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2010-04-27 22:27:41

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  1. astrocytes
    Come to your rescue when injury occurs. Physical support, repair (reactive gliosis = only time you can see astrocytes w/o GFAP stain), modulate inflammation since brain swelling is bad. Derived from neuroectoderm.
  2. Microglia
    Munchers (phagocytes), derived from mesoderm. With tissue damage, they become large & engorged (ameboid). Little cytoplasm, plus small, irregular nuclei.
  3. Oligodendroglia
    Myelinate multiple CNS axons (up to 30 each). Small nuclei & little cytoplasm. Destroyed in MS.
  4. Schwann cells
    Myelinate 1 PNS axon. Destroyed in Guillain-Barre syndrome. Derived from neural crest cells.
  5. What is Nissl substance, & where is it found?
    RER. Found in dendrites & cell bodies of neurons, but not in their axons.
  6. Meissner's corpuscles
    Detect dynamic touch (e.g. manipulation); fast adaptation. Found in hairless (glabrous) skin... so, a massage feels better on your back than your forearms.
  7. Merkel's disks
    Slowly adapting; detect static touch. (Meissner's vs. Merkel's: Merle is old & static.) Found in hair follicles (b/c old men are hairier).
  8. Pacinian corpuscles
    Vibration in pressure. Found in joints, ligaments, deep skin layers.
  9. Neurotransmitter changes with anxiety disorder
    Inc'd norepinephrine, dec'd serotonin.
  10. For what conditions does dopamine increase or decrease?
    Decrease = Parkinson's; increase = schizophrenia.
  11. For what conditions does ACh decrease?
    Alzheimer's, Huntington's
  12. Locations of BBB where capillaries are fenestrated
    Vomiting center (area postrema), OVLT (for osmolarity). Both signal to hypothalamus.
  13. Supraoptic nucleus of hypothalamus
    • Makes ADH (Vasopressin)
    • Mnemonic = ASOP: ADH Supraoptic, Oxytocin Paraventricular.
  14. Paraventricular nucleus of hypothalamus
    Makes oxytocin
  15. Ventromedial area of hypothalamus
    Satiety; stimulated by leptin (circulates in adipocytes)
  16. Posterior hypothalamus
    Sympathetic output (watch your back), heating
  17. Septal nucleus of hypothalamus
    Sexual urges
  18. The deep nuclei of cerebellum
    Don't eat greasy foods: dentate (fine motor), emboliform, globose (spinal cerebellum), fastigial (balance - vestibulocerebellum; truncal posture)
  19. Kluver-Bucy syndrome
    Bilateral amygdala lesions: disinhibited, hypersexuality, hyperorality
  20. Bilateral lesions of mammillary bodies
    Wernicke-Korsakoff syndrome. Wernicke's encephalopathy = reversible: confusion, ataxia, ophthalmoplegia. Korsakoff's psychosis = irreversible: confabulation due to amnesia -- so you don't know you're making things up.
  21. Middle cerebellar peduncle receives input from
  22. Inferior cerebellar peduncle receives input from
  23. Huntington's disease -- including chromosome
    CAG repeats on chromosome 4. Lose GABA neurons from caudate nucleus (makes sense, since caudate = cognitive while putamen = more motor). Depression, dementia, chorea.
  24. Hemiballismus
    Wild flailing of 1 arm. Contralateral subthalamic nucleus lesion --> internal globus pallidus is no longer excited as much --> less tonic inhibition of thalamus.
  25. Intention tremor
    Cerebellar dysfunction. Zigzag motions when pointing toward a target.
  26. Wallenberg syndrome (including the vessel infarcted)
    Lateral medulla, PICA. Sx: nausea/vom/vertigo (vestibular nuclei), dysphagia & palate droop (CN's 9 & 10), ALS -- ipsilateral face, contralateral body, ipsilateral Horner's & ataxia
  27. Basilar artery infarct
    Locked-in syndrome: corticospinal & corticobulbar tracts, also PPRF in pons - but can do vertical gaze b/c that's midbrain (superior colliculus).
  28. Conditions predisposing to aneurysms
    APKD, Ehlers-Danlos, Marfan's, HTN (Charcot-Bouchard), smoking
  29. First structure hit if each ventricle expanded
    • Lateral ventricle = caudate
    • 3rd = hypothalamus
    • 4th = pons
  30. Types of 3rd-ventricle cysts
    Colloid cyst = columnar epithelium, mucin-producing. Cysticercosis = Tenia solium. Echinococcus = dog feces
  31. Glioblastoma multiforme: location, histopathology
    Cerebral hemispheres. Astrocytes stain for GFAP (just like pilocytic astrocytoma in kids). Bizzare, pleomorphic, pseudopalisading tumor cells; central necrosis and hemorrhage.
  32. Meningioma: histopathology
    Arises from arachnoid cells. Whorled pattern of spindle cells; psammoma bodies (calcification).
  33. Oligodendroglioma: location & histopathology
    Often frontal lobe, fried-egg appearance (round, dark nucleus & clear cytoplasm). Slow-growing & relatively rare.
  34. Bitemporal hemianopia
    Lose temporal halves of visual fields, which means lose nasal halves of retina -- the crossing fibers at optic chiasm. From pituitary adenoma or craniopharyngioma (both derivatives of Rathke's pouch).
  35. Pilocytic astrocytoma: location, histopathology
    Posterior fossa (ex. cerebellum). Astrocytes stain GFAP & form Rosenthal fibers -- eosinophilic corkscrew fibers. Benign; good prognosis.
  36. Medulloblastoma: location & histopathology
    Cerebellar; highly malignant. Can compress 4th ventricle. Ages 4-8. Rosettes: hyperchromatic nuclei, little cytoplasm.
  37. Ependymoma
    Poor prognosis, usually roof of 4th ventricle. Perivascular pseudorosettes.
  38. Hemangioblastomas
    Associated with von Hippel-Lindau, usually cerebellar (+ retinal angiomas in von Hippel-Lindau). Can make EPO.
  39. Glaucoma treatments
    • Decrease aqueous humor secretion: alpha-agonists (epinephrine, brimontidine) or beta-blockers (betaxolol, carteolol, timolol).
    • Increase outflow into canal of Schlemm: protaglandin (latanoprost) or cholinergics -- pilocarpine (emergencies), carbachol, physostigmine, echothiophate
  40. Butorphanol
    Agonist at opioid kappa receptors, but partial agonist at mu. (Orphan doesn't have a mom.) Use for pain; causes less respiratory depression than full agonists.
  41. Tramadol
    "Tram it all in"... inhibits serotonin & NE reuptake, also very weak opioid agonist.
  42. Status epilepticus: drugs
    • Phenytoin = prophylaxis
    • Benzodiazepines for acute
  43. Phenytoin MOA & toxicity
    Blocks Na+ channels. Living Large: Gum hyperplasia, double vision, induces CYP450, megaloblastic anemia, ataxia. Also peripheral neuropathy, hirsutism.
  44. Valproic acid
    Neural tube defects (not for use in pregnancy), rare liver toxicity, weight gain.
  45. Carbamazepine
    Teratogen, agranulocytosis & aplastic anemia (like chloramphenicol), induces CYP450
  46. Ethosuximide
    Absence seizures only. GI distress, SJS, urticaria.
  47. Lamotrigine
    All seizure types except absence. SE: SJS.
  48. Drug-induced SLE
    It's not HIPP to have lupus: hydralazine, isoniazid, phenytoin, procainamide.
  49. Induction of anesthesia is faster if...
    ...drug is less soluble in the blood.
  50. An anesthetic is more potent if... is more lipid-soluble (can penetrate BBB more readily)
  51. Prospagnosia
    Can't recognize faces
  52. Anosognosia
    Unaware of your own sensory & motor deficits -- large lesion of non-dominant parietal lobe
  53. Asomatognosia
    Deny ownership of half of body
  54. Alexia
    Reading impairment
  55. Ideomotor apraxia
    Can't follow a verbal command -- ex. can brush teeth spontaneously, but not after being asked to imitate someone who's brushing his/her teeth
  56. 2 structures damaged by uncal herniation
    CN III (blown pupil) & midbrain cerebral peduncle (hemiplegia)
  57. Arnold-Chiari type 1 malformation
    Cerebellar tonsils go thru foramen magnum; often asymptomatic.
  58. Arnold-Chiari type 2 malformation
    Abnormally small posterior fossa: Cerebellar vermis & medulla go through foramen magnum. Associated with myelomeningocele & syringomyelia (crossing spinothalamic fibers).
  59. Dandy-Walker malformation
    Abnormally large posterior fossa: 4th ventricle expands, with ependymal cyst
  60. Crus cerebri
    Midbrain, anterior to substantia nigra. Contains descending fibers from corticospinal & corticobulbar tracts.