Patho Final
Which of the following is a nuerohormone? (GH, ACTH, ADH, T3T4)
ADH
mixed UMN and LMN disorder; progressive disorder
ALS
cortical atrophy and loss of neurons mainly in parietal and temporal lobes; amyloid-containing neuritic plaques and neurofibrillary tangles are present
Alzeimer disease
continuous, worm-like twisting and turning motions
Athetosis
Neurogenic inflammation involves release of chemical mediators by ___ nerve fibers, and these chemicals cause (vasodilation, vasoconstriction) of blood vessels that lead to (acute, chronic) pain
C vasodilation chronic
blocks release of ACH, food poisoning agent
Clostridium botulinum toxin
rare transmittable form of dementia caused by an infective protein called a prion; degeneration of pyramidal and extrapyramidal tracts; mad cow disease
Creutzfeldt-Jacob disease
increaded levels of FBG or insulin requirements between 5-9am without preceding hypoglycemia
Dawn phenomenon
recessive single-gene trait on X chromosome defective dystrophin protein fails to provide normal attachment site for contractile proteins with the CM
Ducheene MD
child is in a wheelchair with a progressive genetic disorder
Duchenne MD
"repair hormone" but excluded from brain because of blood brain barrier
GH
decreases peripheral use of glucose
GH
primary anabolic hormone
GH
prolonged increase induces glucose resistance
GH
sequence of loss of hormones
GH to LH/FSH to TSH to ACTH
Which of the following is (are) not tropic? (LH, FSH, ACTH, GH, MSH)
GH, MSH
found in all tissues; doesn't require insulin for its action; used to transport glucose into nervous system cells
GLUT-1
transporter of glucose into beta cells of pancreas and liver cells
GLUT-2
insulin-dependent glucose transporter of skeletal muscle of adipose tissue
GLUT-4
promotes gluconeogensis/glycogenolysis
Glucagon, cortisol
nervousness, irritability, weight loss, tachycardia, sweating, heat intolerance, exopthalamos
Graves disease
acute immune-mediated polyneuropathy characterized by progressive limb weakness and loss of tendon reflexes; linked to infections with bacterial and/or viral agents
Guillan-Barre syndrome
autoimmune disorder, most common type of hypothyroidism and goiter in children and adults
Hashimoto disease
hereditary disease with chronic progressive chorea, psychological changes and dementia; loss of GABA-secreting neurons; autosomal dominiant
Huntington disease
Injury to the right (C7, T3, L4) spinal nerve by a herniated disk is most likely to lead to leg weakness and pain to the (right, left) leg
L4 left
innervate skeletal muscle fibers
LMN
The polio virus is likely to destroy (UMNs, LMNs) causing (spastic, flaccid) paralysis and (atrophy, hypertrophy) of muscles
LMN flaccid atrophy
normal GH levels but have a genetic defect in IGF production; treated with IGF-1 replacement
Laron-type dwarfism
demyelinating disease of CNS
MS
autoimmune disorder; ab-mediated destruction of ACH receptors and abnormal T-lymphocyte function; fewer ACH receptors are present causes muscle weakness and fatigue
Myasthenia gravis
Which of the following hormones is not produced by the hypothalamas? (TRH, GHIH, CRH, PRL, ADH)
PRL
When blood Ca2+ is low, (calcitonin, PTH) is produced
PTH
increases blood calcium
PTH
degenerative disorder of basal nuclei; destruction of nigrostriatal pathway that produces dopamine
Parkinson disease
frontal and temporal lobe affected; neurons contain Pick bodies; atrophy
Pick disease
cycle of insulin-induced posthypoglycemia episodes; see compensatory increase in glucagon, epinephrine, cortisol and GH with development of hyperglycemia
Somogyi effect
elevates body T
T3/T4
project from motor cortex to brainstem or spinal cord; exert control over the lower motor neurons
UMN
wet brain; vitamin b-12 deficiency; results from chronic alcoholism; weakness of extraocular muscles, nystagmus, ataxia, confusion, unsteady gait, impaired recent memories and cofabulations
Wernicke-Korsakoff syndrome
petit mal; generalized, nonconvulsive events
absensce seizure
removes NT from neuromuscular junction
acetylcholinesterase
due to hypothalamic-pituitary tumor
acquired GH deficiency later in childhood
excessive GH during adulthood; common cause is somatotropic adenoma or excessive GHRH secretion by hypothalamus
acromegaly
hypersecretion of GH (adult)
acromegaly
from tissue damage; characterized by ANS responses
acute pain
destruction of adrenal cortex
addison disease
site of glucocorticoid production
adrenal cortex
site of catecholamine production
adrenal medulla
impaired recognition of normal sensory inputs
agnosia
can alter blood pH
aldosterone
intense pain is associated with light touch
allodynia
pain that follows a non-noxious stimulus to apparently normal skin
allodynia
absence of pain on noxious stimulation or relief of pain without loss of consciousness
analgesia
intermediate-grade
anaplastic astrocytomas
Calcitonin and PTH are (synergists, antagonists)
antagonists
damage to anterior spinal artery and anterior 2/3 of cord; loss of corticospinal motor function, ipsilateral proprioception and contralateral pain and T
anterior cord syndrome
site of TSH production
anterior pituitary
includes neo- and paleospinothalamic tracts
anterolateral pathway
includes tracts for pain, hot, cold, crude trouch
anterolateral pathway
inability to comprehend, integrate, or express language
aphasia
impaired ability to carry out previously learned motor activities
apraxia
control pain because they block enzyme needed for PG synthesis
aspirin/NSAIDS
well-differentiated lesions
astrocytomas
sudden imbalance
ataxia
loss of ability to feel changes in temperature in a limb
athermia
continuous, wormlike, twisting movements
athetosis
akinetic; sudden loss of muscle tone, slackening of jaw
atonic seizure
excessive sweating, salivation, lacrimation
autonomic manifestations
violent, flinging movement of limbs
ballismus
site of PTH action
bone, kidney, and intestines
caused by increased function of basal nuclei inhibitory loop; slowness beginning movement; reduced/absent emotional/facial responses
bradykinesia
slow, shuffling gait, difficulty initiating movements
bradykinesia
irreversible loss of brain function
brain death
promotes osteoblast activity
calcitonin
traveling blood clot lodges within a vessel; affects the middle cerebral artery; most emboli originate in the left ventricle; can originate from fatty plaque within carotid arteries;
cardiogenic embolic stroke
compression-type mononeuropathy of the median nerve; nerve is compressed as it travels through a canal made by the carpal bones and the transverse carpal ligament; can be caused by systemic disease, wrist injury, and with performance of repetitive wrist movements
carpal tunnel
abnormally high growth rate as child approaches normal height for age; occurs after initiation of therapy for GH deficiency or hypothyroidism
catch-up growth
damage to lumbosacral nerve roots
cauda equina syndrome
central gray or white matter is affected
central cord syndrome
decomposition of movements so that each movement component occurs separately instead of being blended together as a smooth. uniform action
cerebellar ataxia
brief, rapid, jerky movements
chorea
sudden, jerky, irregular movements that are coordinated and graceful
chorea
persistent pain that may be accompanied by loss of appetite, depression, sleep disturbances, and other debilitating responses
chronic pain
normal intelligence, short stature, obesity with immature facail features and delayed skeletal maturation
classic GH deficiency
rhythmic contraction/relaxation of limb caused by suddenly stretching a muscle and maintaining the stretched position
clonus
severe, unilateral, supraorbital, or temporal pain lasting 15-180 minutes and is accompanied by conjunctival injection or lacrimation, ipsilateral
cluster headache
ratchet-like movements of arms, form of rigidity
cog-wheel movements
cannot make a purposeful response to stimulation
coma
impaired reabsorption of the CSF from the arachnoid villi to the venous system
communication hydrocephalus
If the spinal cord is severed at T6, from level T7 downward ___ (communication with the brain is lost, spinal cord reflexes are lost, both occur)
communication with the brain is lost
momentary interruption in brain function with or without loss of consciousness
concussion
inattention, disorientation, blunted responsiveness
confusion
causes preventable mental retardation
congenital hypothyroidism
children with moderately short stature, thin build, delayed skeletal and sexual maturity
constitutional short stature
child is taller than peers and is growing at a velocity within the normal range for bone age
constitutional tall stature
bruise to the cortical surface of the brainn due to blunt head trauma
contusion
motor seizure involving the entire body
convulsion
decreases the inflammatory response
cortisol
glucagons, GH, epinephrine and cortisol to maintain or increase maintain or increase blood glucose
counter-regulatory hormones
impact injury from mechanical forces where brainn bounces against skull
coup-contrecoup
preventable mental retardation
cretinism
acts on postsynaptic side of NM junction to block the depolarizing effect of ACH; results in flaccid paralysis
curare
muscle relaxer that inhibits ACH
curare
bright, sharp, burning pain with origin in skin or subq tissues
cutaneous pain
increase in fluid in intracellular space; primary gray matter
cytoxic edema
With increase BP, ADH secretion (increases, decrease, remains unchanged)
decreases
diffuse, throbbing pain that originates in muscles, bones, and tendons and radiates to the surrounding tissues
deep pain
marked inattentiveness and wither lethargic or agitated
delirium
individual is in a long-term coma and paralyzed following traumatic brain injury
denervation atrophy
hyposecretion of ADH
diabetes insipidus
autoimmune destruction of beta cells; lack of insulin; elevated blood glucose; breakdown of body fats and proteins
diabetes mellitus 1
hyperglycemia, inactive lifestyle and overeating, insulin resistance and impaired suppression of glucose production by liver
diabetes mellitus 11
decreased sensitivity to insulin
diabetes mellitus type 11, gestational diabetes
hyposecretion of insulin
diabetes mellitus, type 1
can cause end-stage renal disease; associated with increased work demands glucose reabsorption and microalbuminemia
diabetic nephropathies
leads to destruction of retinal vascular supply/permeability
diabetic retinopathy
microscopic damage to axons in cerebral hemispheres, corpus callosum and brainstem
diffuse axonal injury
fractured leg immobilized in a caste for two months
disuse atrophy
nonfunctional pituitary tumor
don't secrete hormones
articulation, pitch, or quality of speech is affected
dysarthria
hands on knees, can't rapidly pronote/supinate forearms
dysdiadochokinesia
distortions of somesthetic sensation
dysesthesia
drooling, difficulty swallowing
dysphagia
"wry neck" or torticollis
dystonia
abnormal maintenance of posture; twisting, turning of limbs, neck, trunk,
dystonia
derived from layer of epithelium that lines ventricles and spinal canal
ependymomas
occurs between skull and dura; usually results from tear in an artery; rapid compression of brain occurs due to faster arterial flow
epidural hematoma
recurrent seizures
epileptic seizures
The release of which of the following hormones is controlled directly by the nervous system? ( GH, PRL, T3/T4, PTH, epinephrine)
epinephrine
primary stress response hormone
epinephrine
increases blood pressure
epinephrine, ADH, aldosterone
increases blood sugar levels
epinephrine, glucagon, cortisol
True or False: Glutamate and substance P both inhibit pain.
false
True or False: the PAG region is located in the midbrain and causes pain
false
True or False: Most migraines occur with an aura
false
Acute mechanical and thermal painful stimuli are transmitted along _____ _____ fibers
fast AS
Most of the area of the primary sensor cortex is devoted to the perception of sensations from the (fingers & face, trunk, hips & feet, all body areas have equal coverage)
fingers and face
begin simultaneously in both hemispheres
generalized seizures
tall child of tall parents
genetic tall stature
excessive GH
gigantism
astrocytic and oligodendroglial
glial tumors
least differentiated and most aggressive
glioblastoma multiforme
maintains or raises blood sugar by increasing release of glucose from liver into the blood
glucagon
increase gluconeogeneisis
glucagon and cortisol
increase fat usage
glucagon and epinephrine
promote glycogenolysis
glucagon and epinephrine
excitatory NT released by the AS fibers within the spinal cord. acts quickly but lasts only a few msec
glutamate
vascular injury and bleeding
hematomas
inability to attend to or react to stimuli coming from the contralateral side
hemineglect
spontaneous hemorrhage into brain substance resulting in edema, compression, or vasospasms
hemorrhagic stroke
enlargement of the CSF compartment
hydrocephalus
pain sensitivity is increased
hyperalgesia
excessive hormone production; excessive stimulations and hyperplasia of gland or hormone-producing tumor
hyperfunction
increase in resistance to rapid muscle stretch
hyperotonia
exaggerated response to moderate painful stimulus
hyperpathia
syndrome where sensory threshold is raised
hyperpathia
increases metabolic rate and oxygen consumption; increases use of metabolic fuels and increased sympathetic nervous system responsiveness (tachycardia)
hyperthyroidism
absence/impaired development of gland
hypofunction
Hypersecretion of insulin results in (hyperglycemia, hypoglycemia)
hypoglycemia
decreased secretion of pituitary hormones; affects many other endocrine glands
hypopituitarism
site of vasopressin production
hypothalamus
site of neurohormone production
hypothalamus, adrenal medulla
decrease in metabolic rate, myxedema in connective tissues and elevates serum cholesterol (short and mental retardation)
hypothyroidism
reduced excitability; ranges from postural weakness to total flaccid paralysis
hypotonia
lowers blood sugar by moving glucose into body tissues
insulin
secreted with increase blood glucose
insulin
difficulty tracing back of left shin with toes of right foot
intention tremor
early activation of hypothalamic-pituitary-gonadal axis
isosexual precocious puberty
fats broken down in the liver and converted to ketones
ketoacidosis
small, located deeper within brain or in brainstem; caused by embolism, hypertension, small vessel occlusion, hemorrhages, vasospasms, hemotologic abnormalities; cause pure motor or pure sensory hemiplegia and dysarthria with clumsy hand syndrome
lacunar infarcts
shock-like tingling down back and legs and leads to neck flextion
lhermitte symtom
provides an emotional response to pain
limbic cortex
site of insulin action
liver
coronary artery disease, stroke, and peripheral vascular supply insufficiencies
macrovascular complications
insecticide that binds to ACHase extending ACH action
malathion
lack of facial expression
masklike face
1st order neurons travel from spinal cord to medulla
medial lemniscal pathway
allows you to discriminate between a paperclip and a key
medial lemniscal pathway
permits proprioception
medial lemniscal pathway
slow-growing and well-circumscribed; usually benign and can be completely removed if surgically accessible
meningiomas
insulin resistance, hyperglycemia, 'syndrome X,' obesity, increase plasma triglycerides, decrease high density lipoproteins. hypertension, systemic inflammation, abnormal fibrinolysis, macrovascular disease, abnormal function of vascular endothelium
metabolic syndrome
pituitary tumor that is primary or secondary
metastatic
pulsating, throbbing, unilateral headache lasts 1-2 days and is aggravated by physical activity; may be accompanied by nausea and vomiting
migraine headache
carpal tunnel syndrome
mononeuropathy
muscle cells decrease in diameter and weaken due to lack of use
muscle atrophy
progressive degeneration and necrosis of skeletal muscle
muscular dystrophy
muscle weakness resulting from auto immune disease that destroys ACH receptors
myasthenia gravis
involuntary muscle contractions induced by stimuli of cerebral origin; jerky muscles, generalized or confined to face, trunk, or extrmetity
myoclonic seizures
accumulation of hydrophilic mucopolysaccharide substance
myxedema
inhibits ACHase extending ACH action
neostigmine
inhibits action of ACHase allowing ACH to persist in NM junction; used in myasthenia gravis treatment
neostigmine
FPG< 100mg/dL
normal
constant readjustment of eye movement
nystagmus
eyes constantly readjusting
nystagmus
cannot be fully aroused
obtundation
doll's head eye movement
oculocephalic reflex
cold water in ear canal to elicit nystagmus
oculovestibular reflex
miss touching fingertip to nose with eyes closed
over-/under- reaching
missing of target when reaching and overcorrecting
over/under-reaching
responsible for milk letdown
oxytocin
deficiency of all anterior pituitary hormones
panhypopituitarism
arm function still present; loss of function in thoracic, lumbar, or sacral segments of spine
paraplegia
Which of the following is (are) not influenced by the anterior pituitary? (thyroid, parathyroid, adrenal cortex, adrenal medulla)
parathyroid, adrenal medulla
weakness
paresis
spontaneous, unpleasant sensations seen with severe irritation
paresthedia
return of sensation after your foot falls asleep
paresthesia
begins in a specific or focal area of one cerebral hemisphere
partial seizures
Intense stimulation of virtually all types of sensory receptors can lead to pain. This is a statement of the (pattern, specificity) theory of pain
pattern
affect both ANS and somatic NS, due to demyelinating effect of long-term uncontrolled DM
peripheral neuropathies
prolongs coma, loss of all cognitive functions, unaware of self and surroundings, reflex and vegetative functions remain
persistent vegetative state
hyposecretion of GH (child)
pituitary dwarf
can be primary or secondary and may be functional or nonfunctional
pituitary tumor
paralysis; lost of movement
plegia
excessive thirst
polydipsia
paralysis traveling from legs to upper body following a viral infection
polyneuropathy
excessive hunger
polyphagia
excessive urination
polyuria
site of ADH release
posterior pituitary
originate in target gland
primary defects
pinpoints specific location of pain
primary somatosensory cortex
active insulin is formed from a larger molecle
proinsulin
released from inflamed tissues enhance the sensitivity of pain endings but they don't directly stimulate them
prostaglandins
seen in emotionally deprived children; GH function can return to normal after removal from bad environment
psychosocial dwarfism
normal GH, decrease somatomedins
pygmy
originates in a visceral organ but is perceived elsewhere in the body wall that is innervated by neurons entering the same segment of the nervous tissue
referred pain
diskinesias
rhythmic, repetitive, bizarre movements; causes grimacing, pursuing of lips, sticking out tongue
increased resistance to movements in all direction
rigidity
defective levels of stimulation or releasing factors
secondary defects
functional pituitary tumor
secrete hormones
provides a meaning/context for the pain
sensory association area
declining levels of GH in the elderly
somatopause
inhibits the release of insulin and glucagons
somatostatin
sudden complete transaction of cord; loss of motor, sensory, reflex, and autonomic function below the level of energy
spinal cord shock
seizures that do not stop spontaneously or occur in succession
status epilepticus
remain in a sleeplike state
stupor
between dura and arachnoid layer; usually due to tear in small bridging veins; develops more slowly because of slow venous flow; can be acute, subacute, or chronic
subdural hematoma
released more slowly and increases in concentration over seconds/minutes
substance P
repetitive, bizarre movements of face
tardive dyskinesia
dull, aching, diffuse, nondescript headaches occurring in a hatband distribution around the head; may result from oromandibular dysfunction, stress, anxiety, depression, overuse of analgesics or caffein
tension headache
results from hypothalamic dysfunction
tertiary disorders
impaired/lost motor or sensory function following cervical spine injury
tetraplegia
generalized awareness of hurt or pain
thalamus
usually occur in atherosclerotic vessels at bifurcations; affect cortex and cause aphagia or neglect and visual field defects
thrombotic stroke
crisis form of thyrotoxicosis; see high fever, extreme cardiovascular effects and CNS dysfunction; precipitated by stress, trauma
thyroid storm
repetitive winking of eyelids, abnormal facial movements
tic
sudden, irregular contraction; particularly evident in face
tix
grand-mal; vague warning precedes seizure activity; sharp tonic contractions followed by clonic phase of rhythmic bilateral contractions/relaxation of extremities; person is unconscious until RAS begins to function again
tonic-clonic seizures
focal ischemic deficits that last for less than one hour can be warning sign of impending stroke
transient ischemic attacks
single or multiple; associated with head injury
traumatic intracerebral hematomas
"pill-rolling" movements of PD
tremor
involuntary, oscillating contractions of opposing muscle groups around a joint
tremors
True or False: GH and T3/T4 act as synergists
true
True or False: Migraines and tension-type headaches are primary or chronic headaches
true
True or False: Tension-type headaches may be caused by caffeine withdrawls
true
True or False: prostaglandins tend to enhance pain
true
True or False: the NRM is located in the medulla and is thought to inhibit pain
true
can't stand with a steady posture
truncal ataxia
difficulty/inability to maintain steady posture of trunk
truncal ataxia
results from cerbrovascular disorders; cognitive impairment that vary with location and extent of underlying pathology; impaired ability to organize thought, time, materials, belonging, initiating tasks, focusing on task
vascular dementia
fluid escaped into ECF that surrounds brain cells
vasogenic edema
diffuse, poorly-defined pain that results from stretching, distention, or ischemia of tissues in a body organ
visceral pain
genetic short stature
well-proportioned; heigh close to mid-parental height
T3/T4 secretion is generally higher during (summer, winter) months
winter