neuro HY
what is the lab tests for alzheimers
APOE4 increases APOE2 decreases (bad four you, two good to be true)
huntingtons
CAG autosomal dominant - cells lost from the indirect pathway ==> favors the direct pathway ==> causes chorea
stoke that hits the ACA
CL legs
what is the most common tumor in immunocompromes patient
CNS lymphoma
what is the efferent visual pathway
EWN ==> pre-ganglion occulomoter ==> cillary ganglion ==> post ganglion occulomotor nerve ==> sphinctor pupillary muslce (every person calls poop shit)
frontotemporal dementia
HPTP ==> picks disease , difference in activity and reasonioning of the patietn with primative reflexes
what is the risk factor for intraparanimal bleed
HTN ==> lipohylinaosis ==> plaque bbuild up and hyaline deposition in the artery
stroke that hits the MCA
IL face and CL arms
bbrown sequard syndrome
IL motor loss , IL dorsal columns, CL pain and temperature
cabbalifozin
SGLT2 inhibitor
ALS signs
UMN and LMN dysfunction, pure motor only
what part of the brain makes dopapmine
VTA and the subbstantial nigra in the midbrain
what NT is decreased in the brbain from alzheimers
acholine
wet macular degeneration
acute vision loss with metamorphsisa- blurry lines ==> grey to green discoloration of the lens ==> treat with VEGF
injury to CN IV results in
affected eye is not abble to move down and in from superior rectus ==> affected eye is higher on the tilted head
injury to CN VI results in
affected eye is not able to use lateral rectus - abduction
what is this histology of someone with parkensons
alpha syn nuclein with lewy bodies
what is an angiopathy that could lead to alzhiemers
amylodosis
what is a risk factor for lobar hemmorhages
amyloid deposition in the vascular - alzhimers
what is the mesolimbic pathway
associated with schizophrenia, connects the ventral tegmental area to the nucleus accumbens (Schiophrenia is Vere the most trouble accumulates)
what brain regions are affected in huntingtons
atrophy of the caudate and the putamen
huntingons inheriance
autosomal dominant
subdural hematoma
bbanana shaped- bbridging bveins - shaken bbaby syndrome - blood thinners - slow bbleed
subarachnoid hematoma
bberry anuerisms in the middle
stroke that hits the PCA
blindness IL, macular sparing temporal hemanpsois
what is the proper response to shining a light in one eye
both eyes constrict
what makes up the striatium
caudate and putamen
intraparanimal bleed
central bbleed, small
how to urinate
cerebbral cortex inhibits the sacral mituition center and the potine micturion cener activates
what is the indirect pathway
cortex ==> striatium ==> inhibited external GP ==> sunthalamic nucleus inhibited ==> internal GP and subbstantia nigra pars recticulars increased activity ==> thalamus inhibted (Come see everyone star in sussical tonight)
what is the direct dopamine pathway
cortex ==> striatium inhibits ==> inhibits internal GP and substantia nigra pars reticularis ==> allows the thalamus to act (Come straight into the thalamus - into means the inside ones are inhibited)
what is the cause of the negative symtpoms of schizophrenia
decrease in activity of the mesocortical - deccrease in dopamine
what occurs in parkensons
decrease in dopamine from the subbstantia nigra to the striatium
what is the issue with parkensons and the direct dopamine pathway
decrease in dopamine leads to decreased activation of the direct pathway ==> incharge of starting movements
what are the dpoamine receprtos for the direct and indirect pathway
direct is D1 and indirect is D2
what is the NT used in the tubuloinfadubular pathway
dopamine
what is the main chemical messager that is affected in schizophrenia
dopamine
where is the MLF
dorsal pons (helps see parallel)
injury to CN III results in
down and out eye with a blown pupil
dry macular degeneration
drusen deposits ==> red specs
what happens if you have a stoke in the posterior communicating artery
eyes down and out with pure sensory loss
what is seen in the brain as a result of alzheimers
flat gyri with wide sulci
What is the mesocortical pathway
from the ventral tegmental nucleus to the cortex ( they must have a very tan core to not wear a shirt)
where in the brbain does alzheimers hit the hardest
hippocampus
what happens when you have a lesion to the lateral geniculate nucles
homonomous hemianospia with macular sparin
What is the tubuloinfadubbular pathway
hypothalamus ==> pitiutary ==> releases prolactin
what happens with prolactin and dopamine
increase dopamine ==> increased prolactin and decreased GnRh
what is a related assoication with Alzhimers disease
increased APP from autism
cerebral cortex
inhibits the sacral micturion center
polyarthritis arthritical
intermittened episodes of abdominal pain, peripherial neuropathy, renal insufficeny, and severe HTN
what happens when you have a lesion to the left optic nerve
left anopia
epidural hematome
lens shaped - MMA from the maxillary artery - lucid interval
chocart bbouchard microanurism
lenticulostriate brnachies off of the MCA ==> hits the internal capsule ==> pure motor stroke
sacral mitrution center
located S2-S4 level and responsibble for bladder contraction
where do you make norephinphrine
locus cereulus - posterior pons near the floud of the fourth ventricle (Noepi makes you loco)
what test needs to be order before completing cabaglifozin
look at the serum crearinine
how does the MLF work
look to the right ==> lateral rectus ==> CN VI in the pons) ==> abudction ==> crosses CL to the MLF in the pons ==> CNIII ==> midrbain ==> medial rectus
what happens when you have a lesion to the optic chaisma
loos the temporal lision ==> bitemporal hemianiponia
where is the occulomotor nucles
midbrain (meets in the middle)
polymalgia rhmatica
myalgias of the shulder and pelvic girdle muscles, usually with fever and weight loss, don't have weakness
what would you see on histology for altzhimers disease
neurobribillary tangles and hyperphosphroylated Tau proteins (people with alzheimers get people all tangled up) - look like little sticks; sensile plaques of bebta cleavged APP (alzheimers forget their ABCs) - big circles
what is the only medication used for subarachnois hematoma
nimodipine
dementia
no change in consciousness - change in cognition (demon takes over bbody)
what is assoicated with bbladder use and the head
normal pressure hydrocephalus
how do you know there is a problem with the visual reflex pathway
one or both eyes don't constrict to light
polio
only lower MN
where do you make Dynophin
opioid organic - periaquadructal grey matter, dorsal horn of the spinal tract
what is the cause of positive symtoms of schizophrenia
overactive mesolimbic pathway from an increase in dopmanine
what is the issue with parkensons and the indirect pathwya
overactivity of the indirect pathway from the decrease in dopamine leads to muscle issues
lewy body dementia
parkensons with hallucinations, faster oneset
what pathway is increased in positive versus negative symptoms of schiophrenua
positive has overactivyt of the mesolimbic, negative has underactivity of the mesocortical (too much stimulation for the limbic is better than too little stimulation for the core muscles)
what are common causes of berry anuerism
posterior comminicating (down and out eye) and anterior communicating (bitemporal hemaianopsia) (ABBC)
where do you make histamine and orexin
posterior hypothalamus
what gene mutations are associated with alzheimers
pre-sillin 1 and 2
delirium
rapid fluctuation in consciousness - no change in cognition (dreming of sleep)
after a subarachnoid hematoma, what is the greatest risk of death 1-3 days
rebleeding
labor hemmorhage
recurrent large area hemmorhages
pontine mictuition center
relation of external urethral sphinctor within the bladder contraction during voiding
what is the nigrastriatial pathway in charge of
responsible for the coordination of movement
what is the afferent visual pathway
retina ==> optic nerve ==> to the PTA and the LGN - mainly to the PTA ==> splits the signal and sends to the EWN (Have to be able to see to PE)
what happens when you have a lesion to the left optic tract
right homonymous hemisanopisa
what kind of tumors cause hearing loss
shwannomas
what is related to lambert eatson syndrome
small cell lung cancer
vascular dementia
stepwise decline in cognition with cerebrovascular risk factor ==> cognition drops over the the past few years
what is the nigrastiral pathway
sunstantia nigra to the striatium (ParkenSonS)
what happens when you have a lesion to meyers loop
superior lateral geniculate nucleus ==> pie in the sky opp of the lesion
polymotysis
symettrical proximal muscle weakness, elevated muscle enzymes, inflammation, HMC I
what can a subbarachnpoid hematoma lead to
temporal lobe herinations
what is a sign CN III is not working
the eye will be "blown" and facing down and out
what is related to MG
thymona
what is the preventative treatment for migraines
topramate, valproate, TCAs, BB ( prevent the headache and TV BB)
what are the abortive treatments for migranes
tripians, NSAIDS, erfotaminine ( ewh not today migraine)
lambert eaton syndrome
type II HS reaction blocking pre synaptic calcium channels ==> results in proximal muscle weakness that gets bbetter as the day continues
after a subbbarachnoid hematoma, what is the greatest risk of death 7 - 21 days
vasospasm stroke
what area of the brain is primarily affected in schizophrenia
ventral tegmental area (freud said this is vere the trouble is)
arcutate scotomas
visual defects from lesions to the particular region of the optic nerve head ==> shaped like the lesion
what is associated with normal pressure hydrocephalus
wet wobbbly wacky
scotoma
when you have a visual defect that Is surrounded bby an unimpaired visual field - catarcts around the macula, macular denergation - circle in the middle of the screen
when do you see injury to the MLF
with MS
dawsons fingers
with MS - periventricular with oligioclonal bbands in the CSF