Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why

Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.

By signing up, I agree to StudyStack's Terms of Service and Privacy Policy.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove ads
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards




share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

BB2 Cards from FA

Brain and Behavior 2 Flashcards from First Aid

QuestionAnswer
What are risk factors for suicide? White, male, alone, prior attempts, presence and lethality of plan, medical illness, alcohol or drug use, on 3 or more prescription meds.
What is a memory key for suicide risk factors? SAD PERSONS
What does SAD PERSONS represent? Sex (male), Age, Depression, Previous attempt, Ethanol, Rational thought, Sickness, Organized plan, No spouse, Social support lacking
What are the 7 effects of long-term deprivation of affection? 1. Weak2. Wordless3. Wanting (socially)4. Wary (lack trust)5. Weight loss6. anaclitic depression7. physical illness [Hint: 5 W's and 2 more]
What is the result of severe long-term deprivation of affection? death
Irreversible changes of long term deprivation of affection occurs after how long? 6 months
What is anaclitic depression? depression in an infant owing to continued separation from caregiver--can result in failure to thrive. Infant becomes withdrawn and unresponsive
What can cause regression to younger behavior in children? Stress:- physical illness- punishment- birth of new sibling- tiredness
What are evidence of physical abuse in children? - healed fractures on x-ray- cigarette burns- subdural hematomas- multiple bruises- retinal hemorrhage or detachment
Who is usually the abuser in physical abuse in children? female primary caregiver
Physical abuse in children leads to how many deaths in the U.S.? ~3000 deaths/yr.
At what ages does sexual abuse in children peak? 9 to 12 years of age
What are evidence of sexual abuse in children? genital/anal trauma, STDs, UTIs
Who is usually the abuser in sexual abuse in children? known to victim, usually male
What are the developmental milestones at about 3 months old in an infant? - holds head up- social smile- Moro reflex disappears
What are the developmental milestones at about 4-5 months old in an infant? - rolls on back- sits when propped
What are the developmental milestones at about 7-9 months old in infancy? - stranger anxiety- sits alone- orients to voice
What are the developmental milestones at about 12-14 months old in infancy? - upgoing Babinski disappears
What are the developmental milestones at about 15 months old in infancy? - walking- few words- separation anxiety
When does a child achieve object permanence? Toddler, 12-24 months old
When does a child achieve rapprochement? Toddler, 18-24 months old
When can a child parallel play? Toddler, 24-48 months old
When does a child achieve core gender identity? Toddler, 24-36 months old
When does a child become toilet trained? Preschool, 30-36 months old
What are the development milestones at about 3 years old in preschool? - group play- rides tricycle- copies line or circle drawing
What are the development milestones at about 4 years old in preschool? - cooperative play- simple drawings (stick figure)- hops on 1 foot
What are the developmental milestones during the schoolage years (6-11y/o)? - development of conscience (superego)- same-sex friends- identification with same-sex parent
What are the developmental milestones during adolescence? - abstract reasoning (formal operations)- formation of personality
When is adolescence for boys and for girls? Boys: 13 years oldGirls: 11 years old
What are the 5 changes in the elderly? 1. sexual changes: sexual interest does NOT decrease (men: slower erection/ejaculation, longer refractory period; women: vaginal shortening, thinning, dryness)2. sleep patterns: decreased REM, decreased slow-wave sleep, increased sleep latency, increase
What are the Kubler-Ross dying stages? Denial-Anger-Barganing-Grieving-Acceptancedon't occur necessarily in this order[Hint: Death Arrives Brining Grave Adjustments]
What is grief? normal bereavement characterized by shock, denial, guilt, and somatic symptomsTypically lasts 6mo. to 1yr.
What is pathologic grief? includes excessively intense or prolonged grief or grief that's delayed, inhibited, or denied
Name 2 neurotransmitter changes associated with depression. Decreased NE and serotonin (5-HT)
Name 1 neurotransmitter change associated with Alzheimer's disease. Decreased Ach
Name 2 neurotransmitter changes associated with Huntington's disease. Decreased GABA and Ach
Name 1 neurotransmitter change associated with Schizophrenia Increased Dopamine
Name 1 neurotransmitter change associated with Parkinson's disease. Decreased Dopamine
Name 7 functions of the frontal lobe. Concentration, Orientation, Language, Abstraction, Judgment, Motor regulation, Mood
What is the most notable change in function in a frontal lobe lesion? Lack of social judgment
What percentage of time is spent in stage 1 sleep? 0.05
What percentage of time is spent in stage 2 sleep? 0.45
What percentage of time is spent in stage 3-4 sleep? 0.25
What percentage of time is spent in REM sleep? 0.25
Name 5 possible waveform patterns seen in the various sleep/wake stages. Alpha, Beta (highest frequency, lowest amplitude), Theta, Delta (lowest frequency, highest amplitude), Sleep spindles with K-complexes
What waveform pattern is seen in a young adult who is awake (eyes open), alert, and has active mental concentration? Beta waves
What waveform pattern is seen in a young adult who is awake but has his/her eyes closed? Alpha waves
What waveform pattern is seen in a young adult who is in light (stage 1) sleep? Theta waves
What waveform pattern is seen in a young adult who is in deeper (stage 2) sleep? Sleep spindles and K-complexes
What waveform pattern is seen in a young adult who is in the deepest, Non-REM (stage 3-4) sleep? Delta waves
What waveform pattern is seen in a young adult who is in REM sleep? Beta waves
What is a helpful mnemonic for the order of the corresponding waveform patterns in each stage of sleep? At night, BATS Drink Blood.
Name 3 possible findings in non-REM sleep. Sleepwalking, night terrors, and bedwetting
Name 5 possible findings in REM sleep. Dreaming, loss of motor tone, possible memory processing function, erection, and increased brain 02 use
What is considered the key to initiating sleep? Serotonergic predominance of the raphe nucleus
What neurotransmitter can reduce REM sleep? NE
Extraocular movements during REM sleep are due to what portion of the brain? Parapontine Reticular Formation/Conjugate Gaze Center
What phenomenon caused REM sleep to be known as 'paradoxical' or 'desynchronized' sleep? The EEG pattern during REM sleep is the same as the EEG of a person that is awake and alert.
What medication shortens stage 4 sleep and is useful in the treatment of night terrors and sleepwalking? Benzodiazepines
What medication shortens stage 4 sleep and can be used to treat enuresis? Imipramine
Name 4 physiological actions found in REM sleep. Increased/variable pulse, rapid eye movements, increased/variable blood pressure, and penile/clitoral tumescence
How often does REM sleep occur? Every 90 minutes (duration may increase during the night)
Does REM sleep increase or decrease with age? Decreases
What is the principal neurotransmitter involved in REM sleep? Ach
Distinguish between central and obstructive sleep apnea. In central sleep apnea, there is no respiratory effort. In Obstructive sleep apnea, there is respiratory effort against airway obstruction.
Define sleep apnea. Person stops breathing for at least 10 seconds during sleep.
Name five findings associated with sleep apnea. Obesity, loud snoring, systemic/pulmonary HTN, arrhythmias, and possibly sudden death.
Name a possible chronic outcome of sleep apnea. Chronic fatigue
What is narcolepsy? Person falls asleep suddenly
Are hallucinations common in narcolepsy patients? Yes. Both hypnagogic (just before sleep) and hypnopompic (with awakening) are both common.
Define cataplexy. Sudden collapse (falls asleep) while awake.
Does narcolepsy have a genetic component? Yes. Studies have shown a strong genetic component of narcolepsy.
What is a common treatment for narcolepsy? Stimulants (e.g. amphetamines)
Name 3 changes in sleep stages often found in people with depression. 1. Reduced slow-wave sleep 2. Decreased REM latency 3. Early morning awakening (important screening question)
Name 2 effects of stress on the body. 1. Induces production of FFA, 17-OH corticosteroids, lipids, cholesterol, and catecholamines 2. Affects water reabsorption, muscular tonicity, gastrocolic reflex, and mucosal circulation.
What 3 things does the differential diagnosis for sexual dysfunction include? 1. Drugs (e.g. antiHTN, neuroleptics, SSRIs, and ethanol) 2. Diseases (e.g. depression and diabetes) 3. Psychological (e.g. performance anxiety)
What is the order of loss or orientation? Time, place, and Person
What questions do you have to answer when assessing an patient's orientation? Is the patient aware of him/herself as a person? Does the patient know his/her name?
Define Anosognosia. being unaware that one is ill
Define Autotopagnosia. Being unable to locate one's own body parts
Define depersonalization. body seems unreal or dissociated
A person who is unable to remember things that occurred after a CNS insult has…? Anterograde Amnesia
Anterograde amnesia caused by thiamine deficiency? Korsakoff's amnesia
What is destroyed in Korsakoff's Amnesia? Mamillary bodies(bilaterally)
What patient population will you see Korsakoff's? Alcoholics
What else is classically associated with Korsakoff's? Confabulations, ie. Making it up as you go along
What is the inability to remember things that happened before CNS insult? Retrograde Amnesia
What is retrograde amnesia a complication of? ECT-electroconvulsive therapy(shock)
What are the maladaptive signs of substance use? Tolerance, Withdrawl, Substance taken in larger amounts than intended, Persistent desire or attempst to cut down, lots of energy spent trying to obtain substance, withdrawl from responsibility, used continued in spite of knowing the problems that it cause
How is maladaptive pattern of substance abuse defined? 3 or more of the above signs in 1 year
What is the definition of substance abuse? maladaptive pattern of use leading to clinically significant impairment or distress, symptoms have not met criteria for dependence
What is the criterion for dx of substance abuse? One or more of the following in 1 year: Recurrent use resulting in failure to complete responsiblities, recurrent use in physically hazardous situations, recurrent legal problems, continued use in spite of persistent problems of use
What are the signs of alcohol use? Disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts
What are the signs of alcohole withdrawl? Tremor, Tachycardia, HTN, malaise, nausea, seizures, delirium tremens, tremulousness, agitation, hallucinations
What are the signs of opioid intoxication? CNS depression, nausea and vomiting, constipation, pupillary constriction, seizures
What are the signs of opioid withdrawl? Anxiety, insomnia, anorexia, sweating/piloerection(cold turkey), fever, rhinorrhea, nausea, stomach cramps, diarrhea, flu-like symptoms, yawning
What are the signs of Amphetamine intoxication? Psychomotor agitation, impaired judgement, pupillary dilation, HTN, tachycardia, euphoria, prolonged wakefulness and attention, cardiac arrhythmias, delusions, hallucinations, fever
What are the signs of Amphetamine withdrawl? Post-use crash, including anxiety, lethargy, headache, stomach cramps, hunger, severe depression, dysphoric mood, fatigue, insomnia/hypersomnia
What are the signs of cocaine intoxication? Euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, HTN, hallucinations(including tactile:bugs on skin), paranoid ideations, angina, and sudden cardiac death
What are the signs of cocaine withdrawl? Hypersomnolence, fatigue, depression, malaise, severe craving, suicidality
Whare are the signs of PCP intoxication? Belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis and delirium
What are the signs of PCP withdrawl? Recurrence of intoxication symptoms due to reabsorption in GI tract, sudden onset of severe, random, homicidal violence
What are the signs of LSD intoxication? Marked anxiety and depression, delusions, visual hallucinations and flashbacks
Whare are the signs of Marijuana intox? Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired jugdment, social withdrawl, increased appetite, dry mouth and hallucinations
What are the signs of Barbiutate intox? respiratory depression
Whar are the signs of barbituate withdrawl? Anxiety, seizures, delirium, life-threatening CV collapse
Whare are the signs of Benzodiazepine intox? Amnesia, ataxia, somnolence, minor resp depression
What are the signs of benzo withdrawl? Rebound anxiety, seizures, tremor, insomnia
Whare are the signs of caffeine intox? restlessness, insomina, increased diuresis, muscle twitching, cardiac arrhythmias
What are the signs of caffeine withdrawl? Headache, lethargy, depression, weight gain
Who do you need to see to witness caffeine withdrawl approx every six weeks? Blake Williams
What are the symptoms of nicotine intoxication? Restlessness, insomnia, anxiety, arrhythmias
Whar are the signs of nicotine withdrawl? Irritablility, headache, anxiety, weight gain, craving, tachycardia
What is the trigger for DT's? alcohols withdrawl
When do DT's peak? 2-5 days after last drink
Are DT's life threatening? Yes
What are the symptoms of DT's(in order of appearance)? ANS Hyperactivity(tachycardia, tremors, and anxiety), Psychotic symptoms(hallucinations, delusions), confusion
How many heroin addicts are there in the US? ~500,000
Is Heroin prescribable? NO, it is schedule I (ie. not prescribable)
What are the signs of narcotic abstinence syndrome? dilated pupils, lacrimation, rhinorrhea, sweating, yawning, irritability, and muscle aches
What is a hallmark sign of heroin addiction? track marks
What are some related diagnoses of Heroin addicts? Hepatitis, abscesses, OD, hemorrhoids(reason enough to shy away), AIDS, and right-sided endocarditis
What are 2 opioid comptetitive inhibitors? Naloxane and Naltrexone
What drug is used for long term maintenance of heroin detox? Methadone
What are the characteristics of Delirium? Decreased attention span and level of arousal, disorganized thinking, hallucinations, illusions, misperceptions, disturbance of sleep-wake cycle, cognitive dysfxn
What is the most common psych illness on medical and surgical floors? Delirium, often reversible
What is the key to delirium diagnosis? Waxing and waning level of conciousness that develops rapidly
What are some common causes of delirium? substance use/abuse or medical illness
Whare are the characteristics of Dementia? development of mulitple cognitive deficits: memory, apahasia, apraxia, agnosia, loss of abstract thought, behavioral/personality changes, impaired judgement
What is the key to dementia diagnosis? rule out delirium-patient is alert, no change in level of conciousness. More often gradual onset.
What can be confused with dementia in elderly? depression
What is dementia characterized by? commonly irreversible memory loss
How is a major depressive episode characterized? 5 of the following for 2 weeks, including (1) depressed mood or (2) anhedoniSleep disturbances, Loss of Interest, Guilt, Loss of Energy, Loss of Concentration, Change in Appetite, Psychomotor retardation, Suicidal ideation, Depressed mood
How is a major depressive disorder characterized? Recurrent-requires 2 or more depressive episodes with a symptom free interval of 2 months
What is the lifetime prevalence for Major Depressive Disorder in Males and Females: 13% for males, and 21% for females
What is Dysthymia? milder form of depression lasting at least 2 years
Define a Manic episode. Distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week
To be a manic episode what characteristic behaviors must be present? 3 or more of the following: Distractibility, Insomnia, Grandiosity, Flight of Ideas, Inc in Activity/pyschomotor agitation, Pressured Speech, Thoughtlessness
What is a Hypomanic Episode? it is like a manic episode except mood disturbance is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization; no psychotic features
How many criteria sets exist for bipolar disorder? 6 separate criteria exist for bipolar disorders with combinations of manic, hypomanic, and depressed episodes
Bipolar I describes? manic
Bipolar II describes? hypomanic
What is drug of choice for bipolar? Lithium
What is Cyclothymic disorder? milder form of bipolar lasting at least 2 years
If a patient consciously fakes or claims to have a disorder in order to attain a specific gain, how is this behavior described? Malingering
In what kind of disorder does a person consciously create symptoms in order to assume a sick role and get medical attention? Factitious Disorder
What syndrome is manifested by a chronic history of multiple hospital admissions and willingness to receive invasive procedures? Munchausen's
What is it called when a parent causes their child to become ill in order to receive attention? Munchausen's by proxy
Is the motivation concious in Munchausen's by proxy? NO
What are the 6 somatoform disorders? conversion, somatoform pain disorder, hypochondriasis, somatization disorder, body dysmorphic disorder, pseudocyesis
Are the illness production and motivation in somatoform disorders consicous drives? No
Define Conversion disorder. symptoms suggest motor or sensory neurologic or physical disorder, but tests and PE are negative
What is a pain somatoform disorder? pain that is not explained completely by illness
What is Hypochondriasis? misinterpretation of normal physical findins, leading to preoccupation with and fear of having a serious medical illness in spite of medical reassurance
What is a somatization disorder? Varitey of complaints in multiple organ systems
Whate is body dysmorpic disorder? patient is convinced that part of one's own anatomy is malformed
Whate is pseudocyesis? false belief of being pregnant associated with objective signs of pregnancy
What is primary gain? what the symptom does for the patient's internal psychic economy
What is secondary gain? What the symptoms gets the patient(sympathy or attention)
What is tertiary gain? what the caretaker gets
Define a panic disorder. Discrete period of intense fear and discomfort peaking in 10 minutes with 4/5 characteristics
What are the 5 characteristics of panic? Palipitations, Abdominal distress, Nausea, Increased perspiration, Chest pains, chills and choking
When must a painc disorder be dx? in the context of the occurrence
What is a phobia? fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or entity
What does exposure to object of phobia evoke? an anxiety response
Does the person who has the phobia recognize their fear as excessive? yes, they are exhibiting insight
What are treatment options of phobias? systematic desensitization
Does the phobic fear interfere with normal routine? yes
what is the fear of marriage? gamophobia
what is the fear of pain? algophobia
what is the fear of heights? acrophobia
what is the fear of open places? agoraphobia
What is post-traumatic stress disorder? when a person experienced or witnessed an event that involoved actual or threatened death or serious injury. The traumatic event is reexperienced; person persistently avoids stimuli associated with the trauma and experiences persistent symptoms of increas
What is the response to the traumatic event? intense fear, helplessness or horror
How long does the disturbance due to PSSD last? > 1 month and causes distress or social/occupational impairment
Define Personality trait. an enduring pattern of perceiving, relating to, and thinking about the environment and oneself that is exhibited in a wide range of important social and personal contexts
Define Personality disorder when patterns become inflexible and maladaptive, causing impairment in social or occupational functioning or subjective distress
How are Cluster A personalities described? as odd or ecentric; cannot develop meaningful social relationships; Weird
What are the types of Cluster A personalities? Paranoid, Schizoid, Schizotypal
Describe a Paranoid Personality distrustful and suspicious; projection is main defense mech
Describe a Schizoid Personality. voluntary social withdrawl; no psychosis; limited emotional expression
Describe a Schizotypal Personality. interpersonal awkwardness, odd thought patterns and appearance
How are Cluster B personalities described? Dramatic, emotional, or erratic; Wild
Name the types of Cluster B personalities. Antisocial, Borederline, Histrionic, Narcissistic
How would you describe an Antisocial? as having a disregard for and violation of rights of others, criminality
Who are more likely to be antisocial, male or female? male
How would you describe a Borderline personality? unstable mood and behavior; impulsive, sense of emptiness
Who are more likely to be borderline, male or female? female
How would you describe a histrionic personality? excessive emotionally, somatization, attention seeking, sexually provocative
How would you desribe a Narcissistic personality? grandiosity; sense of entitlement, many demand 'top' physician/best health care
How are Cluster C personalities described? Anxious and fearful, 'Worried'
What are the types of Cluster C personalities? Avoidant, Obsessive-Compulsive, Dependent
How would you describe an avoidant personality? sensitive to rejection, socially inhibited, timid, feelings of inadequacy
How would you decribe an obsessive-compulsive? preoccupation with order, perfectionism and control
How would you decribe a dependent personality? submissive and clinging, excessive need to be taken care of, low self-confidence
Hallucinations are…. perceptions in the absence of external stimuli
Illusions are…. misinterpretation of actual external stimuli, ex. Mistaking coat rack for man
Delusions are…. false beliefs not shared by other memebers of culture/subculture that are firmly maintained in spite of obvious proof to the contrary
What is the difference between delusions and loos associations? delusion is a disorder in the content of thought(the actual idea) where a loose association is a disorder in the form of thought(the way the idea is tied together)
How many hallucination types are there? Name them. 7; Visual, Auditory, Olfactory, Gustatory, Tactile, Hypnagogic, Hypnopompic
When are the halluinations common? Visual(acute organic brain syndrom), Auditory(Schizophrenia), Olfactory(aura of psychomotor epilepsy), Gustatory(rare), Tactile(DT's and Cocaine abusers), Hypnagogic(while going to sleep), Hypnopmpic(while waking from sleep)
How is Schizophrenia described? periods of psychosis and disturbed behavior lasting >6months,
What are the Positive symptoms of Schizophrenia? Hallucinations, delusions, strange behavior and loose associations
What are the negative symptoms of schizophrenia? flat affect, social withdrawl, thought blocking, lack of emotion
Whare are the 4 A's of schizophrenia? Ambivalence(uncertainty), Autism(self-preoccupation and lack of communication), Affect(blunted), Associations(loose)
Name the 5 subtypes of schizophrenia. Disorganized, Catatonic, paranoid, Undifferentiated, Residual
What is the Fifth A? Auditory hallucinations
What are the etiologic factors for schizophrenia? genetics and environment, genetics outweigh env
What is the lifetime prevalence for schizophrenia? 1.5%-(males/females, blacks/whites) presents earlier in men
What is a schizoaffective disorder? a combo of schizophrenia and a mood disorder
What is Electroconvulsive Therapy(ECT)? a tx option for major depressive disorder refractory to other tx. It is painless and produces a seizure with transient memory loss and disorientation.
What complication result from ECT? complications associated with anesthesia and retrograde amnesia
What are Freud's three structures of the mind -Id-Superego-Ego
What thought structures is the Id responsible for? (3 things) - Primal urges-sex-agression(Think-'I want it')
What thought structures is the Superego responsible for? (2 things) - Moral values-conscience(Think-'You know you cant have it')
What thought structures is the Ego responsible for? Bridge and mediator between the unconscious mind and the world (Think-Deals with conflict)
Define ego defenses. automatic and unconscious reactions to phychological stress
What are the MATURE ego defenses? (4) -Sublimation-Altruism-Suppression-Humor(Mneumonic: Mature women wear a SASH)
Define altruism. Guilty feelings alleviated by unsolicited generosity toward others
What is an example of altruism? Mafia boss makes large donation to charity
Define humor. Appreciating the amusing nature of an anxiety-provoking or adverse situation
What is an example of humor? Nervous medical student jokes about the boards
Define sublimation. Process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with one's value system.
What is an example of sublimation? Aggressive impulses used to succeed in business ventures
Define suppression. Voluntary (unlike other defenses) withholding of an idea of feeling from conscious awareness
What is an example of suppression? Choosing not to think about the USMLE until the week of the exam
What are the immature ego defenses? (12) Acting out, Disassociation, Denial, Displacement, Fixation, Identification, Isolation, Projection, Rationalization, Reaction formation, Regression, Repression
Define acting out. Unacceptable feelings and thoughts are expressed through actions
What is an example of acting out? Temper tantrums
Define dissociation. Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress
What is an example of dissociation? Extreme forms can result in multiple personalities (dissociative identity disorder).
Define denial. Avoidance of awareness of some painful reality
What is an example of denial. A common reaction in newly diagnosed AIDS and cancer patients
Define displacement. Process whereby avoided ideas and feelings are transferred to some neutral person or object
What is an example of displacement? Mother yells at child because she is angry at her husband
Define fixation. Partially remaining at a more childish level of development
What is an example of fixation? Men fixating on sports games
Define identification. Modeling behavior after another person
What is an example of identification? Abused child becomes an abuser
Define isolation. Separation of feelings from ideas and events
What is an example of isolation? Describing murder in graphic detail with no emotional response
Define projection. An unacceptable internal impulse that is attributed to an external source
What is an example of projection? A man who wants another woman thinks his wife is cheating on him
Define rationalization. Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame
What is an example of rationalization? Saying the job was not important anyway, after getting fired
Define reaction formation. Process whereby a warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite
What is an example of reaction formation? A patient with libidinous thoughts enters a monastery
Define regression. Turning back the maturational clock and going back to earlier modes of dealing with the world
What is an example of regression? Seen in children under stress (eg., bedwetting) and in patients on dialysis (eg., crying)
Define repression. Involuntary withholding of an idea or feeling from conscious awareness.
What is the basic mechanism underlying all ego defenses? Repression
What term fist described by Freud is used to refer to repressed sexual feelings of a child for the opposite-sex parent, accompanied by rivalry with same-sex parent? Oedipus comple
XWhat are the four factors in hopelessness? -Sense of Impotence (powerlessness)-Sense of Guilt-Sense of Anger-Sense of loss/Deprivation leading to depression(Mnemonic IGAD!)
Define classical conditioning. Learning in which a natural response is elicited by a conditioned stimulus that previously was presented in conjunction with an unconditioned stimulus
Give an example of classical conditioning. Pavlov's dogs (ringing of a bell provoked salivation in dogs)
Which is the natural response in Pavlov's experiment? salivation
Which is the conditioned (learned) stimulus in Pavlov's experiment? ringing bell
Which is the unconditioned stimulus in Pavlov's experiment? food
Define operant conditioning. Learning in which a particular action is elicited because it produces a reward
What is positive reinforcement? the desired reward which produces an action
Give an example of positive reinforcement of opperative conditioning. a mouse presses a button to get food
What is negative reinforcement? the removal of an aversive stimulus so as to increase behavior
Give an example of negative reinforcement of opperative conditioining. a mouse presses a button to avoid shock (do not confuse with punishment)
What type of behavior requires a continuous reinforcement schedule? behavior which shows the most rapid extinction when not rewarded
Give an example of continuous reinforcement schedule. A person gets upset when a vending machine doesn't work
What type of behavior requires a variable ratio reinforcement schedule? behavior which shows the slowest extinction when not rewarded
Give an example of variable ratio reinforcement schedules. A person continuing to play a slot machine at a casino
What term is used to describe the form of insight therapy developed by Freud which is often used for changing chronic personality problems? Psychoanalysis
Name 4 characteristics of psychoanalysis. -costly-lengthy-intensive-places great demands on the patient
What is the topographical term used in psychoanalysis used to describe what you are aware of? Conscious
What is the topographical term used in psychoanalysis used to describe what you are able to make conscious with effort? Preconscious
Give an example of preconscious topography. remembering your phone number
What is the topographical term used in psychoanalysis to describe what you are not aware of? Unconscious
What is the central goal of Freudian psychoanalysis? To make the patient aware of what is hidden in his/her unconscious
What are the two most famous forms of intelligence testing? Stanford-Binet and Wechsler
What number is defined as the mean for standard IQ testing? 100 (with a standard deviation of 15)
What is the IQ criteria for diagnosis of mental retardation? IQ lower than 70 (or 2 standard deviations below the mean)
What are two factors with which IQ scores are correlated? Genetics and school achievement
Is IQ testing more highly correlated with genetics or school achievement? School achievement
According to the Homunculus man, place the following in order (from medial to lateral). hand, foot, tongue, face, trunk foot, trunk, hand, face, tongue
(T or F) Can Bell's palsy occur idiopathically? TRUE
(T or F) Can fasiculations be present in a LMN lesion? TRUE
(T or F) Is the anterior nucleus of the thalamus part of the limbic system? TRUE
(T or F) Is the cingulate gyrus part of the limbic system? TRUE
(T or F) Is the Entrorhinal cortex part of the limbic system? TRUE
(T or F) Is the hippocampal formation part of the limbic system? TRUE
(T or F) Is the mammillary body part of the limbic system? TRUE
(T or F) Is the septal area part of the limbic system? TRUE
(T or F) Thoracic outlet syndrome results in atrophy of the interosseous muscles? TRUE
(T or F) Thoracic outlet syndrome results in atrophy of the thenar and hypothenar eminences? TRUE
(T or F) Thoracic outlet syndrome results in disappearance of the radial pulse upon moving the head to the opposite side? TRUE
(T or F) Thoracic outlet syndrome results in sensory deficits on the medial side of the forearm and hand? TRUE
A lesion of the globus pallidus causes what disease? Wilson's disease
A lesion of the mammillary bodies (bilateraly) produces what? Wernicke-Korsakoff's encephalopathy (confabulations, anterograde amnesia)
A lesion of the optic chiasm produces? bitemporal hemianopsia
A lesion of the right dorsal optic radiation (parietal lesion) produces? left lower quadrantic anopsia (a temporal lesion)
A lesion of the right Meyer's loop (temporal lobe) produces? left upper quadrantic anopsia (a temporal lesion)
A lesion of the right optic nerve produces? right anopsia
A lesion of the right optic tract produces? left homonymous hemianopsia
A lesion of the right visual fibers just prior to the visual cortex produces? left hemianopsia with macular sparing
A lesion of the Striatum can cause which 2 diseases? Huntington's and Wilson's disease
A positive Babinski is an indicator for a (UMN or LMN) lesion? UMN lesion
A rupture of the middle menigeal artery causes what type of hematoma? (epidural or subdural) epidural hematoma
A rupture of the superior cerebral veins causes what type of hematoma? (epidural or subdural) subdural hematoma
An aneurysm of the anterior communicating artery may cause what type of defects? visual defects
An aneurysm of what artery may cause CN III palsy? posterior communicating artery
Are D1 neurons in the basal ganglia inhibitory or excitatory? Excitatory
Are D2 neurons in the basal ganglia inhibitory or excitatory? Inhibitory
Beginning with anterior communicating artery describe the path around the circle of Willis. ant. comm. - ACA - ICA - post. comm. - PCA - PCA - post. comm. - ICA - ACA - ant. comm.
Bell's Palsy is seen as a complication in what 5 things? AIDS, Lyme disease, Sarcoidosis, Tumors, Diabetes (ALexander Bell with STD)
Brodmann's area 17 is? principal visual cortex
Brodmann's area 22 is? Wernicke's area (associative auditory cortex)
Brodmann's area 3,1,2 is? principal sensory area
Brodmann's area 4 is? principal motor area
Brodmann's area 41, 42 is? primary auditory cortex
Brodmann's area 44, 45 is? Broca's area (motor speech)
Brodmann's area 6 is? premotor area
Brodmann's area 8 is? frontal eye movement and pupilary change area
CN I has what function? smell
CN I passes through what 'hole'? cribriform plate
CN II has what function? sight
CN II passes through what 'hole'? optic canal
CN III has what 4 functions? eye movement, pupil constriction, accommodation, eyelid opening
CN III inervates what 5 muscles. medial rectus, superior rectus, inferior rectus, inferior oblique, levator palpebrae superioris
CN III passes through what 'hole'? superior orbital fissure
CN IV has what function? eye movement
CN IV inervates what muscle. superior oblique
CN IV passes through what 'hole'? superior orbital fissure
CN IX has what 4 functions? posterior 1/3 taste, swallowing, salivation (parotid), monitoring carotid body and sinus
CN IX passes through what 'hole'? jugular foramen
CN V has what 2 functions? mastication, facial sensation
CN V1 passes through what 'hole'? superior orbital fissure
CN V2 passes through what 'hole'? foramen rotundum
CN V3 passes through what 'hole'? foramen ovale
CN VI has what function? eye movement
CN VI inervates what muscle. lateral rectus
CN VI passes through what 'hole'? superior orbital fissure
CN VII has what 4 functions? facial movement, anterior 2/3 taste, lacrimation, salivation(SL, SM glands)
CN VII passes through what 'hole'? internal auditory meatus
CN VIII has what 2 functions? hearing, balance
CN VIII passes through what 'hole'? internal auditory meatus
CN X has what 5 functions? taste, swallowing, palate elevation, talking, thoracoabdominal viscera
CN X passes through what 'hole'? jugular foramen
CN XI has what 2 functions? head turning, shoulder shrugging
CN XI passes through what 'hole'? jugular foramen (descending) -- foramen magnum (ascending)
CN XII has what function? tounge movements
CN XII passes through what 'hole'? hypoglossal canal
Complete the muscle spindle reflex arc by placing the following in order: alpha motor, Ia afferent, muscle stretch, extrafusal contraction, intrafusal stretch. muscle stretch - intrafusal stretch - Ia afferent - alpha motor - extrafusal contraction
Extrafusal fibers are innervated by what motor neuron? alpha motor neuron
From which 3 spinal roots does long thoracic nerve arises? C5, C6, C7
General sensory/motor dysfunction and aphasia are caused by stroke of the? (ant. circle or post. circle) anterior circle
Give 3 characteristics of a LMN lesion. atrophy, flaccid paralysis, absent deep tendon reflexes
Give 3 charateristics of internuclear ophthalmoplegia (INO) medial rectus palsy on lateral gaze, nystagmus in abducted eye, normal convergence.
Give 4 characteristics of an UMN lesion. spastic paralysis, increased deep tendon reflexes, + Babinski, minor to no atrophy
Golgi tendon organs send their signal via what nerve? group Ib afferents
Horner's Syndrome is present if the lesion in Brown-Sequard is above what level? T1
How are the fibers of the corticospinal tract laminated? (legs/arms medial or lateral?) arms- medial, legs-lateral
How are the fibers of the dorsal column laminated? (legs/arms medial or lateral?) legs-medial, arms-lateral
How are the fibers of the spinothalmic tract laminated? (sacral/cervical medial or lateral?) cervical-medial, sacral-lateral
How do glucose and amino acids cross the blood-brain barrier? carrier-mediated transport mechanism
How does the hypothalamus control the adenohypophysis? via releasing factors (ie. TRH, CRF, GnRF, etc.)
Huntington's patients typically have what type of movements? Chorea
If the radial nerve is lesioned, what 2 reflexes are lost? triceps reflex and brachioradialis reflex
If you break your humerus mid-shaft, which nerve would likely injure? radial nerve
If you break your medial epicondyle of the humerus, which nerve would likely injure? ulnar nerve
If you break your supracondyle of the humerus, which nerve would likely injure? median nerve
If you break your surgical neck of the humerus, which nerve would likely injure? axillary nerve
In a lesion of the radial nerve, what muscle is associated with wrist drop? extensor carpi radialis longus
Intrafusal fibers are encapsulated and make up muscle spindles that send their signal via what nerve? group Ia afferents
Intrafusal fibers are innervated by what motor neuron? gamma motor neuron
Is Bell's palsy an UMN or a LMN lesion? LMN
Is the Babinski reflex (positive or negative) when the big toe dorsiflexes and the other toes fan-out? positive (pathologic)
Name 2 locations for lesions in Syringomyelia? ventral white commissure and ventral horns
Name 3 locations for lesions in Vit.B12 neuropathy(Friedreich's ataxia)? dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts
Name 7 functions of the hypothalamus? Thirst/waterbalance, Adenohypophysis control, Neurohypophysis control, Hunger/satiety, Autonomic regulation, Temperature regulation, Sexual emotions. TAN HATS
Name the 4 foramina that are in the posterior cranial fossa? internal auditory meatus, jugular foramen, hypoglossal canal, and foramen magnum.
Name the 5 foramina that are in the middle cranial fossa? optic canal, superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum.
Name the 5 functions of the Limbic system? Feeding, Fighting, Feeling, Flight, sex (F--K) [the famous 5 F's]
Name the 5 segments of the brachial plexus in order from proximal to distal. roots - trunks - divisions - cords - branches
Name the type of movement with slow writhing movements (esp. the fingers)? Athetosis
Name the type of movement with sudden, jerky, purposeless movements? Chorea
Name the type of movement with sudden, wild flailing of one arm? Hemiballismus
Neurons from the globus pallidus have what action on the ventral anterior nucleus? Inhibitory
Neurons from the striatum have what action on the globus pallidus? Inhibitory
Place the following in order (from light entering the eye to reflex). Pretectal nuclei, pupillary constrictor muscle, retina, ciliary ganglion, Edinger-Westphal nuclei, CN II, CN III. retina, CN II, pretectal nuclei, Edinger-Westphal nuclei, CN III, ciliary ganglion, pupillary constrictor muscle
Stimulation from the paraventricular nucleus cause the release of what hormone? oxytocin
Stimulation from the supraoptic nucleus cause the release of what hormone? ADH (vasopressin)
The Blood-Brain Barrier is formed by what 3 structures? choriod plexus epithelium, intracerebral capillary endothelium, astrocytes. (First Aid says Arachnoid but the brains say thatТs a typo)
The central retinal artery is a branch off what larger artery? ophthalmic artery
The embryologic defect of having a cervical rib can compress what 2 structures? subclavian artery and inferior trunk of the brachial plexus
The fasciculus cuneatus contains fibers from the upper or lower body? upper extremities
The fasciculus gracilis contains fibers from the upper or lower body? lower extremities
The hippocampal formation is connected to the mammillary body and septal area via what structure? fornix
The hippocampus has input from what two areas? entorhinal cortex, septal area
The hippocampus has output to what two areas? mammillary body, septal area
The infraorbital nerve is a branch off what larger nerve? CN V2
The Nucleus Ambiguus has fibers from what 3 CNs? CN IX, X, XII
The Nucleus Solitarius has fibers from what 3 CNs? CN VII, IX, X
Traction or tear of the superior trunk of the brachial plexus causes what syndrome? Erb-Duchenne palsy (waiter's tip)
Vertigo, ataxia, visual deficits, and coma are caused by stroke of the? (ant. circle or post. circle) posterior circle
Visual fibers from the lateral geniculate body terminate on the upper and lower banks of what fissure? Calcarine fissure
What 1 nerve root is assoc. with the achilles reflex? S1
What 1 nerve root is assoc. with the biceps reflex? C5
What 1 nerve root is assoc. with the patella reflex? L4
What 1 nerve root is assoc. with the triceps reflex? C7
What 2 areas have sensation deficit in a lesion of the median nerve? lateral palm/thumb and the radial 2 1/2 fingers
What 2 areas have sensation deficit in a lesion of the ulnar nerve? medial palm and the ulnar 1 1/2 fingers
What 2 cutaneus nerves are lost in a lesion of the radial nerve? posterior brachial cutaneous and posterior antebrachial cutaneous
What 2 spinal roots make up the inferior trunk of the brachial plexus? C8, T1
What 2 spinal roots make up the superior trunk of the brachial plexus? C5, C6
What 2 structures pass through the internal auditory meatus? CN VII, VIII
What 2 symptoms are seen with a lesion of the musculocutaneus nerve? difficulty flexing the arm, variable sensory loss
What 2 symptoms are seen with a lesion of the ulnar nerve? weak intrinsic muscles of the hand, Pope's blessing
What 3 blood barriers does the body have? blood-brain, blood-gas, blood-testis
What 3 muscles are lost in a lesion of the musculocutaneous nerve? coracobrachialis, biceps brachii, and brachialis
What 3 muscles are lost in a lesion of the radial nerve? triceps brachii, brachioradialis, and extensor carpi radialis longus
What 3 structures pass through the foramen magnum? spinal roots of CN XI(ascending), brainstem, vertebral arteries
What 3 structures pass through the optic canal? CN II, ophthalmic artery, central retinal vein
What 4 'muscles' does the radial nerve innervate? Brachioradialis, Extensors of the wrist and fingers, Supinator, Triceps. (BEST)
What 4 areas is there decreased output in Parkinson's? substantia nigra pars compacta, globus pallidus, ventral anterior nucleus, cortex
What 4 movements are limpaired in a lesion of the ulnar nerve? wrist flextion, wrist addduction, thumb adduction, and adductiont of the 2 ulnar fingers
What 4 movements are lost in a lesion of the median nerve? forearm pronation, wrist flexion, finger flexion, and several thumb movements
What 4 structures pass through the jugular foramen? CN IX, X, XI(descending), jugular vein
What 4 things do the lateral striate arteries supply? internal capsule, caudate, putamen, globus pallidus
What 5 spinal nerves that make up the brachial plexus? C5, C6, C7, C8, T1
What 5 structures pass through the supperior orbital fissure? CN III, IV, V1, VI, ophthalmic vein
What 5 types of cells make up the suportive cells of the CNS/PNS? Astrocytes, Microglia, Oligodendroglia, Schwann cells, Ependymal cells.
What are 2 characteristics of Tabes Dorsalis? impaired proprioception and locomotor ataxia
What are 3 clinical findings of the arm in Erb-Duchenne palsy? arm hangs by the side, medially rotated, forearm is pronated
What are the 2 classic causes of Erb-Duchenne palsy? blow to the shoulder and trauma during birth
What are the 3 classic symptoms of Horner's syndrome? ptosis, miosis, anhydrosis
What are the 4 classic findings of Brown-Sequard syndrome? ipsi motor paralysis(spastic), ipsi loss of dorsal column, contra loss of spinothalamic, ipsi loss of ALL sensation at the level of the lesion
What are the input and output of the anterior nucleus of the thalamus? input - mammillary body, output - cingulate gyrus
What are the input and output of the cingulate gyrus? input - anterior nucleus of the thalamus, output - entorhinal cortex
What are the input and output of the entorhinal cortex? input - cingulate gyrus, output - hippocampal formation
What are the input and output of the mammillary body? input - hippocampal formation, output - anterior nucleus of the thalamus
What are the input and output of the septal area? input - hippocampal formation, output - hippocampal formation
What artery do the lateral striate branch off of? internal carotid artery
What artery does the anterior inferior cerebellar artery branch off of? basilar artery
What artery does the anterior spinal artery branch off of? vertebral artery
What artery does the posterior inferior cerebellar artery branch off of? vertebral artery
What artery does the superior cerebellar artery branch off of? basilar artery
What artery supplies Broca's and Wernicke's speech areas? middle cerebral artery
What artery supplies the medial surface of the brain (foot-leg area)? anterior cerebral artery
What bone do all the foramina of the middle cranial fossa pass through? sphenoid bone
What CN arises dorsally? CN IV trochlear
What CN is the afferent limb of the pupillary light reflex? CN II
What CN is the efferent limb of the pupillary light reflex? CN III
What CNs lie medially at the brain stem? CN III, VI, XIII (3 - 6 - 12)
What CNS/ PNS supportive cell has the following functions: central myelin production? Oligodendroglia
What CNS/ PNS supportive cell has the following functions: inner lining of the ventricles? Ependymal cells
What CNS/ PNS supportive cell has the following functions: peripheral myelin production? Schwann cells
What CNS/ PNS supportive cell has the following functions: phagocytosis? Microglia
What CNS/ PNS supportive cell has the following functions: physical support, repair, K+ metabolism? Astrocytes
What disease does Tabes Dorsalis result from? tertiary syphilis
What disorder results from a lesion in the medial longitudinal fasciculus (MLF). Internuclear ophthalmoplegia (INO)
What embryologic defect is thoracic outlet syndrome caused by by having a cervical rib.
What happens if a swinging light test is performed on a Marcus Gann pupil (afferent pupil defect)? results in pupil dialation of the defective eye as the light is swung from the normal eye to the defective eye
What happens if you illuminate one pupil in a normal patient? both eyes constrict (consensual reflex)
What hypo/hyper-kinetic disorder is marked by decreased serum ceruloplasm and Keyser-Fleischer rings in the eyes. Wilson's disease
What is a Argyll Robertson pupil? the eyes DO NOT constrict to light, but DO accommodate to near objects
What is affected in a central VII lesion (lesion above the facial nucleus - UMN)? paralysis of the contralateral lower quadrant
What is affected in a peripheral VII lesion (lesion at or below the facial nucleus - LMN)? paralysis of the ipsilateral face both upper and lower.
What is the common name for a peripheral VII lesion? Bell's palsy
What is the consequence when your CNS stimulates the gamma motor neuron and the intrafusal fibers contract? increased sensitivity of the reflex arc
What is the direct pathway from the striatum to the cortex? The striatum to the substantia nigra pars reticularis /medial globus pallidus to the thalamus to the cortex (excitatory path)
What is the embryologic tissue origin of Microglia (ecto/meso/edo)? Mesoderm
What is the indirect pathway from the striatum to the cortex? The striatum to the lateral globus pallidus to the subthalamic nucleus to the substantia nigra/medial globus pallidus to the thalamus to the cortex (inhibitory pathway but still increases the thalamic drive)
What is the lesion in Brown-Sequard syndrome? hemisection of the spinal cord
What is the most common circle of Willis aneurysm? anterior communicating artery
What is the name for the small muscle fiber type that regulates muscle length? Intrafusal fibers
What lesion produces coma? reticular activating system
What lesion produces conduction aphasia, poor repetition w/ poor comprehension, and fluent speech? Arcuate fasiculus
What lesion produces Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)? Amygdala (bilateral)
What lesion produces motor(expressive) aphasia with good comprehension? Broca's area (motor speech)
What lesion produces personality changes and deficits in concentration, orientation, judgement? frontal lobe - these are frontal release signs
What lesion produces sensory(fluent/receptive) aphasia with poor comprehension? Wernicke's area (associative auditory cortex)
What lesion produces spatial neglect syndrome? right parietal lobe -- contralateral neglect.
What lobe of the brain is the Broca's area in? frontal
What lobe of the brain is the frontal eye movement and pupillary change area in? frontal
What lobe of the brain is the premotor area in? frontal
What lobe of the brain is the primary auditory cortex area in? temporal
What lobe of the brain is the principal motor area in? frontal
What lobe of the brain is the principal sensory area in? parietal
What lobe of the brain is the principal visual cortex area in? occipital
What lobe of the brain is the Wernicke's area in? temporal
What midbrain structure is important in mitigating voluntary movements and making postural adjustments? Basal Ganglia
What mineral causes the pathology of Wilson's disease copper
What muscle depresses and extorts the eye? inferior rectus
What muscle elevates and intorts the eye? superior rectus
What muscle extorts, elevates, and adducts the eye? inferior oblique
What muscle fiber type makes up the muscle bulk and provides the force for contraction? Extrafusal fibers
What muscle intorts, depresses, and abducts the eye? superior oblique
What muscle sensor senses tension and provides inhibitory feedback to alpha motor neurons? golgi tendon organs
What muscular disorder is a medial longitudinal fasciculus syndrome associated with? Multiple Sclerosis (MLF=MS)
What nerve is known as the great extensor nerve? radial nerve
What neurotransmitter is decrease in Parkinson's disease dopamine
What nucleus if typically lesioned in hemiballismus? contralateral subthalamic nucleus
What nucleus of the hypothalamus controls circadian rhythms? suprachiasmatic nucleus
What nucleus of the hypothalamus controls hunger? lateral nucleus
What nucleus of the hypothalamus controls satiety? ventromedial nucleus
What nucleus of the hypothalamus controls sexual emotions? septate nucleus
What nucleus of the hypothalamus controls thirst and water balance? supraoptic nucleus
What part of the hypothalamus (ant./post.) controls autonomic regulation? anterior hypothalamus
What part of the hypothalamus (ant./post.) controls cooling when hot? anterior hypothalamus
What part of the hypothalamus (ant./post.) controls heat conservation when cold? posterior hypothalamus
What part of the ventral spinal cord is spared with complete occlusion of the ventral artery? dorsal columns
What passes through the cavernous sinus? (nerves and artery CN III, IV, V1, V2, VI, post-ganglionic SNS and the Internal carotid artery
What reflex is lost in a lesion of the musculocutaneous nerve? biceps reflex
What structure passes through the foramen ovale? CN V3
What structure passes through the foramen rotundum? CN V2
What structure passes through the foramen spinosum? middle meningeal artery
What structure passes through the hypoglossal canal? CN XII
What symptom is seen with a lesion of the axillary nerve? Deltoid paralysis
What symptom is seen with a lesion of the median nerve? decreased thumb function
What syndrome is seen with a lesion of the long thoracic nerve? Winged scapula
What syndrome is seen with a lesion of the lower trunk of the brachial plexus? Claw hand
What syndrome is seen with a lesion of the posterior cord of the brachial plexus? Wrist drop
What syndrome is seen with a lesion of the radial nerve? Saturday night palsy
What syndrome is seen with a lesion of the upper trunk of the brachial plexus? Waiter's tip (Erb-Duchenne palsy)
What two bones do all the foramina of the posterior cranial fossa pass through? temporal and occipital bones
What two hypothalamic nuclei does the posterior pituitary(neurohypophysis) receive neuronal projections from? supraoptic nucleus and paraventricular nucleus.
What type of fibers do the corticospinal tracts carry? motor
What type of fibers do the dorsal columns carry? sensory - pressure, vibration, touch, proprioception
What type of fibers do the spinothalmic tracts carry? sensory - pain and temperature
What type of function does CN I have? (sensory, motor, or both) sensory
What type of function does CN II have? (sensory, motor, or both) sensory
What type of function does CN III have? (sensory, motor, or both) motor
What type of function does CN IV have? (sensory, motor, or both) motor
What type of function does CN IX have? (sensory, motor, or both) both
What type of function does CN V have? (sensory, motor, or both) both
What type of function does CN VI have? (sensory, motor, or both) motor
What type of function does CN VII have? (sensory, motor, or both) both
What type of function does CN VIII have? (sensory, motor, or both) sensory
What type of function does CN X have? (sensory, motor, or both) both
What type of function does CN XI have? (sensory, motor, or both) motor
What type of function does CN XII have? (sensory, motor, or both) motor
What type of lesion is seen in Amyotrophic Lateral Sclerosis? combo of UMN and LMN lesions with no sensory deficit
What type of lesion is seen in Multiple Sclerosis? random asymmetric lesions in mostly white matter of the cervical region
What type of lesion is seen in Poliomyelitis and is it genetic or acquired? acquired LMN lesion causing flaccid paralysis
What type of lesion is seen in Werdnig-Hoffmann disease and is it genetic or acquired? genetic LMN lesion causing flaccid paralysis (aka. Floppy infant disease)
What type of molecule can cross the blood-brain barrier most easily? (lipid/nonlipid, polar/nonpolar) Lipid-soluable/nonpolar molecules
What vagal nuclei controls motor innervation to the pharynx, larynx, and upper esophagus? Nucleus Ambiguus (Motor=aMbiguus)
What vagal nuclei controls visceral sensory in formation like taste and gut distention? Nucleus Solitarius (Sensory=Solitarius)
What vagal nuclei sends parasympathetic fibers to the heart, lungs, and upper GI? dorsal motor nucleus of CN X
What would happen temperature regulation if you lesioned your posterior hypothalamus? lose the ability to conserve heat
What would happen temperature regulation if you lesioned your ventromedial nucleus of the hypothalamus? have hyperphagia and become obese
When is a positive Babinski a normal reflex? during the first year of life
Where is the lesion in a patient with hemiballismus? Subthalamic nucleus
Where is the lesion in Parkinson's? Substantia nigra pars compacta
Which CN is the only nerve that does not abut the wall in the cavernous sinus? CN VI (abducens)
Which CNs pass through the middle cranial fossa? CN II - VI
Which CNs pass through the posterior cranial fossa? CN VII - XII
Which division of the facial motor nucleus has duel innervation? (upper or lower) upper division
Which thalamic nucleus has a visual function? Lateral Geniculate Nucleus (LGB)
Which thalamic nucleus has an auditory function? Medial Geniculate Nucleus (MGB)
Which thalamic nucleus has pre-motor function? Ventral Anterior Nucleus (VA)
Which thalamic nucleus has the function of body senses(proprioception, pressure, pain, touch, vibration)? Ventral Posterior Lateral Nucleus (VPL)
Which thalamic nucleus has the function of facial sensation and pain? Ventral Posterior Medial Nucleus (VPM)
Which thalamic nucleus is the primary motor cortex? Ventral Lateral Nucleus (VL)
Which way does the head deviate in a unilateral lesion (LMN) of CN XI? (toward or away) toward the lesion -- note: First-Aid is wrong in the book)
Which way does the jaw deviate in a unilateral lesion (LMN) of CN V? (toward or away) toward the lesion
Which way does the patient tend to fall in a unilateral lesion (LMN) of the cerebellum? (toward or away) toward the lesion
Which way does the tongue deviate in a unilateral lesion (LMN) of CN XII? (toward or away) toward the lesion
Which way does the uvula deviate in a unilateral lesion (LMN) of CN X? (toward or away) away from the lesion
Why does the arm hang by the side in Erb-Duchenne palsy? paralysis of shoulder abductors
Why is L-dopa use for parkinsonism instead of dopamine? L-dopa crosses the blood-brain barrier while dopamine does not.
Why is the arm medially rotated in Erb-Duchenne palsy? paralysis of the lateral rotators
Why is the forearm pronated in Erb-Duchenne palsy? loss of the biceps brachii
Name 4 possible routes of herniation in the brain 1. Cingulate herniation under the falx cerebri 2. Downward transtentorial (central) herniation 3. Uncal herniation 4. Cerebellar tonsillar herniation into the foramen magnum
Name 3 herniation syndromes that can cause either coma or death when the herniations compress the brainstem 1. Downward transtentorial (central) herniation 2. Uncal herniation 3. Cerebellar tonsillar herniation into the foramen magnum
How often do primary brain tumors undergo metastasis? Very rarely
Are the majority of adult tumors supratentorial or infratentorial? Supratentorial
Are the majority of childhood tumors supratentorial or infratentorial? Infratentorial
What is the second most common primary brain tumor? Meningioma
Where do meningiomas most commonly occur? Convexities of hemispheres and parasagital region
From what cells do meningiomas most commonly arise? Arachnoid cells external to the brain
Are meningiomas resectable? Yes
What are a common histopathological finding of meningiomas? Psammoma bodies. These are spindle cells concentrically arranged in a whorled pattern.
What is the most common primary brain tumor? Glioblastoma multiforme (grade IV astrocytoma)
What is the prognosis for Glioblastoma multiforme? Prognosis is grave. Usually only have a year life expectancy.
Where are Glioblastoma multiformes found? Cerebral hemispheres
What is the common histopathology found in Glioblastoma multiforme? Pseudopalisading' tumor cells border central areas of necrosis and hemorrhage
What is an oligodendroglioma? A relatively rare, slow growing, benign tumor.
Where do oligodendrogliomas most often occur? Most often found in the frontal lobes
What is the common histopathology associated with oligodendrogliomas? Fried egg' appearance of cells in tumor. Often calcified.
What is the third most common primary brain tumor? Schwannomas
What is the origin of the Schwannoma? Schwann cell origin. Often localized to the 8th cranial nerve (acoustic schwannoma). Bilateral schwannoma found in NF2.
What is the common histopathology associated with schwannoma? Antoni A=compact palisading nuclei; Antoni B=loose pattern
What is the most common type of pituitary adenoma? Prolactin secreting
Name two presenting sequelae of a pituitary adenoma. 1. Bitemporal hemianopsia (due to pressure on the optic chiasm) 2. Hypopituitarism
What is the origin of a Pituitary adenoma? Rathke's pouch
Name 5 primary brain tumors with peak incidence in adulthood. 1. Meningioma 2. Glioblastoma multiforme 3. Oligodendroglioma 4. Schwannoma 5. Pituitary adenoma
Name 5 primary brain tumors with peak incidence in childhood. 1. Medulloblastoma 2. Hemangioblastoma 3. Ependymomas 4. Low-grade astrocytoma 5. Craniopharyngioma
What is a medulloblastoma? Highly malignant cerebellar tumor. A form of primitive neuroectodermal tumor (PNET). Can compress 4th ventricle causing hydrocephalus
What is the common histopathology associated with medulloblastomas? Rosettes or perivascular pseudorosette pattern of cells
What is a Hemangioblastoma? Most often a cerebellar tumor. Associated with von Hippel Lindau syndrome when found with retinoblastoma.
What is the common histopathology associated with Hemangioblastoma? Foamy cells and high vascularity are characteristic. Can produce EPO and lead to polycythemia.
What are ependymomas? Ependymal cell tumors most commonly found in the 4th ventricle. May cause hydrocephalus
What is the common histopathology associated with Ependymomas? Characteristic perivascular rosettes. Rod-shaped blepharoblasts (basal ciliary bodies) found near the nucleus.
What is a low-grade astrocytoma? Diffusely infiltrating glioma. In children, it is most commonly found in the posterior fossa.
What is a craniopharyngioma? Benign childhood tumor. Often confused with pituitary adenoma because both can cause bitemporal hemianopsia. Calcification of the tumor is common.
What is the origin of a craniopharyngioma? Derived from the remnants of Rathke's pouch
Approximately what percentage of brain tumors arise from metastasis? 0.5
Name 5 sites from which tumor cells metastasize to the brain. 1. Lung 2. Breast 3. Skin (melanoma) 4. Kidney (renal cell carcinoma) 5. GI
What is a helpful mnemonic to remember the site of metastasis to the brain? Lots of Bad Stuff Kills Glia
Name two of the most common sites of metastasis after the regional lymph nodes The liver and the lung
Name the 5 primary tumors that metastasize to the liver 1. Colon 2. Stomach 3. Pancreas 4. Breast 5. Lung
Which is more common: metastasis to the liver or primary tumors of the liver? Metastasis to the liver is more common
What is a helpful mnemonic to remember the types of cancer that metastasize to the liver? Cancer Sometimes Penetrates Benign Liver
What are 6 primary tumors that metastasize to bone? 1. Kidney 2. Thyroid 3. Testes 4. Lung 5. Prostate 6. Breast
What is a helpful mnemonic to remember what tumors metastasize to bone? BLT with a Kosher Pickle
Out of the 6 primary tumors that metastasize to bone, which two are the most common? Metastasis from the breast and prostate are the most common
Which is more common: metastasis to bone or primary tumors of bone? Metastatic bone tumors are far more common than primary tumors
What is the most common organ to receive metastases? Adrenal glands. This is due to their rich blood supply. The medulla usually receives metastases first and then the rest of the gland.
What is the most common organ to 'send' metastases? The lung is the most common origin of metastases. The breast and stomach are also big sources.
What causes the paraneoplastic effect of Cushing's disease? ACTH or ACTH-like peptide (secondary to small cell lung carcinoma)
What causes the paraneoplastic effect of SIADH? ADH or ANP (secondary to small cell lung carcinoma and intracranial neoplasms)
What causes the paraneoplastic effect of hypercalcemia? PTH-related peptide, TGF-a, TNF-a, IL-2 (secondary to squamous cell lung carcinoma, renal cell carcinoma, breast carcinoma, multiple myeloma, and bone metastasis)
What causes the paraneoplastic effect of Polycythemia? Erythropoietin (secondary to renal cell carcinoma)
What causes the paraneoplastic effect of Lambert-Eaton syndrome? Antibodies against presynaptic Ca2+ channels at NMJ (Thymoma, bronchogenic carcinoma)
What causes the paraneoplastic effect gout? Hyperuricemia due excess nucleic acid turnover (secondary to cytotoxic therapy of various neoplasms)
What is the most common cause of dementia in the elderly? Alzheimer's disease
What are 2 degenerative diseases of the cerebral cortex? 1. Alzheimer's2. Pick's disease
What is the pathology of Alzheimer's? Associated with senile plaques (beta-amyloid core) and neurofibrillary tangles
What are neurofibrillary tangles? Abnormally phosphorylated tau protein
What genes is the familial form of Alzheimer's associated with? Genes are chromosomes 1, 14, 19 and 21
Where is the aopE-4 allele located? Chromosome 19
Where is the p-App gene located? 21
What is the pathology of Pick's disease? Associated with Pick bodies, intracytoplasmic inclusion bodies
Where is Pick's disease specific for? The frontal and temporal lobes
What is the second most common cause of dementia in the elderly? Multi-infarct dementia
What are 2 degenerative diseases that affect the basal ganglia and brain stem? 1. Huntington's disease2. Parkinson's disease
How is Huntington's disease inherited? Autosomal dominant
What are the clinical symptoms of Huntington's disease? Dementia, chorea
What is the pathology of Huntington's disease? Atrophy of the caudate nucleus
What is the pathology of Parkinson's disease? Associated with Lewy bodies and depigmentation of the substantia nigra
What chemical can Parkinson's disease be linked to? MPTP, a contaminant in illicit street drugs
What are the clinical symptoms of Parkinson's disease? TRAP= Tremor (at rest)cogwheel RigidityAkinesiaPostural instability(you are TRAPped in your body)
What is a degenerative disorder of the Spinocerebellar tract? Friedrich's ataxia (olivopontocerebellar atrophy)
What are 3 degenerative disorders of the motor neuron? 1. Amyotrophic lateral sclerosis (ALS)2. Werdnig-Hoffman disease3. Polio
What is the common name for ALS? Lou Gehrig's disease
What neurons are affected in ALS? Both the upper and lower motor neurons
How does Werdnig-Hoffman disease present? At birth as a 'floppy baby'
What is another symptom of Werdnig-Hoffman disease? Tongue fasciculations
What neurons are affected in Polio? Lower motor neurons only
What are 2 common organisms that target the brain in AIDS pts? 1. Toxo!Toxo!Toxo!2. Cryptococcus
What damage does toxoplasma cause in the brain? Diffuse (intracerebral) calcifications
What damage does cryptococcus cause in the brain? Periventricular calcifications
Where are most brain tumors located in adults? 70% are supratentorial (cerebral hemispheres)
What is the incidence of brain tumors in adults? Metastases> Astrocytoma (including glioblastoma)> Meningioma
What are the pathological signs of glioblastoma multiforme (GBM)? -Necrosis-Hemorrhage-Pseudo-palisading
What is the shape of GBMs? Butterfly' glioma
What is the prognosis for a pts diagnosed with a GBM? Very poor
Where are most childhood brain tumors located? 70% below tentorium (cerebellum)
What is the incidence of brain tumors in children? Astrocytoma> Medulloblastoma> Ependymoma
What are the 4 types of intracranial hemorrhages? 1. Epidural hematoma2. Subdural Hematoma3. Subarachnoid hemorrhage4. Parenchymal hematoma
What artery is compromised in an epidural hematoma? Middle meningeal artery
What event is the rupture of the middle meningeal artery secondary to? Temporal bone fracture
What blood vessels are affected in subdural hemorrhages? Rupture of bridging veins
What is the course of a subdural hemorrhage? Venous bleeding (less pressure) with delayed onset of symptoms
In what persons is subdural hemorrhage often seen? Elderly individuals, alcoholics, and blunt trauma
What is the usual cause of a subarachnoid hemorrhage? A:
How do patients present with a subarachnoid hemorrhage? Worst headache of my life'
What does the spinal tap show in a subarachnoid hemorrhage? Bloody or xanthochromic
What causes a parenchymal hematoma? -HTN-Amyloid angiopathy-Diabetes Mellitus-Tumor
Where do berry aneurysms occur? At the bifurcations in the Circle of Willis
What is the most common site for a berry aneurysm? The bifurcation of the anterior communicating artery
What does rupture of a berry aneurysm lead to? Stroke
What is the most common complication of a berry aneurysm? Rupture of the aneurysm
What diseases are berry aneurysms associated with? -Adult polycystic kidney disease-Ehlers-Danlos syndrome-Marfan's syndrome
What are some demyelinating and dysmyelinating diseases? 1. Multiple sclerosis (MS)2. Progressive multifocal leukoencephalopathy (PML)3. Postinfectious encephalomyelitis4. Metachromatic Leukodystrophy5. Guillain-Barre syndrome
What is the classic triad of MS? SIN1. Scanning speech2. Intention Tremor3. Nystagmus
How is the prevalence of MS geographically distributed? Higher prevalence with greater distance from the Equator
What is the pathology of MS? -Periventricular plaques-Preservation of axons-Loss of oligodendrocytes-Reactive astrocytic gliosis-Increased protein (IgA) in CSF
What is the course of MS? In most pts, the course is remitting and relapsing
How do pts present with MS? -Optic neuritis (sudden loss of vision)- MLF syndrome (internuclear ophthalmoplegia)-Hemiparesis-Hemisensory symptoms-Bladder/bowel incontinence
What is PML associated with? JC virus
Which demyelinating disease is seen in 2-4% of AIDS patients? PML
What is another name for Guillain-Barre syndrome? Acute idiopathic polyneuritis
What is the pathogenesis of Guillain-Barre syndrome? Inflammation and demyelination of peripheral nerves and motor fibers of ventral roots (sensory effect less severe than motor)
What clinical symptoms are present? -Symmetric ascending muscle weakness beginning in the distal lower extremities-Facial diplegia in 50% of cases-Autonomic fx may be severely affected
What are the lab findings in Guillain-Barre syndrome? Elevated CSF protein with normal cell count ('albumino-cytologic dissociation')
What are associated with Guillain-Barre? 1. Infections (herpesvirus or C. jejuni)2. Inoculations3. Stress
What causes poliomyelitis? Poliovirus
How is the polio virus transmitted? Fecal-oral route
Where does it initially replicate? The oropharynx and small intestine
How does it spread? Through the bloodstream to the CNS
What is the pathology of poliomyelitis? Destruction of anterior horn cells, leading to LMN destruction
What are the symptoms of poliomyelitis? -Malaise-Headache-Fever-Nausea-Abdominal pain-sore throat
What are the signs of LMN lesions seen in poliomyelitis? -Muscle weakness and atrophy-Fasciculations-Fibrillation-Hyporeflexia
What are the lab findings in poliomyelitis? -CSF with lymphocytic pleocytosis with slight elevation of protein-Virus recovered from stool or throat
What do partial seizures affect? One area of the brain
What seizures are categorized as simple partial? Awareness intact-Motor-Sensory-Autonomic-Psychic
What is a complex partial seizure? Impaired awareness
What area of the brain is affected by generalized seizures? Diffuse area
What are the 5 types of generalized seizures? 1. Absence2. Myoclonic3. Tonic-clonic4. Tonic5. Atonic
Describe an absence seizure. A blank stare (petit mal- it's in 1st aid this way!!)
Describe a myoclonic seizure. Quick,repetitive jerks
Describe a tonic-clonic seizure. Alternating stiffening and movement (grand mal)
Describe a tonic seizure. Stiffening
Describe an atonic seizure. drop' seizures
Define epilepsy. Epilepsy is a disorder of recurrent seizures.
T/F. Partial seizures can not generalize. False- Partial seizures can generalize.
What are the common causes of seizures in children? -Genetic-Infection-Trauma-Congenital-Metabolic
What are the common causes of seizures in adults? -Tumors-Trauma-Stroke-Infection
What are the common causes of seizures in the elderly? -Stroke-Tumor-Trauma-Metabolic-Infection
What is another term for Broca's aphasia? Expressive aphasia
What is another term for Wernicke's aphasia? Receptive aphasia
Describe Broca's aphasia. Broca's is nonfluent aphasia with intact comprehension. BROca's is BROken speech.
Describe Wernicke's aphasia. Wernicke's is fluent aphasia with impaired comprehension.Wernicke's is Wordy but makes no sense.
Where is Broca's area located? Inferior frontal gyrus
Where is Wernicke's area located? Superior Temporal Gyrus
Describe Horner's syndrome. Sympathectomy of face (lesion above T1). Interruption of the 3-neuron oculosympathetic pathway.
What are the symptoms of Horner's? 1. Ptosis 2. Miosis3. Anhidrosis and flushing of affected side of face
What is ptosis? Slight drooping of the eyelids
What is miosis? Pupil constriction
What is anhidrosis? Absence of sweating
What tumor is Horner's syndrome associated with? Pancoast's tumor
Where does the 3 neuron oculosympathetic pathway project from? The hypothalamus
Where does the 3 neuron oculosympathetic pathway project to? 1. Interomediolateral column of the spinal cord2. Superior cervical (sympathetic) ganglion3. To the pupil, smooth muscles of the eyelids and the sweat glands
Where is the most common site of syringomyelia? C8-T1
What is the pathology of syringomyelia? Softening and cavitation around the central canal of the spinal cord.
What neural tracts are damaged? Crossing fibers of the spinothalamic tract
What clinical symptoms are present with syringomyelia? Bilateral pain and temperature loss in the upper extremities with preservation of touch sensation
What congenital malformation is often associated with syringomyelia? Arnold Chiari Malformation
Define syrinx. Tube, as in syringe
What is the pathogenesis of Tabes dorsalis? Degeneration of the dorsal columns and dorsal roots due to tertiary syphilis.
What are the clinical symptoms of Tabes dorsalis? -Charcot joints-Shooting pain-Argyll-Robertson Pupils-Absence of deep tendon reflexes
What neural deficits are present in Tabes dorsalis? Impaired proprioception and locomotor ataxia
Created by: megankirch