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  1. Hirschsprung's disease
    • NCC: missing rectal ganglia 
    • myentreric plexus dysfunction
  2. Horner's
    • (all ipsilateral)
    • Ptosis
    • Anhydrosis
    • Miosis
    • Peripheral: T1, stellate, carotid endorectomy
    • cervical rib, apical lung tumor, pancoast
  3. Descending hypothalamic axons or hypothalamospinal
    • drive all preganglionic sympathetic neurons
  4. central vs. peripheral
    peripheral: face only decreased sweating vs. whole body
  5. Pancoast tumor
    • pulmonary sulcus tumor or superior sulcus tumor
    • tumor of the pulmonary apex
    • Most Pancoast tumors are non-small cell cancers.
    • Can compress of a brachiocephalic vein, subclavian artery, phrenic nerve, recurrent laryngeal nerve, vagus nerve, or, characteristically, compression of a sympathetic ganglion resulting in a range of symptoms known as Horner's syndrome.
  6. Nissle bodies
    • rough ER: synthesis neurotransmitter
    • NOT in axon->
  7. subcellular neuron transport
    • anterograde (400mm/day): microtubules, kinesin move proteins to axon terminal
    • retrograde (200mm/day): microtubules, dynein transport lysosomes and recycled membrane
    • retrograde: neurotrophic viruses, zoster, herpes, polio, rabies, tetanus(toxin)
    • mainly via motor
  8. What kind of nerves can regenerate?
    • PNS & myelinated by schwann cells
    • endoneurium
    • rate of 1-3mm per day about the rate of diffusion
  9. Which cranial nerve cannot regenerate if severed?
    CN II: extension of brain-> oligodendrocytes and meninges
  10. What are the most common brain neoplasms?
    • Glioblastoma: supratentorial, compress portion of cerebral hemisphere
    • Meningioma:
    • Schwannoma: MC (VIII) can compress facial CN V
  11. craniopharyngioma
    • Rathke's pouch
    • histology: adamantioma
    • optic chiasm compression
    • calcified
  12. choroid plexus
    in all 4 ventricles
  13. 3 openings in 4th ventricle
    • 2 foramena of luschka (lateral aperture)
    • 1 foramen of Magendie (median aperture)
  14. cerebral aqueduct features
    • midbrain
    • connect 3rd & 4th ventricles
  15. CSF production
    400-500cc with space 90-150cc
  16. What feature of Normal pressure hydrocephalus is common with Parkinsons?
    • apraxic (magnetic) gait
    • NPH: wacky, wobbly, wet -> dementia, apraxic gait, (infantile) incontinence
  17. Bladder control
    • 1. sacral spinal cord (autonomic)
    • 2. brainstem: inhibit emptying reflex allow filling
    • 3. cortex: voluntary
  18. Defects in neural crest cells can cause which of the following
    • A. Cyanotic cardiac malformation
    • B. Carniopharyngioma
    • C. Septum secundum atrial defect
    • D. Mutliple Sclerosis
    • E. Tracheoesophageal fistula
    •  A.
    • A. Cyanotic cardiac malformation
    • B. Carniopharyngioma: oral ectoderm of Rathke's pouch
    • C. Septum secundum atrial defect: septum primum not secundum
    • D. Mutliple Sclerosis: NCC form schwann cells not oligodendrocytes
    • E. Tracheoesophageal fistula: mesoderm
  19. What is Clarke's nucleus?
    • relays proprioception to cerebellum
    • dorsal spinocerebellar tract
    • lower limb
    • Friedreich's ataxia: ataxia, dysarthria, muscle weakness or paralysis and skeletal defects
  20. Renshaw cells
    • tetanus toxin target
    • inhibitory interneurons 
    • gray matter of the spinal cord
    • associated w/ alpha motor neuron.
    • receive an excitatory collateral from the alpha neuron's axon as they emerge from the motor root, and are thus "kept informed" of how vigorously that neuron is firing.
    • They send an inhibitory axon to synapse with the cell body of the initial alpha neuron and/or an alpha motor neuron of the same motor pool.
    • negative feedback mechanism. 
    • may be supplied by more than one alpha motor neuron collateral and it may synapse on multiple motor neurons.
  21. corticospinal tract (pyramidal)
    • UMN axons down spinal cord
    • contains mostly axons originated from the motor cortex
    • made up of: the lateral corticospinal tract and the anterior corticospinal tract
    • contains the Betz Cell (the largest pyramidal cells)
    • discrete voluntary skilled movements, such as precise movement of the fingers and toes
    • decuss in the medulla oblongata (medulla-spinal cord junction)
  22. What is the UMN effect on muscle stretch reflexes?
    • net inhibitory (on future or excessive contractions)
    • therefore lesion will lead to clonus, spasticity of reflexes
    • net inhibitory on golgi tendon organs too (hypersensitive)
    • clasp knife
  23. When a neuron undergoes wallerian degeneration how does it present clinically?
    • fasiculations: random twitches of denervated.
    • then atrophy
  24. Pt falls and after cannot spread fingers, what bone is fractured or dislocated?
    hamate->ulnar nerve
  25. Important wrist bones
    • hamate->ulnar nerve, spread fingers
    • lunate->carpal tunnel syndrome
    • scaphoid->most freq fractured carpal bone, avascular necrosis
  26. Tabes dorsalis
    • syphilitic myelopathy
    • slow degeneration (specifically, demyelination) of the sensory neurons that carry afferent information
    • in the dorsal columns (posterior columns) of the spinal cord
    • (proprioception), vibration, and discriminative touch.
    • parasthesia
    • pain
    • polyuria
    • "sensory ataxia"
    • positive Romberg's test (close eyes->sway) 
    • impaired response to light (Argyll Robertson pupil)
  27. Romberg's test
    person requires at least two of the three following senses to maintain balance while standing: proprioception (the ability to know one's body in space); vestibular function (the ability to know one's head position in space); and vision (which can be used to monitor [and adjust for] changes in body position).
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2013-04-18 06:23:48

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