Neuro 1

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A tumor compresses the right side of the spinal cord at C3 - and it's impinging on the corticospinal and spinothalamic tracts. What do you observe first?: Alteration of pain and temperature sensations from the left lower limb A tumor is growing in the third ventricle. Which of the following parts of the brain might be compressed?: Anything diencephalon Thalamus, hypothalamus, epithalamus, subthalamus

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Amyotrophic lateral sclerosis: Hyporeflexia in the upper limbs and hyperreflexia in the lower limbs (lose UMN and LMN) Progressive spinal muscle atrophy of the ventral horn Primary lateral sclerosis (corticospinal tract) = spastic paralysis in lower limbs, increased tone and reflexes, flaccid paralysis in upper limbs Common in cervical enlargement (brachial plexus- C5-T1) Destroying LMNs (ventral horn) in brachial plexus bilaterally and lesioning up the corticospinal tract

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Anesthetic has been administered to a patient. What will be anesthetized first?: C-fibers (most sensitive to anesthesia, but most resistant to anoxia) Blood supply to the dorsal roots of the upper thoracic spinal nerves has been interrupted = transient anoxia of the roots.: Loss of sensory limb of the muscle stretch reflexes Brown Sequard Syndrome: Ipsilateral loss of epicritic sensations (two-point discrimination) and contralateral loss of pain and temperature below the lesion Ipsilateral spastic weakness below the lesion; ipsilateral flaccid paralysis at the level of the lesion; bilateral sensory deficits below the lesion Caused by lateral hemisection of spinal cord --> affects DCML and corticospinal tract ipsilaterally. Contralateral loss of pain and temperature 1-2 segments below the lesion (lesion of three systems: principal UMN pathway of corticospinal tract, one or both dorsal columns, the spinothalamic tract) CORD HEMISECTION = 2 IPSILATERAL + 1 CONTROLATERAL; spinal shock, cord shuts down below lesion Also lesion descending hypothalamics - ipsilateral Horner Syndrome (if cord lesion is above T1) = ptosis, miosis, and anhydrosis

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Complete transection of spinal cord: Spinal shock seen initially below the lesion; bilateral Babinski signs seen later Diencephalon forms: thalamus, hypothalamus, epithalamus, subthalamus - 1b (third ventricle) Drinking alcohol during pregnancy causes FAS, which affects neural crest cell development. what happens?: fewer axons in the fasiculus gracilis Fasciculus gracilis vs. cuneatus: FG- proprioception, touch, etc in lower limb (T5 down, but it runs all the way up) - more medial (GM) FC- " in upper limb - more lateral Guillain Barre Syndrome: Inflammatory rxn against myelin formed by Schwaan Cells (derivatives of neural crest cells) s/p GI or respiratory illness --> polyneuropathy Affects motor limbs - limb weakness, weakness of CN muscles and respiratory muscles (bilateral motor deficits that ascend from distal to proximal) - can involve phrenic nerve

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Hemisection at C5. Expect retrograde chromatolysis to occur: in Lamina I of the dorsal horn contralateral and below the lesion Imaging shows enlarged lateral ventricle. What might be site of blockage?: Foramen of Munro Lamina I of spinal cord: Neuronal cell bodies of anterolateral system fibers (dorsal horn) - A-delta fibers Lamina II of spinal cord: Axon terminals of dull pain fibers (dorsal horn)- C fibers Lamina IX of spinal cord: Axon terminals of the corticospinal tract Axon terminals of group Ia fibers (stretch reflex) Neuronal cell bodies of gamma motor neurons Axon terminals of Renshaw cells *ventral horn - motor nuclei

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Lamina VII of spinal cord: Clarke's Nucleus Neuronal cell bodies of dorsal spinocerebellar tract axons Neuronal cell bodies of fibers that carry unconscious proprioception to the cerebellum

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Lateral division of dorsal roots: A-delta (sharp pain and cold), C-fiber (dull achy pain and warmth); free nerve endings Small diameter, C is unmyelinated (goes to substantia gelatinosa) *more resistant to anoxia and sensitive to anesthesia Think lateral - anterolateral (pain/temp)

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Loss of vibratory sense in the lower limb on the right, weakness and hyperactive reflexes in the right lower limb and a loss of pain and temperature that begins below the L2 dermatome on the left. Where is the lesion?: T12 spinal cord segment on the right

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Male has a cyst-like protrusion in the dorsal midline of back. Imaging shows cyst has CSF but spinal cord is in the normal position in the vertebral canal.: Spina bifida with menigocele Medial division of dorsal roots: Ia (muscle spindles), Ib (golgi tendon organs), II (muscle spindles), A-beta (mechanoreceptors pressure, vibration, texture, touch) *most sensitive to anoxia and resistant to anesthesia

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Mesencephalon forms: midbrain - 2 (cerebral aqueduct) Multiple Sclerosis: Inflammation of myelinated axons (formed by oligodendrocytes) in CNS (autoimmune rxn) Marked by presence of plaques (demarcated areas of demyelinatoin near lateral ventricles) Optic neuritis

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Newborn born with spina bifida with meningocele. What won't be found in cyst: pia mater Occlusion of anterior spinal artery at the level of T5 spinal cord segment: Bilateral spastic paralysis; bilateral loss of pain and temperature sensations below the lesion; no alteration of vibratory sense (DC spared) Bilateral babinski signs (indicates upper motor neuron lesion - damage to corticospinal tract) Common at mid-thoracic levels S2-S4 lesioned = spastic bladder (bladder fills with min amt of urine and have urge to empty)

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Patient develops pain on both legs, altered sensation of touch in both legs, and increased tendency to urinate. His gait is unsteady. What else is revealed: Patient sways back and forth with eyes closed Pineal gland is part of the: epithalamus Poliomyelitis: Hyporeflexia (areflexia), muscle weakness, fasiculations; no sensory deficits, muscle atrophy, common at lumbar levels. Only affects LMNs. Virus taken up retrogradely transported by axons that innervate skeletal muscle (causing wkns of skeletal muscle innervated by the affected neurons)

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Progressive enlargement of the central canal at C8 that compresses some axons crossing at this level of the cord. What is an initial sign or symptom of this condition?: Altered response to pin prick sensations in both hands pt has a lesion to spinal cord- exam shows loss of touch sensation in RUE and RLE but loss of pain and temperature sensations from LUE and LLE. Spastic weakness is seen in both limbs on the right. Lesion most likely: Resulted from a hemisection of the cord on the right above the cervical enlargement.

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Pt has wkns of hand and states she does not feel temperature differentation between hands. What's goin on?: Bilateral retrograde chromatolysis in dorsal horn neurons Rhombencephalon forms: 1. Metencephalon (pons/cerbellum - 3a - 4th ventricle) 2. Myelencephalon (medulla - 3b - central canal) Student falls causing complete hemisection of the R side of spinal cord at T5. Which groups will have neurons that show retrograde chromatolysis?: Lamina V neurons at T10 on the left Would also expect pain and temperature loss below T5 on the left and loss of unconscious proprioception in the RLE because the dorsal spinocerebellar tract was included in hemisection (next to corticospinal tract)

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Subacute combined degeneration: Vitamin B12 pernicious anemia (misshaped RBCs - destroyed by spleen; antibodies raised against intrinsic factor) Demyelination of dorsal columns + spinocerebellar tract + corticospinal tract, and is upper thoracic/lower cord Present with paresthesias, bilateral spastic weakness (lose UMNs), Babinski signs, and antibodies to intrinsic factor

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Syringomyelia: Cavitation of the cord (usually cervical) = Bilateral loss of protopathic (pain and temp) sensations and bilateral paralysis in the upper limbs with intact vibratory sense; as disease progresses there is muscle weakness - eventually flaccid paralysis and atrophy of upper limb muscles due to destruction of ventral horn cells May present with hydrocephalus and arnold-chiari II malformation

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Tabes dorsalis: Slow degeneration of sensory neurons that carry afferent information - degenerating nerves are in the dorsal columns (proprioception, vibration, and discrimination) --> caused by late-stage syphilis Bilateral alteration of pressure and vibratory sensations; hyporeflexia; normal muscle strength (doesn't affect UMNs) Pain, paresthesias, polyuria; Romberg sign (sensory ataxia) = sway with eyes closed, Argyll Robertson pupils (gaze problem, pupillary light reflex is suppressed), common at lumbar cord levels

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Telencephalon forms: 1a - cortex (lateral ventricle) Tetanus: Continuous contractions/spasms of axial/limb/cranial muscles US imaging shows ffetus has defect in rostral end of neural tube: Telencephalon will most likely be absent = death Ventral root of spinal nerve T1 has been cut...what next?: Anterograde (Wallerian) degeneration of axons distal to cut (and retrograde degeneration - retrograde chromatolysis = dispersed Nissl substance, ecentric nucleus, swelling of cell body)

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What are Berry aneurysms?: occur at branch points of the carotid circultaion What is derived from neural crest cells?: Schwaan cells, chromaffin cells in adrenal medulla, pia mater cells, neuron cell bodies in sympathetic trunk (not dura mater cells) What is expected if you stimulate Ib fibers in muscular nerve: Golgi tendon organ Activation of inhibitory interneurons to alpha motor neurons to the same muscle

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Which blood vessel directly supplies arterial blood to telencephalon?: Middle cerebral artery