controls Body Movement
-Contralateral |
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What does the Dorsal Column Medial Lemniscus (DCML) do? Above the Caudal Medulla, what side?
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-Fine touch, proprioception, vibration--Contralateral
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What does the Spinothalamic Tract (STT) do? Above the Caudal Medulla, what side?
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-Crude touch, pain, and temperature
-Contralateral |
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Look at Slide 46 for Rostral Medulla Locations of:
-STT -DCML -CST -CN VIII -CN IX -CN X -CN XII |
GO FUCKING LOOK
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Where does the Vestibulocochlear Nerve (CN 8) emerge from?
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-Caudal Medulla on the Dorsal Side
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Where does the Glossopharyngeal (CN 9) emerge from?
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-Caudal Medulla on the Lateral Side
-Comes out near the Vagus Nerve (CN 10) and the STT |
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Where does the Vagus Nerve (CN 10) emerge from?
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-Caudal Medulla on the Lateral Side
-Comes out near the Glossopharyngeal Nerve (CN 9) and the STT |
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Where does the Hypoglossal Nerve (CN 12) emerge from?
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-Caudal Medulla on the Ventrolateral Side
-Fibers run along the Medial Lemniscus -Emerge near the CST |
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Which artery supplies the Medial Medulla?
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ASA
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If the Anterior Spinal Artery was occluded, which Spinal Tracts would be affected? Which side would the patient experience problems??
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-DCML and CST
-Contralateral Side |
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What the fuck does the Hypoglossal Nerve (12) do?
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Muscles of the Tongue
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A Patient comes in with tongue problems. They've been experiencing these problems for a long time and the muscles on the right side of their tongue seem to atrophied. The patient tells you that the problems started initially with paralysis of the right side of the tongue. What is the problem? Where? Which artery could be Involved?
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-Hypoglosal Nerve Nucleus or Tract Lesion
-Medulla -Anterior Spinal Artery |
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What is Medial Medullary Syndrome? How does it Occur? What is affected? What results?
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-Problems with Medial Medulla
-Anterior Spinal Artery Occlusion -Hypoglossal Nucleus or Nerve - Paralysis an Eventual Atrophy of the Tongue Ipsilateral to the Lesion -CST (Medullary Pyramids) - Paralysis of Contralateral Arm and Leg -Medial Lemniscus - Loss of Tactile Sense and Proprioception from Contralateral Arm and Leg |
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Which tracts are affected by Medially Medullary Syndrome? Which ones are not? What does this mean?
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-Hypoglossal Nerve, DCML, CST
-SST -Patient will still have crude touch, pain, and temperature sensation |
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What is another name for Lateral Medullary Syndrome?
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Wallenburg Syndrome
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What is another name for Wallenburg Syndrome?
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Lateral Medullary Syndrome
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What is Horner's Syndrome? How can it result? What other stuff happens? What artery could cause this?
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-Loss of Pupil Dilation on Ipsalateral Side
-Due to Descending Sympathetic Fibers being hit -Miosis, Ptosis, Anydrosis -PICA |
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A patient comes in with ptosis, miosis, and lack of sweating (anhydrosis). What is wrong? Which nerve fibers are involved? What artery is likely involved?
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-Horner's Syndrome
-Descending Autonomic Sympathetics on Ipsalateral Side -PICA |
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What is the Nucleus Ambiguas? Where is found?
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-A Motor Nucleus for CN9 and CN10
-Medulla - Next to STT |
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A patient has a Dysphagia, Dysarthia, and loss of gag reflex on the right side. Which cranial nerve(s) and nucleus/nuclei are involved? Which other tract might be involved due to its close proximity?
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-CN9 and CN10
-Nucleus Ambiguas -STT |
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A patient is experiencing hearing loss. Which cranial nerve is affected? Which artery might be involved?
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-CN8 - Vestibulocochlear
-AICA |
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Where does the Trigeminal Nerve (CN 5) Emerge?
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Lateral Pons
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Where does the Abducens Nerve (CN 6) Emerge?
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Ventromedial Pons
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Where does the Facial Nerve (CN 7) Emerge?
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Lateral Pons
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What does the Abducens Nerve (CN 6) do?
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Motor Innervation to Lateral Rectus
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LOOK AT SLIDE 51 for CN V, VI, VII, and VIII
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GOOOOOOO
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What are some things that can cause Locked-In Syndrome? In the Pons, what is Hit? What is Spared?
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-Bilateral Ventral Pontine Infarcts, Central Pontine Myelinolysis
-Hit - CST, Lower Corticobulbar, Abducens -Spared - Medial Lemniscus, STT, Spinal Trigeminal, Facial Motor |
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What is Central Pontine Myelinolysis? What can you notice on an MRI? What types of patients is it often associated with?
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-Demyelinating Condition associated with Rapid Correction of Hyponatremia
-Dark "I" in the Pons -Alcoholics, Malnourished, Transplant Patients |
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Lesion to the Facial Motor Nucleus or Nerve. What Results?
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Paralyzed Ipsalateral Face
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Lesion to the Abducens Nerve and Lateral Gaze Center. What Results?
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-Paralyzed Ipsalateral Eye with Loss of Lateral Gaze
-Loss of Ispalateral Conjugate Gaze |
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Lesion to the Medial Lemniscus that extends Anteriorly. Lesion is above the Caudal medulla. What Results?
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Loss of FIne Touch, Bivration, and Proprioception from CL body
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Lesion to the STT that extends medially and laterally. Lesion is above the caudal medulla. What Results?
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Loss of Paint and Temp from CL Face and Body
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Lesion to the main Trigeminal Nucleus that extends rostrally. What Results?
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Loss of Fine touch and Vibration of Ipsalateral Face
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Lesion to the Spinal Trigeminal Tract that extends laterally. What Results?
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Loss of Pain and Temp from Ipsalateral Face
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What is Nystagmus?
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Involuntary Eye Movement
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What is Involuntary Eye Movement known as?
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Nystagmus
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Lesion to Vestibular Division of CN8.
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-Vertigo
-Nystagmus |
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Lesion to Cochlear Division of CN8.
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-Tinnitus
-Hearing Loss |
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Lesion to Facial Nerve.
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-Facial Weakness
-Loss of Taste Sensation, Salivation, and Tearing, |
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Go Look at Slide 56!
-CST -Trochlear Nerve (CN 4) -Occulomotor Nerve (CN 3) |
-3 Comes out Anteriorly
-4 Crosses and goes Posteriorly |
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What the fuck does the Occulomotor Nerve do?
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-Parasympathetics - Pupillary Sphincter and Ciliary Muscles
-Eye Muscles |
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What does the Trochlear Nerve do?
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Superior Oblique Muscle
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Where is the lesion site for Weber Syndrome? What happens?
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-Oculomotor Nerve Palsy
-Contralateral Hemiparesis or Hemiplegia |
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A patient comes in with a Right Oculomotor Nerve Palsy. They also have Contralateral Hemiparesis or Hemiparesis. What do they have?
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Weber Syndrome
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Parinaud Syndrome Lesions. What results?
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-Compression on Posterior Midbrain
-Vertical Gaze Center - Loss of Vertical Gaze, Eyes deviate downward -Vergence Center - Nystagmas on Eye Convergence -Posterior Commissure and Tectum - Loss Pupillary light of response, possibly with accomodation intact |
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A patient comes in with loss of vertical gaze. They exhibit nystagmous on eye convergence. They also have lost their pupillary light response. What's wrong with them?
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Parinaud Syndrome
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Meninges
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Bad ass
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Look at slide 62 for hematomas
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Look at slide 62 for hematomas
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Describe an Epidural Hematoma.
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-Lens Shaped - Doesn't follow brain
-Middle Meningeal Artery |
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Describe a Subdural Hematoma.
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-Crescent Shaped - Follows Brain
-Tearing of the Bridging Veins |
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Describe a Sub-Arachnoid Hematoma.
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-"Worst Headache of my Life"
-Blood from Arteries within Pial Membrane -Caused by Head Trauma or Aneurysm |
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A patient comes in with a Texaco Star shaped pattern in their MRI of brain. What the fuck is going on?
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Sub-Arachnoid Hematoma
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A patient has CSF displaced into the spinal canal, blood volume is reduced in the brain, displacement of brain tissue
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Intracranial Mass
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What is CPP?
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That stupid class people took
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What is CPP? How is it calculated?
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-Cranial Perfusion Pressure
-CPP = MAP (Mean Arterial Pressure) - ICP (Intracranial Pressure) |
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What are the 2 major classes of herniation?
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Based on Tentorial Notch
-Supratentorial -Infratentorial |
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What is indicated by RBCs in the CSF? WBCs?
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-Subarachnoid Hematoma or Traumatic Spinal Tap
-Infection |
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A patient comes in and complains of head pain. You take a CSF sample and that shit looks cloudy. What do you suspect?
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Bacterial Meningitis
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What are the Non-Neuronal Cells in the PNS? What do they do?
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-Satellite Cells - Support Cell Bodies
-Schwann Cells - Secrete Neurotrophic Factors |
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What are the Non-Neuronal Cells in the CNS? What do they do?
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-Oligodendrocytes
-Astrocytes -Microglia - Scavengers -Ependymal - Form Barrier between Compartment |
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What does the CST do? Where are its Neurons? Describe the Path. Look at Slide 77 for location of tracts.
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-Motor
-UMN - In Motor Cortex, Crosses over at Caudal Medulla -LMN - Cell Body is in the Anterior Horn of the Spinal Cord |
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What happens with an UMN Lesion of the Hypoglossal Nerve? What happens with an LMN Lesion of the Hypoglossal Nerve? What does this mean?
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-Contralateral Atrophy and Deviation
-Ipsalateral Atrophy -UMN Crosses |
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Where are the Cell bodies of LMNs located?
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Anterior Horn of the SC
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What are Alpha Motor Neurons? Why are they called Alpha Motor Neurons?
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-LMNs
-Alpha Fibers are found on LMNs |
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What is a Fasciculation? What causes it?
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-Spontaneous Firing of a Motor Neuron
-LMN dying |
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What is a Deep Tendon Reflex?
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Stretch Reflex
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What happens with a LMN Lesion to Deep Tendon Reflexes? What happens with an UMN Lesion?
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-LMN - Hyporeflexia or Areflexia due to broken reflex circuit
-UMN - Hypereflexia |
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Muscle Spindle
-What happens when muscle is stretched? -What happens when muscle is contracted? |
-AP Frequency Increases
-Alpha + Gamma Neuron Coactivation (Tightens Spindle to continue detection) |
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What types of shit will you see with an UMN if its Acute? Chronic?
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-Acute - Flaccid Paralysis
-Chronic - Hyperreflexia |
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What is a Clonus?
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Rapid Alternating Contraction/Relaxation of a stretched muscle
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What is Clasp Knife Rigidity? How does it work? What time of damage might be suspected?
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-Describes resistant to passive movement of a joint when spasticity is present
-Muscles first resistant to the Movement (due to increased DTR) -Resistance melts away rapidly (GTO-based reflex kicks in) -Chronic UMN Damage |
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If a patient comes in and has a tough time initially moving their muscles that slowly melts away, what is this called? What type of damage would you expect?
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-Clasp Knife Rigidity "Spastic Catch"
-Chronic UMN damage |
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What is ALS? What happens in ALS? What are some symptoms? Who is typically affected?
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-Amyotrophic Lateral Sclerosis
-Progressive Degeneration of CSTs and Alpha Motor Neurons (Both UMNs and LMNs) -Symmetric gait disturbance, limb weakness, change in reflexes -Older patients |
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You have a new patient who is older. He complains of symmetric gait disturbance, limb weakness, and change in reflexes. He also has dysarthia and dysphagia with respiratory complications. What do you suspect?
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Amytrophic Lateral Sclerosis (ALS)
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Describe an Epidural Hematoma.
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-Lens Shaped
-Doesn't go into Grooves -Tearing of Middle Meningeal Artery |
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Describe a Subdural Hematoma.
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-Tearing of the Bridging Veins
-Crescent-Shaped -Follows grooves of brain |
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Describe a Sub-Arachnoid Hematoma
|
-"Worst headache of my life"
-Blood in the CSF -Arteries within the Pial Membrane |
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What are the major causes of Neuropathy?
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-Diabetes
-Alcohol |
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What is going on In Guillain-Barre Syndrome?
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-Inflammatory Neuropathy
-Acute Paralytic Illness |
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What is a Polyradiculoneuropathy?
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Neuropathy that affects Nerve Roots
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What is a Neuropathy?
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Functional Disturbances and/or pathological changes in the PNS
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What type of Neuropathy is Carcot-Marie-Tooth Disease? How does a patient present?
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-Hereditary
-Pes Cavus - High Plantar Arches with Hammer Toes and Atrophy of Foot Muscles -Stork Leg (Inverted Wine Bottle) due to Weakness/Wasting in Lower Leg and Foot -Foot Drop and Stepped Gait |
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A patient walks in Pes Caveus (High Plantar Arches and weak foot muscles), weak legs, and their foot looks like an inverted wine bottle (Stork Leg). What do they probably have?
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Charcot-Marie-Tooth Disease
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What is an Acoustic Neuroma? What symptoms would a patient with this shit have?
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-Vestibular Schwannoma
-Tinnitus and Hearing Loss |
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Presynaptic Disorders are usually caused by what? What are they characterized by?
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-Decrease in ability to release NT or Uncontrolled release of NT
-Warm Up Phenomenon |
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You suspect that a patient has a Disorder of NMJ. They exhibit warm up phenomenon which is characterize of what type?
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Presynaptic
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Postsynaptic disorders are usually caused by what? What are they characterized by?
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-Decrease in Availability of ACh on Motor Endplate
-Fatigueability |
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What causes Lambert-Eaton Myasthenic Syndrome (LEMS) ? What are the symptoms associated with it? What is the treatment for it?
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-Prevents Calcium entry and NT Release
-Autoimmune Disorder - Abs against VCCCs -Symptoms - Muscle weakness, fatigue, diminished reflexes, autonomic dysfunctions -Treatment - Plasmaphoresis to remove IgGs, suppress immune system, treat tumor |
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You are told about a patient who has a difficult time with calcium entry and NT release. He was muscle weakness and fatigue.
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LEMS - Lambert-Eaton Syndrome
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What type of disorder is LEMS? What about is Myasthenia Gravis?
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-Presynaptic
-Postsynaptic |
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What the fuck is going on in Myasthenia Gravis?
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-Muscle Weakness
-Due to Abs against AChR Receptos -Increased Degradation of Receptors |
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A patient produces Abs to his ACh Receptors. What disorder does he have?
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Myasthenia Gravis
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At what level do CN 3 and 4 emerge? Which side? Which side do they Innervate?
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-Midbrain
-3 - Anterior, Ipsalateral -4 - Posterior, Contralateral |
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Which Cranial Nerve Emerges at the Level of the Midbrain and does Contralateral Innerveration
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Trochlear Nerve (CN 4)
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What are the only 2 Cranial Nerves that do Contralateral Innervation?
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Optic and Trochlear
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Which Cranial Nerves Emerge at the Level of the Pons?
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5, 6, 7 (maybe 8)
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Which Cranial Nerves Emerge at the Level of the Medulla?
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9, 10 , and 12
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What is the Edinger Westphal Nucleus? Where is it found?
|
-Parasympathetic Nucleus for CN III
-Medial to the Occulomotor Nucleus in the Midgrain |
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What is the Parasympathetic Nucleus for the Occulomotor Nerve? Where is found?
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-Edinger-Westphal Nucleus
-Midbrain |
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Where is the Abducens Nucleus located?
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Medial Pons
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Where is the Nucleus Ambiguus? Which Cranial Nerves are involved?
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-Medial Medulla
-9 and 10 |
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Where is the Nucleus of the Solitary Tract? Which Cranial Nerves are involved?
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Sensory Nucleus of 8, 9, and 10
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What is the Nucleus that controls sensory innervation of 8, 9, and 10?
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Nucleus of Solitary Tract
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Which nucleus is responsible for parasympathetic innervation of CN 9 and 10?
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Nucleus Ambiguus
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What types of Symptoms would you expect with a Cranial Nerve 4 Lesion?
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-Difficulty walking down steps
-Double Vision -Come in with a head tilt |
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A patient comes in with double vision, head tilted, difficulty walking down steps. What do you suspect?
|
Trochlear Nerve Lesion
|
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What types of Symptoms would you expect with a CN III Compression?
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-Eye Down and Out - Can't counter Lateral Rectus and Superior Oblique
-Dilated Pupil - Loss of Parasympathetics -Eyelid Droop |
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A patient comes in with their left eye looking down and out and it stuck in this position. Their pupils are dilated, and their eyelid is drooped. WTF is going?
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CNIII Compression
|
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Which Cranial Nerves are responsible for taste sensation?
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-Glossopharyngeal Nerve (9) - Posterior 1/3 of Tongue
-Facial Nerve (7) - Anterior 2/3 of Tongue |
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Which Cranial Nerve is responsible for Taste Sensation to the Posterior 1/3 of the Tongue?
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Glossopharyngeal Nerve 9
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Which Cranial Nerve is responsible for Taste Sensation to the Anterior 2/3 of the Tongue?
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Facial Nerve 7
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What would you expect to happen due to a CN III Lesion?
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-Eye would be Down and Out (ABducted)
-Ptosis -Pupil Dilation |
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A patient has a dilated and unresponsive pupil What is this a sign of?
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Occulomotor Nerve Compression
|
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Which Cranial Nerve is most susceptible to problems due to increased ICP?
|
Abducens Nerve (CN6)
|
|
Describe the function of the MLF during looking left.
|
The Left Abducens Nuclei causes the Left Lateral Rectus to ABduct. Fibers from the right MLF (named for where it goes) connect to the right Occulomotor Nerve which causes the Right Medial Rectus to ADduct.
|
|
What is found in the PPRF (Paramedian Pontine Reticular Formation)?
|
Abducens Nucleus and MLF
|
|
If the Right MLF is damaged, what would you expect? What is this called?
|
-Loss of Conjugate Eye movement. The Right eye cannot ADduct.
-INO |
|
What is INO (Internuclear Opthalmoplegia)? How does it happen?
|
-DIsorder of Conjugate Gaze
-MLF Lesion |
|
A dinosaur walks into your office. He tells you that all of his internal anatomy above his head is human. He has a difficult time looking at you (down and in). What do you suspect?
|
Trochlear Nerve Lesion
|
|
What is responsible for Voluntary Saccades? Which side?
|
-Frontal Eye fields and Superior Colliculi
-Contralateral |
|
What is a saccade?
|
quick, fast eye tracking like
|
|
Voluntary Saccades
|
Contralateral FEF
|
|
What is the Vestibulo-Ocular (VOR) Reflex? What function does it serve?
|
-Vestibular Nuclei Input
-Generates Eye Movements Equal and Opposite to Head Movements -Keeps Images steady during head movement? |
|
What reflex helps us keep images steady during eye movement? How?
|
-VOR (Vestibulo-Ocular Reflex)
-Generates Eye Movements Equal and Opposite to Head Movements |
|
You brush a patients eye with a q-tip. What happens? What is this reflex called?
|
-Corneal Reflex
-Sensory - Opthalmic Division (V1) of the Trigeminal Nerve (V) -Motor - Branch of Facial Nerve (VII) which causes contraction of the orbicularis Oculi muscles |
|
Describe the Corneal Reflex.
|
-Sensory - Opthalmic Division (V1) of the Trigeminal Nerve (V)
-Motor - Branch of Facial Nerve (VII) |
|
What is Bells Palsy? How does it happen? How might it happen?
|
-Loss of Muscles of Facial Expression
-Facial Nerve -HSV-1 |
|
Patient has loss of muscles of facial expression. What might they have? What is this caused by?
|
-Bell's Palsy
-Facial Nerve |
|
What results from a UMN Lesion of the Facial Nerve? Why? What about a LMN lesion?
|
-Contralateral Effects on the Lower Quadrant only - Upper Quadrant is controlled bilaterally from the cortex
-Ipsilateral Effects |
|
What are the shared functions of Glossopharyngeal and Vagus Nerves?
|
Speech and Swallowing
|
|
Which 2 Nerves are Involved in the Gag Reflex? Which Nucleus?
|
-9 and 10
-Nucleus Ambiguus |
|
What is the DCML responsible for? Go through all the neurons.
|
-1 - Dorsal Root Ganglion, Ascend in the Fasciculus Gracilis
-2 - Nucleus Gracilis in the Caudal Medulla, Internal Arcuate -3 - VPM of Contralateral Thalamus. Projects to the SS Cortex |
|
LOOK at SLIDE 140 for DCML!!!!!
|
GOOOOOOO
|
|
What is the Romberg Test?
|
Close eyes, see if they fall
|
|
What causes a positive Romberg test?
|
DCML problem
|
|
Describe the STT Neurons.
|
-1 - Dorsal Root Ganglion. Goes up or down a 1-2 levels
-2 - Dorsal Horn of SC. Cross at Anterior White Commissure, Ascend in CTT -3 - VPL of Contralateral Thalamus, projects to Contralateral SS Cortex |
|
What is the DCML responsible for? Go through all the neurons.
|
-1 - Dorsal Root Ganglion, Ascend in the Fasciculus Gracilis
-2 - Nucleus Gracilis in the Caudal Medulla, Internal Arcuate -3 - VPM of Contralateral Thalamus. Projects to the SS Cortex |
|
LOOK at SLIDE 140 for DCML!!!!!
|
GOOOOOOO
|
|
What is the Romberg Test?
|
Close eyes, see if they fall
|
|
What causes a positive Romberg test?
|
DCML problem
|
|
Read Slide 158
|
No Sympathetics in the brain. Come from lower. Pupil Dilation is Sympathetic. Patient will have Miosis (Pupil Constriction)
|
|
What is Horner Syndrome?What are some symptoms?
|
-Damage to Sympathetic Out-flow to the face.
Loss of Sweating Pupil Constriction Lid Droop |
|
What is Syringomyelia? What are some typical findings?
|
-Damage to Central Cavity of SC
-Bilateral loss of Pain and Temperature Sensation - Due to STT crossing at Anterior White Commissure |
|
What does the Basal Ganglia do?
|
Selection and Suppression of Movements
|
|
How does the Basal Ganglia Increase Motor Output?
|
-DIrect Pathway
-Decreases Basal Ganglia Output -Increases Thalamic Activity |
|
How does the Basal Ganglia Decrease Motor Output?
|
-Indirect Pathway
-Increases Basal Ganglia Output -Decreases Thalamic Activity |
|
What is the Basal Ganglia's effect on the Thalamus?
|
Inhibitory
|
|
What goes wrong in Parkinsons? What are some symptoms?
|
-Loss of Da Producing Neurons in Substantia Nigra
-Parkinson's patients are TRAPD -Tremor (resting) -Rigidity -Akinesia (Hypokinesia, Bradykinesia) -Posteral Instability (Flexed Posture, Festinating Gate) -Dementia |
|
A patient exhibits all of the following. What do they have?
-Tremor (resting) -Rigidity -Akinesia (Hypokinesia, Bradykinesia) -Posteral Instability (Flexed Posture, Festinating Gate) -Dementia |
Parkinson's
|
|
Which pathway is disrupted in Parkinson's? What types of Neurons?
|
-Nigro-Striatal Pathways
-Dopamine Neurons |
|
Drug Induced Parkinsons involved what drug?
|
MPTP - Synthetic Heroine COntaminant
|
|
What is Huntington's Disease? How does it result? What are its effects?
|
-Inherited disease of the CNS
-Degeneration of the Caudate and Putamen -Progressive Dementia and Involuntary Choreic Movements |
|
What causes the Dementia in Huntingtons?
|
Degeneration of Neurons in the Cerebral Cortex
|
|
What causes the Chorea in Huntingtons?
|
Degeneration of the Basal Ganglia
|
|
Patient has Dementia, Cognitive Personality Changes, and Chorea. What the fuck is their problemsssss?
|
Huntingtons
|
|
What will the brain of a Huntington's patient look like?
|
Decreased Caudate, Putamen, and Cerebral Volume with Increased Ventricles
|
|
What is Hemiballismus? What causes it?
|
-Unintentional, Forceful Flinging Movements of the arms and leg
-STN Hit |
|
What is Unintentional, Forceful Flinging Movements of the arms and leg?
|
Hemiballismus
|
|
STN Hit + Unintentional Forceful flinging movements = what?
|
Hemiballismus
|
|
What is Dystonia?
|
-Persistence of a Postural Abnormality
-Sustained Posture or Position of any part of the boyd |
|
What is Wilson Disease a disorder of? What is affected? What is its hallmark? What can result?
|
-Disorder of Copper Metabolism
-Affects Brain and Liver -Kayser-Fleischer Ring (Copper Colored Ring) around the Cornea |
|
Disorder of Copper Metabolism affecting brain and liver.
|
Wilson Disease
|
|
What are the Normal functions of the Cerebellum?
|
-Execution of Planned Motor Acts
-Establishes direction, timing, and force of planned motor acts -Compares intended movements with ongoing movement -Involved in motor learning |
|
Which brain structure is involved in the following:
-Execution of Planned Motor Acts -Establishes direction, timing, and force of planned motor acts -Compares intended movements with ongoing movement -Involved in motor learning |
Cerebellum
|
|
If a patient has a cerebellar dysfunction, on which side will their symptoms manifest?
|
Ipsalateral
|
|
What are some symptoms of Cerebellar Dysfunction?
|
-Intention Tremor
-Disequilibrium - Loss of balance, gate and trunk dystaxia -Dyssnergia - loss of coordination, nystagmus |
|
A patient comes in exhibit all of the symptoms below. Which brain structure might be malfunctioning?
-Intention Tremor -Disequilibrium - Loss of balance, gate and trunk dystaxia -Dyssnergia - loss of coordination, nystagmus |
Cerebellum
|
|
Which part of the Cerebellum is selectively damaged in alcoholics? What symptoms result?
|
-Vermis
-Gait Ataxia without Limb Ataxia |
|
Gait Ataxia without Limb Ataxia
|
Vermis Cerebellum David Wong
|
|
Monkey
|
Banana
|
|
Which part of the Cerebellum is selectively damaged in alcoholics? What symptoms result?
|
-Vermis
-Gait Ataxia without Limb Ataxia |
|
Gait Ataxia without Limb Ataxia
|
Vermis Cerebellum David Wong
|
|
Monkey
|
Banana
|
|
Where in the brainstem do Serotenergic pathways originate from?
|
Raphe Nuclei
|
|
Where in the brainstem do NE pathways originate from?
|
Locus Ceruleus and Lateral Tegmental Area
|
|
Where in the brainstem do Dopaminergic pathways originate from?
|
SNc (Substania Nigra Compacta) and VTA (Ventral Tegmental Area)
|
|
What is an EEG? What does in measure? What types of stuff is it usually used for?
|
-Electroencephalogram
-Cortical Activity -Sleep States and Seizure evaluation |
|
What does a Normal EEG taken from a quiet, awake individual look like?
|
Asynchronous, Low Voltage, Fast Activity
|
|
How many different stages of sleep are they? How are they characterized on an EEG?
|
-1 - Theta Rhythms
-2 - Sleep Spindles -3 and 4 - Delta Rhythms -5 - REM Sleep - Beta Rhythm, which is characteristic of a waking state |
|
Which stage (#) is REM sleep? What type of sleep rhythm is seen? What is this characteristic of?
|
-5
-Beta Rhythm -Waking State |
|
In which stage of sleep does dreaming typically occur?
|
REM
|
|
Why do you only go through all the sleep stages once when you sleep?
|
You usually don't. You usually go through them multiple times since you sleep more than 2 hours a night.
|
|
Why is REM Sleep called "Paradoxical Sleep"?
|
Because in some ways REM Sleep is deeper than stage 4 sleep but in others it closely resembles the awake state
|
|
During which stage of sleep is Sleep-Walking typically seen? Which stage (#) is this?
|
-Deep Slow Wave Sleep (SWS)
-3 and 4 |
|
What are the names of each stage of sleep?
|
-1 - Drowsy Sleep
-2 - Light Sleep -3 and 4 - Deep Slow Wave Sleep -5 - REM Sleep |
|
What is Insomnia?
|
Can't Sleep or fall asleep
|
|
What are some causes of Insomnia?
|
-Anxiety, Depression, STRESS, Pain
-Fear of David Wong -Side effects of meds, alcohol, poor sleep habits -Disruption of circadian rhythms? -Age? |
|
What are some effects that result from insomnia?
|
-Problems with Memory and Concentration
-Potential Link with CV Disease -4x Increase in Likelihood of Depression -Impaired Job and Home Performance |
|
A patient exhibits all of the following. What might they be suffering from?
-Problems with Memory and Concentration -Potential Link with CV Disease -Depression -Impaired Job and Home Performance |
Insomnia
|
|
What is Obstructive Sleep Apnea? What happens? What can cause it?
|
-Brief Periods of Interrupted Breathing During Sleep
-Woken up all the fucking time during sleep -Overweight, Heavy Snoring |
|
What is Narcolepsy? What causes it?What are some symptoms?
|
-Enter REM SLeep Directly from the Waking State
-Loss of Orexin (Hypocretin) -EDS - Excessive Daytime Sleepiness -Cataplexy - Sudden loss of muscle tone in awake state -Hallucinations while falling or awakening from sleep -Sleep Paralysis |
|
Loss of Orexin can lead to what?
|
Nacrolepsy
|
|
What is Cataplexy? Which disorder is it associated with?
|
-Sudden Loss of Muscle Tone in awake state
-Narcolepsy |
|
What are the Ascending Pathways of the Reticular System Associated with? Descending Pathways?
|
-Attention, Arousal, and Consciousness
-Motor, Reflex, and Autonomic Function |
|
Which pathways of the Reticular Formation are associated with the following:
-Attention -Arousal -Consciousness |
Ascending Pathways
|
|
Which pathways of the Reticular Formation are associated with the following:
-Motor Function -Reflex Function -Autonomic Function |
Descending Pathways
|
|
What are the Functions of the Reticular Formation?
|
-Activates the Cerebral Cortex (Arousal and Wakefulness)
-Integrates Cranial Nerve Reflexes -Modulates Pain (Intrinsic Analgesic System) -Influences Voluntary Movements -Regulates Autonomic Nuclei -Integrates Respiration and Sleep |
|
Which brain structure is responsible for the following:
-Activates the Cerebral Cortex (Arousal and Wakefulness) -Integrates Cranial Nerve Reflexes -Modulates Pain (Intrinsic Analgesic System) -Influences Voluntary Movements -Regulates Autonomic Nuclei -Integrates Respiration and Sleep |
Reticular Formation
|
|
What 3 things are involved in consciousness?
|
Alertness
Attention Awareness |
|
What causes the Persistent Vegetative State? What is lacking?
|
-Severe, Diffuse Cerebral Cortical Damage with Brainstem Function Intact ("Cerebral Death")
-No Evidence of awareness, responsiveness, or interaction with environment |
|
What the fuck is going on in a Coma? What can cause it?
|
-Unconscious
-NOT Sleep, Fainting/Syncope, Innattention -Diffuse Axonal Injury |
|
What is the Decorticate Posture in Coma? How does it result?
|
-Arms up and chest
-Damage above the Red Nucleus |
|
What is the Decerebrate Posture in Coma? How does it result?
|
-Arms down
-Damage below the Red Nucleus - Rubrospinal Tract (Flexor Bias ) is now Offline |
|
Based on the information that the Decorticate and Decerebrate postures result from damage above and below (respectively) the red nucleus, what type of shit is the red nucleus likely contain?
|
Descending Motor Pathways
|
|
What is the Reticulospinal Tract involved in?
|
-Motor Tract
-Feed forward -Extensor Bias |
|
What is the Vestibulospinal Tract involved in?
|
-Motor Tract
-Feedback adjustments -Arm and Leg Extension Bias -Damage Seen in Decerebrate Rigidity |
|
Which tract is likely cut during Decerebrate position? How do you know this?
|
-Rubrospinal Tract
-Arm and Leg Extension Bias in the Tract -Dr. Best's slides said so |
|
Which tract?
-Motor Tract -Feed forward -Extensor Bias |
Reticulospinal
|
|
Which tract?
-Motor Tract -Feedback adjustments -Arm and Leg Extension Bias -Damage Seen in Decerebrate Rigidity |
Vestibulospinal Tract
|
|
Glasgow Coma Scale
|
-3 - out
-3-8 - Severe Head Injury, Coma -9-12 - Moderate Head Injury -13-15 - Mild Head Injury |
|
If a patient has absence of Grimacing or Eye Opening, which Cranial Nerves might you suggest a problem with?
|
Afferent 5 (Trigeminal)
Efferent 7 (Facial) |
|
If a patient has absence of the Corneal Reflex, which Cranial Nerves might you suggest a problem with?
|
5 and 7
|
|
If a patient has absence of the Light Reflex, which Cranial Nerves might you suggest a problem with?
|
2 and 3
|
|
If a patient has absence of the Oculovestibular Response, which Cranial Nerves might you suggest a problem with?
|
3, 4, 6, 8
|
|
If a patient has absence of their Gag Reflex, which Cranial Nerves might you suggest a problem with?
|
9 and 10
|
|
Based on the information that the Decorticate and Decerebrate postures result from damage above and below (respectively) the red nucleus, what type of shit is the red nucleus likely contain?
|
Descending Motor Pathways
|
|
What is the Reticulospinal Tract involved in?
|
-Motor Tract
-Feed forward -Extensor Bias |
|
What is the Vestibulospinal Tract involved in?
|
-Motor Tract
-Feedback adjustments -Arm and Leg Extension Bias -Damage Seen in Decerebrate Rigidity |
|
Which tract is likely cut during Decerebrate position in coma? How do you know this?
|
-Vestibulospinal
-Arm and Leg Extension Bias in the Tract -Dr. Best's slides said so |
|
Which tract?
-Motor Tract -Feed forward -Extensor Bias |
Reticulospinal
|
|
Which tract?
-Motor Tract -Feedback adjustments -Arm and Leg Extension Bias -Damage Seen in Decerebrate Rigidity |
Vestibulospinal Tract
|
|
Based on the information that the Decorticate and Decerebrate postures result from damage above and below (respectively) the red nucleus, what type of shit is the red nucleus likely contain?
|
Descending Motor Pathways
|
|
What is the Reticulospinal Tract involved in?
|
-Motor Tract
-Feed forward -Extensor Bias |
|
What is the Vestibulospinal Tract involved in?
|
-Motor Tract
-Feedback adjustments -Arm and Leg Extension Bias -Damage Seen in Decerebrate Rigidity |
|
Which tract is likely cut during Decerebrate position in come? How do you know this?
|
-Rubrospinal
-Arm and Leg Extension Bias in the Tract -Dr. Best's slides said so |
|
Which tract?
-Motor Tract -Feed forward -Extensor Bias |
Reticulospinal
|
|
Which tract?
-Motor Tract -Feedback adjustments -Arm and Leg Extension Bias -Damage Seen in Decerebrate Rigidity |
Vestibulospinal Tract
|
|
Glasgow Coma Scale
|
-3 - out
-3-8 - Severe Head Injury, Coma -9-12 - Moderate Head Injury -13-15 - Mild Head Injury |
|
If a patient has absence of Grimacing or Eye Opening, which Cranial Nerves might you suggest a problem with?
|
Afferent 5 (Trigeminal)
Efferent 7 (Facial) |
|
If a patient has absence of the Corneal Reflex, which Cranial Nerves might you suggest a problem with?
|
5 and 7
|
|
If a patient has absence of the Light Reflex, which Cranial Nerves might you suggest a problem with?
|
2 and 3
|
|
If a patient has absence of the Oculovestibular Response, which Cranial Nerves might you suggest a problem with?
|
3, 4, 7
|
|
If a patient has absence of their Gag Reflex, which Cranial Nerves might you suggest a problem with?
|
9 and 10
|
|
If someone shoots cold water in your right ear what normally happens? Due to what reflex? What happens if there is bilateral compromise of the reflex? How is this tested?
|
-Brain thinks you turned your head left
-Eyes move right and then return to middle -Vestibulo-Ocular Reflex -Eyes and Head go the same way -Calorics testing |
|
What does Calorics testing test?
|
-VOR
-Water in Ear - Left Ear as example -Cold Water - Brain interprets as head movement away from cold water (to the right); Eyes move left and then back to midline -Warm Water - Brain interprets as head movement toward warm water (to the left); Eyes move right and then back to midline |
|
What is the normal response to cold water in the left ear? What about warm water?
|
-Cold - Brain thinks you turned your head to the right. Result - Saccade back to left
-Warm - Brain thinks you turned your head to the left. Result - Saccade back to right |
|
If 1 Eye does not ADduct on Spontaneous Eye Movements or in response to Reflex Maneuvers, what type of lesion would you suspect?
|
MLF
|
|
How can you tell the difference between brain death and coma?
|
Presence of Brainstem reflexes
|
|
What is a Simple Partial Seizure? How do they occur? What are some symptoms?
|
-Small but Local Progress to Generalized Vague Locations
-Aura-Auditory or Visual Hallucinations -Emotional Experience -Legs or face may Twitch -DOES NOT IMPAIR CONSCIOUSNESS |
|
How long is conscious lost for in a Simple Partial Seizure?
|
It isn't lost
|
|
What happens in a Complex Partial Seizure? What is affected? What are some symptoms
|
-ALTERED CONSCIOUSNESS
-Psychomotor or Temporal Lobe -Sensory, Motor and ANS Symptoms -Blank stare, Confusion, no recollection of seizure |
|
What is the main difference between a Simple and Complex Partial Seizure?
|
Loss of Consciousness in Complex
|
|
Different types of Generalized Seizures - Describe:
-Absence (petit mal) -Myclonic -Tonic Clonic -Atonic |
Different types of Generalized Seizures - Describe:
-Absence (petit mal) - Occur in children, last seconds, loss of activity and not responsive -Myclonic - Large jerky movements -Tonic Clonic - Alternating Intense Contraction and Relaxation, Hoarse cry out, confused, sore -Atonic - Drop attacks |
|
Which type of Generalized Seizure is described?
1) Alternating Intense Contraction and Relaxation, Hoarse cry out, confused, sore 2) Drop attacks 3) Occur in children, last seconds, loss of activity and not responsive 4) Large jerky movements |
1) Tonic Clonic
2) Atonic 3) Absence (petit mal) 4) Myclonic |
|
What does "Generalized" in Generalized Seizure refer to?
|
-Seizure of both hemispheres
-Not local |
|
Where do Sympathetics come off the CNS?
|
T1-L2
|
|
Where do Parasympathetics come off the CNS?
|
CNS and S2-S4
|
|
Describe the Preganglionics and Postganglionics in the Sympathetic Nervous System. Length? NT? Synapse?
|
Preganglionics
-Short -ACh -In Ganglia Postganglionics -Long -NE (usually) -Target Organ |
|
Describe the Preganglionics and Postganglionics in the Parasympathetic Nervous System. Length? NT? Synapse?
|
Preganglionics
-Long -ACh -On Organ Postganglionics -Short -ACh -Target Organ |
|
What NT is typically used in Somatic Motor Neurons? What type of receptor
|
-ACh
-Nicotinic |
|
What type of Receptor do Preganglionic Sympathetics act on? Postganglionics?
|
-Preganglionic - Nicotinic
-Postganlgionic - Adrenergic |
|
What type of Receptor do Preganglionic Parympathetics act on? Postganglionics?
|
-Preganglionic - Nicotinic
-Postganlgionic - Muscarinic |
|
Describe the different components of Urinary Bladder Control and what each one does.
|
-Pontine Micturition Center (via Reticulospinal Tract) - General Coordination, like UMN
-Sympathetic (T10-L2) - Stop Pee -Parasympathetics (S2-S4) - Pee -Somatic Motor (S2-S4) - Stop Voluntarily |
|
What role does the Pontine Micturition Center play in Urinary Bladder Control? How?
|
-General Coordination, like UMN
-via Reticulospinal Tract |
|
What role do Sympathetics play in Urinary Bladder Control? Where do they come from?
|
-Stop Peeing
-T10-L2 |
|
What role do Paraympathetics play in Urinary Bladder Control? Where do they come from?
|
-Pee
-S2-S4 |
|
What role do Somatic Motor Fibers play in Urinary Bladder Control? Where do they come from?
|
-Stop Voluntarily
-S2-S4 |
|
What is Lower Motor Neuron Bladder? What causes it? Why? What results?
|
-Nonreflex or Autonomous Bladder
-Sacral Spinal Cord or Cauda Equina Lesion (Similar to LMN) -No Parasympathetic to start Peeing -Urinary Retention - Fills to Max Capacity and then Dribbles -Overflow Incontinence |
|
A patient comes in complaining about peeing. They feel pressure in their bladder and when they pee, they only pee a little bit. What the fuck is going on? Why?
|
Lower Motor Neuron Bladder
-Nonreflex or Autonomous Bladder -Sacral Spinal Cord or Cauda Equina Lesion (Similar to LMN) -No Parasympathetics to start Peeing -Urinary Retention - Fills to Max Capacity and then Dribbles -Overflow Incontinence |
|
What is Upper Motor Neuron Bladder? What causes it? Why? What results?
|
-Autonomic Reflex Bladder
-Loss of Pontine Micturition Center (Similar to UMN Lesion) -Loss of General Coordination -Hyperactive Bladder - Empties Reflexively and not completely |
|
A patient comes in complaining about peeing. They are peeing all the time but they don't seem to fully empty their bladder. You suspect some type of nerve problem. What would it be?
|
Upper Motor Neuron Bladder
-Autonomic Reflex Bladder -Loss of Pontine Micturition Center (Similar to UMN Lesion) -Loss of General Coordination -Hyperactive Bladder - Empties Reflexively and not completely |
|
What would you suspect is wrong in an individual with an Atonic Bladder? How would you treat them?
|
-Spinal Shock Immediately following Injury
-MUST Catheterize |
|
What type of Bladder problem is associated with Overflow Incontinence?
|
Lower Motor Neuron Bladder
|
|
What causes Uninhibited Bladder?
|
-Loss of Cortical Input
|
|
Describe the Micturation Reflex.
|
1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing 3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes |
|
What initiates the Micturation Reflex?
|
Stretch Receptors fire
|
|
Describe the Micturation Reflex.
|
1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing 3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes |
|
In the Micturation Reflex, what happens after stretch receptors are activated?
|
-Parasympathetic Neurons Fire (Pee)
-Motor Neurons Stop |
|
In the Micturation Reflex, what happens after Parasympathetic Neurons Fire and Motor Neurons Stop Firing?
|
-Smooth Muscle Contracts the Internal Sphincter and it is passively pulled opne
-External Sphincter Relaxes -YOU PEE!!!!! |
|
What is the main function of the Hypothalamus?
|
Homeostasis
|
|
What is Leptin? What is its function? What happens when it is lost?
|
-Hormone Produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure -Obesity, Diabetes, Sterility |
|
How could decreased Leptin result in Obesity?
|
-Leptin is produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure -Loss of Leptin - Eat More, Get Fat |
|
Which part of the Hypothalamus is the Heat Dissipation Center?
|
Anterior Hypothalamic Nuclei
|
|
Which part of the Hypothalamus is the Heat Conservation Center?
|
Posterior Hypothalamic Nuclei
|
|
What is the function of the Anterior Hypothalamic Nuclei?
|
Heat Dissipation Center
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What is the function of the Posterior Hypothalamic Nuclei?
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Heat Conservation Center
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What might a lesion to the Anterior Hypothalamic Nuclei cause? Why?
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-Hyperthermia
-Loss of Heat Dissipation Center |
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What might a lesion to the Posterior Hypothalamic Nuclei cause? Why?
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-Inability to raise core temperature
-Loss of Heat Conservation Center |
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Describe the Micturation Reflex.
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1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing 3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes |
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What initiates the Micturation Reflex?
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Stretch Receptors fire
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Describe the Micturation Reflex.
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1) Stretch Receptors fire
2) Parasympathetic Neurons Fire; Motor Neurons Stop Firing 3) Smooth Muscle contracts Internal Sphincter passively pulled open. External Sphincter relaxes |
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In the Micturation Reflex, what happens after stretch receptors are activated?
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-Parasympathetic Neurons Fire (Pee)
-Motor Neurons Stop |
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In the Micturation Reflex, what happens after Parasympathetic Neurons Fire and Motor Neurons Stop Firing?
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-Smooth Muscle Contracts the Internal Sphincter and it is passively pulled opne
-External Sphincter Relaxes -YOU PEE!!!!! |
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What is the main function of the Hypothalamus?
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Homeostasis
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What is Leptin? What is its function? What happens when it is lost?
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-Hormone Produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure -Obesity, Diabetes, Sterility |
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How could decreased Leptin result in Obesity?
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-Leptin is produced in Adipose Tissue
-Inhibits Food Intake and Energy Expenditure -Loss of Leptin - Eat More, Get Fat |
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Which part of the Hypothalamus is the Heat Dissipation Center?
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Anterior Hypothalamic Nuclei
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Which part of the Hypothalamus is the Heat Conservation Center?
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Posterior Hypothalamic Nuclei
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What is the function of the Anterior Hypothalamic Nuclei?
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Heat Dissipation Center
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What is the function of the Posterior Hypothalamic Nuclei?
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Heat Conservation Center
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What might a lesion to the Anterior Hypothalamic Nuclei cause? Why?
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-Hyperthermia
-Loss of Heat Dissipation Center |
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What might a lesion to the Posterior Hypothalamic Nuclei cause? Why?
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-Inability to raise core temperature
-Loss of Heat Conservation Center |
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Describe the Pupillary Reflex. Neurons/Nerves in the pathway? What is the Direct Reflex? What is the Consensual Reflex?
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-Constriction of both pupils when light is shone
-Optic Nerve is Sensory --> Projects to Edinger-Westphal Nucleus --> Motor is Occulomotor Nerve -Direct - Each Pupil constricts when light is shone directly into that eye -Consensual - each pupil constricts when light is shone into the other eye |
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What is the direct pupillary reflex?
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Each Pupil constricts when light is shone directly into that eye
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What is the consensual pupillary reflex?
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Each pupil constricts when light is shone into the other eye
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What happens to the Direct and consensual Pupillary Light Reflexes when the Optic Nerve is lesioned?
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-Direct Reflex - Disappears - No Sensory for the light
-Consensual Reflex - Remains intact since sensory from other eye |
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What happens to the Direct and consensual Pupillary Light Reflexes when the Occulomotor Nerve is lesioned?
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-Direct Reflex - Lost (Only contralateral eye constricts)
-Consensual Reflex - Lost for same reasons |
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Which Nerve is responsible for hearing? Be specific.
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Cochlear division of Vestibulocochlear Nerve
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What is an Acoustic Neuroma? What results?
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-Schwann Cell Tumor of the COchlear Nerve
-Deafness, Vertigo, nausea, tinnitus, nystagmus |
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What is an Acoustic Neuroma? Which Nerves are affected?
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-Schwann Cell Tumor of the COchlear Nerve
-Vestibulocochlear (both divisions) and Facial |
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Which Cranial Nerve regulates COmpensatory Eye Movements?
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Vestibulocochlear Nerve
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Describe how the Ear recognizes changes in position?
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-Otolithic Membrane (crystals) respond to gravity
-Connected to the Utricle via the Macula -Deflection of Macula causes Hyperpolarization -Utricle is sensitive to changes in motion |
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How does the Ear recognizes changes in position?
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-Otolithic Membrane (crystals) respond to gravity
-Connected to the Utricle via the Macula -Deflection of Macula causes Hyperpolarization -Utricle is sensitive to changes in motion |
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What allows the Ear to recognize position? Which portion detects Angular Movements? Which portion defects Linear Acceleration?
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Cochlea
-Semicircular Canals - Angular Acceleration -Utricle and Saccule - Linear Acceleration |
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A patient is experiencing disequilibrium, vertigo, and nystagmus. Which cranial nerve might have a lesion?
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Vestibulocochlear
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What are some symptoms that may result from a Vestibulocochlear Nerve Lesion?
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Disequilibrium
Vertigo Nystagmus |
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What is Conductive Hearing Loss? What can cause it?
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-Problems that impair the ability of vibrations to reach the organ of corti
-Middle Ear Infection, Obstruction |
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What is Sensorineural Hearing Loss? What can cause it?
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-Problems that impair the ability of the hair cells or the cochlear nerve to respond
-Damage from Noise Exposure, Vestibulocochlear Nerve Tumor, Degeneration of Hair Cells |
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What is Central Hearing Loss?
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-Lesion of Primary Auditory Cortex or Wernicke's Area
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Describe the Weber Test? What happens with Conductive Loss? What about Sensorineural Loss?
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-Tuning fork on head
-Lateralizes Hearing problems -Conductive - The bad ear is louder because conductive problem masks ambient noise in room -Sensorineural - The good ear is louder because it can't be detected in the bad ear |
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Describe the Weber Test? What happens with Conductive Loss? What about Sensorineural Loss?
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-Tuning fork on head
-Lateralizes Hearing problems -Conductive - The bad ear is louder because conductive problem masks ambient noise in room -Sensorineural - The good ear is louder because it can't be detected in the bad ear |
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Describe the Rinne Test. How does it work? What happens with Conductive Loss? What about Sensorineural Loss?
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-Compares Air Conduction vs. Bone Conduction in an ear
-Conductive - Good Ear AC >BC, Bad Ear BC > AC because it can't be conducted normally -Sensorineural Loss - AC > BC for both |
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Describe the Rinne Test. How does it work? What happens with Conductive Loss? What about Sensorineural Loss?
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Describe the Rinne Test. How does it work? What happens with Conductive Loss? What about Sensorineural Loss?
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Increases in Engolymph.
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Affects Vestibular and Cochlear Systems
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What is Meniere's Disease? What symptoms result?
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-Increased Pressure in the Membranous Labyrinth of the Ear
-Hearing Loss and Vertigo |
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Which disorder results in increased pressure in the membranous labyrinth of the ear? What symptoms result?
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-Meniere's Disease
-Hearing Loss and Vertigo |
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What is Dementia? How is it characterized? How can you tell the difference between Dementia and Delirium?
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-"Deprived of ind")
-Serious loss of cognitive ability in a previously-unimpaired person, beyond what might be expected from normal aging -Slow Insidious Onset and Progressive Course -Dementia - Patient can cell whats going on; Delirium - cannot |
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What is Delirium?
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-Fluctuating Consciousness and Impaired Attention
-Acute Onset |
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How is Dementia due to Normal Pressure Hydrocephalus treated?
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-Shunt to divert CSF
-Reverse Dementia -DUH |
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What type of disorder is Alzeheimer's? What are its major features? How is it diagnosed?
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-Neurodegenerative Disorder
-Progressive Memory Impairment, Disordered Cognitive Function, Altered Behavior, Progressive Decline in Language Function -Sufficient Numbers of Plaques and Tangles |
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A patient exhibits Progressive Memory Impairment, Disordered Cognitive Function, Altered Behavior, and Progressive Decline in Language Function. What the fuck is wrong with them?
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They are either:
A) A Cubs Fan B) Suffer from Alzheimer's Disease |
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What are the Neurofibrillary Tangles in Alzheimer's due to?
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-Intraneuronal Bundles of Tau Protein
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Which mutations are commonly associated with Alzheimer's Disease?
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-APP (Amyloid Precursor) Gene on Chromosome 21
-Presenilin 1 (PS1) Gene on Chromosome 14 -Presenilin 2 (PS2) Gene on Chromosome 1 |
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Certain APOE genotypes play a role in Alzheimer's. Which one(s) are protective and which one(s) are risk factors?
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-Risk Factor - APOE4
-Protective - APOE e2 |
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What happens to neurons in AD? Which Neurons?
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-Selective Loss of ACh Neurons
-From Deep Nuclei in the Septum to Hippocampus and Basal Nucleus of Meynert to the Cerebral Cortex |
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Which neurodegenerative disorder usually exhibits Selective Loss of ACh Neurons from Deep Nuclei in the Septum to Hippocampus and Basal Nucleus of Meynert to the Cerebral Cortex?
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Alzheimers
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Compared to Healthy brain, what effects are seen in a brain of an individual with severe AD?
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Severely enlarged ventricles, cortical, and hippocampal shrinkage
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You perform a brain scan and your patient shows severely enlarged ventricles and degeneration of the caudate and putamen. What da problem is?
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Huntingtons
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What is the general function of the Frontal Lobe?
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-Personality
-Higher Centers for Voluntary Motor Activities |
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What is the general function of the Parietal Lobe?
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Peripheral Sensations
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What is the general function of the Temporal Lobe?
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-Smell
-Taste -Hearing |
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What is the general function of the Occipital Lobe?
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Vision
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In which lobe of the brain is the primary motor cortex located?
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Frontal Lobe
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Which lobe of the brain is responsible for general functions including:
-Personality -Higher Centers for Voluntary Motor Activities |
Frontal Lobe
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In which lobe of the brain is the somatosensory cortex located?
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Parietal Lobe
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Which lobe of the brain is responsible for general functions including:
-Smell -Taste -Hearing |
Temporal Lobe
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Which lobe of the brain is responsible for general visual functioning?
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Occipital Lobe
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What the shit do Broca's Area and Wernicke's area play a role in?
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Language
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What do the Anterior Cingulate Gyrus, Amygdala, and Hippocampus form together?
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Limbic Lobe
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What type of stuff is the Anterior Cingulate Gyrus (Anterior Cingulate Cortex) involved in?
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Pain
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What type of stuff is the Amygdala involved in?
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Anger and Fear Response
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What type of stuff is the Anterior Hippocampus involved in?
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Memory and Emotion
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Which portion of the LImbic Lobe is involved in Pain processing?
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Anterior CIngulate Gyrus (Anterior Cingulate Cortex)
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Which portion of the LImbic Lobe is involved in anger and the fear response?
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Amygdala
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Which portion of the LImbic Lobe is involved in memory and emotion?
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Hippocampus
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What is Sensitization?
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-Receptors respond more easily - Threshold has decreased
-Respond mot strongly to a given stimulus |
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What is called when receptors respond more strongly to a given stimulus?
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Sensitization
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What is Hyperalgesia?
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Increased response to painful inputs
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What is Allodynia?
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Pain resulting from normally non-nocioceptive stimuli
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What is pain resulting from normally non-nocioceptive stimuli?
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Allodynia
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What are some Endogenous Pain Control Mechanisms?
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-Enkephalinergic Interneurons
-Noradrenergic Projections -Canniboid Receptors -Sertonergic Projections -Endogenous Opiods |
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What is Referred Pain?
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-Pain of Visceral or Parietal Origin perceived as Somatic Pain
-Somatic Region to which the pain is referred is always a dermatome innervated by the same dorsal roots that supply the irritated structure |
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What types of symptoms will one experience with Normal Pressure Hydrocephalus?
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Delirium
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How the heck is Normal Pressure Hydrocephalus normal?
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Pressure is increased but normalizes
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