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2011-01-08 17:43:30

NeuroHisto, Neurophysio
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  1. Which has the ability to regenerate? CNS or PNS
    PNS, nerves regrow at 3mm/day
  2. Astrocytes
    The supporting glial cell of the CNS both structurally and metabolically; contains GFAP marker useful in identifying tumors
  3. Microglia
    phagocytic cells of the CNS
  4. Oligodendrocytes
    myelin-forming cells of the CNS; 1 cell can myelinate up to 30 axons
  5. Schwann cells
    myelinating cells of the PNS; 1 Schwann cell produces 1 internode
  6. Ependymal cells
    line central canal and ventricles; produce CSF
  7. Neurofibromatosis, type 1
    • Neurofibromas
    • Gliomas of optic nerve, pigmented lesions of iris (Lisch nodules) and cafe‐au‐lait spots
    • NF1 gene at 17q11.2 – neurofibromin – tumor suppressor gene
  8. Neurofibromatosis, type 2
    • Bilateral schwannomas and multiple meningiomas may occur
    • Gliomas (ependymomas of spinal cord)
    • NF2 gene at 22q12 ‐ merlin
  9. Tuberous Sclerosis
    • Hamartomas of brain – cortical tubers and subependymal hamartomas (candleguttering)
    • Organ cysts, angiofibromas, shagreen and ash‐leaf (skin) patches, and subungual fibromas.
    • Genes – TSC1 at 9q34 – hamartia; TSC2 at 16p13.3 – tuber in
    • Subependymal giant cell astrocytomas can occur
  10. Von Hippel‐Lindau
    • Hemangioblastoma – cerebellum, retina, brain, spinal cord)
    • Pancreas, liver, kidney cysts
    • Renal cell carcinoma
    • Gene on chromosome 3p25‐26 coding pVHL
    • Hemangioblastoma cells produce erythropoietin – polycythemia
  11. Sturge‐Weber
    • Venous angiomatous masses in leptomeninges
    • Ipsilateral port‐wine stain of face
    • Mental retardation, seizures, hemiplegia, radiopacities in skull
  12. Which tract carries parasympathetics to S2-S4? What happens when this tract is severed?
    Corticospinal tract to the sacral nerves; loss of voluntary bladder and bowel control.
  13. Which spinal tracts are affected in with vitamin B12 neuropathy (aka: subacute combined degeneration)?
    Dorsal columns, lateral corticospinal tracts, spinocerebellar tracts (arm/leg dystaxia)
  14. Guillain-Barre syndrome: which nerves are affected?
    motor fibers of ventral roots and peripheral nerves producing LMN symptoms (m weakness, ascending flaccid paralysis, areflexia)
  15. Guillain-Barre syndrome: Features
    • Demyelination and edema
    • Upper cervical root (C4) involvement and respiratory paralysis
    • Facial diplegia (CN involv)
    • Elevated protein (causing papilledema)
    • Lesser degree: paresthesias
    • Increased CSF protein w/o pleocytosis (albuminocytologic dissociation)
  16. where does spinal cord end on infants and adults?
    • infants-L3
    • adults-L1
  17. Disk herniation between L4 and L5: which spinal nerve will be affected?
    L5; the spinal nerves T1-S4 come out below their corresponding vertebrae; the lumbar nerves cross over the junction above the corresponding vertebrae
  18. Disk herniation between C5 and C6: which nerve is affected?
    C6; the spinal nerves C1-C7 emerge above their corresponding vertebrae but unlike T and L spinal herniations, Cervical herniations affect the nerve emerging at that junction
  19. Conus medullaris syndrome (S3-coccygeal)
    Results in bilateral pain, normal reflexes, incontinence and sexual functions impaired, onset sudden and bilateral
  20. Cauda Equina syndrome (L3-Coccygeal)
    unilateral pain, unilateral muscle atrophy and absent lower reflexes (S1 and L3)
  21. Explain corticobulbar innervation of facial nerve nucleus
    • Facial nerve nucleus that innervates the upper face receives bilateral corticobulbar input
    • Facial nerve nucleus that innervates the lower face receives only contralateral corticobulbar input
  22. With trigeminal sensation, which is contralateral vs. ipsislateral: pain and temp (ventral) vs. discrimination and pressure (dorsal)?
    • pain and temp: contralateral, 2nd order fibers decussate in lower medulla
    • discr. and pressure: ipsilateral, 2nd order nuclei are in the principal sensory nucleus of V
  23. What is the drug of choice for Tic douloureux?
  24. Functions of CN VII
    • Facial movements
    • taste (ant 2/3)
    • salivation
    • lacrimation
    • general sensation from external ear
    • Stapedius m (hyperacusis if paralyzed)
  25. Crocodile tears
    lacrimation during eating as a result of aberrant regeneration after trauma
  26. 3 Things required for balance
    • cerebellum
    • sight
    • vestibular system
  27. Functions of CN IX
    • Taste and general sensation (post 2/3)
    • Salivation (parotid)
    • Swallowing (stylopharyngeus)
    • Input from carotid sinus and body
  28. Functions of CN XI
    • Cranial division-n.ambiguus-intrinsic mm of the larynx via inferior (recurrent laryngeal nerve) except cricothyroid m.(CNX)
    • Spinal division-from C1-C6-sternocleidomastoid and trapezius
  29. Stylopharyngeus
    Inferior (Recurrent) laryngeal nerve->intrinsic larynx mm
    • CNIX
    • CNX
    • CNXI