USMLE/NBME neuro (05/2013)

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1. 5-HT Made in Raphe nucleus (pons). Decrease 14. Astrocytes Made from neuroectoderm. physical support
(serotonin) leads to depression. Decrease also leads to and repair (forms glial scar) Metabolize K,
anxiety. removal of excess neurotransmitter, and
maintenance blood brain barrier. Marker is
2. Absence Recordable in multiple areas of brain (petit
GFAP.
generalized mal), brief little staring spell, no aura, 3 per
seizure second spike and wave--very important. No 15. Atonic Recordable in multiple areas of the brain.
post confusion generalized Characterized by sudden loss of muscle tone
seizure and collapse
3. Ach Made in Basal nucleus of Meynert. Decrease
leads to Alzheimers. Decrease leads to 16. B12 Demyelination of dorsal columns, lateral
Huntingtons. It is increased in burst during deficiency corticospinal tracts and spinocerebellar tracts.
REM sleep causes leading to ataxic gait, paresthesia, and
what in impaired vibration and position sense.
4. Achilles S1 nerve root
spine
Reflex
17. Basal plate anterior horn, motor area of spinal cord, also it
5. ADH and Are both made by the hypothalamus but are
is the medial part of the brainstem
Oxytocin stored and released by posterior pituitary
18. Biceps C5 nerve root
6. Alar plate posterior horn, sensory area of spinal cord.
reflex
also it is the lateral part of the brainstem.
19. Bitemporal Damage to optic chiasm (caused by pituitary
7. Alzheimers Genes: APP (21--Gama and Beta secretase
hemianopia tumor commonly)
disease cuase AB amyloid to accumulate), Presenilin-
1 (14), Presenlin-2 (1). 20. Brocas Can understand but cant speak. Damage to
ApoE2-protective, ApoE3-normal, ApoE4- aphasia Brocas area
Alzheimer's (19).
21. Brown- lesion to half of spinal cord will cause
Decrease in ACh. Wide sulci b/c of cortical
Sequard ipsilateral weakness and loss of vibration, joint
atrophy.
syndrome and position sensation, and proprioception but
Extracelluar AB amyloid plaques and
contralateral loss of pain and temperature.
intracellular Neurofibrillary tangles are found
ipsilateral loss of all sensation at the level of
(abnormally phosphorylated Tau proteins).
the lesion due to dermatome loss.
Causes Dementia.
22. Cataract When the lens becomes cloudy and needs to
8. Amyotrophic Combined UMN and LMN lesions. No loss of
be replaced.
lateral sensory, cognition or oculomotor deficits.
sclerosis Defect in superoxide dismutase 1. Tongue 23. Central Macular degeneration
(ALS) fasciculations with eventual atrophy. Fatal b/c scotoma
effects breathing muscles. Disease is due to 24. Cerebellum Aids in coordination and balance. Sends info to
degeneration of nerve axon... not myelin the contralateral cortex, so eventually it effect
9. Anterior Controls cooling, parasympathetics, the ipsilateral body. Output fibers are purkinje
hypothalamus reproduction/sex, and drinking... A/C (air fibers send to deep nuclei then these have
conditioning) fibers that go to cortex

10. Anterior Decussates 2 levels up in the spinal cord. 25. CN blood I, II--Anterior cerebral artery
spinothalamic Used for Crude (light) touch and pressure. supply III, IV--Posterior cerebral artery
tract Goes to VPL V, VI, VII--AICA
VIII, IX, X--PICA
11. Aqueous Made in the Ciliary processes->posterior
XI, XII--Anterior spinal artery
humor chamber->pupil->Anterior chamber-
pathway >Trabecular network->canal of Schlemm- 26. CN XII stick out tongue and it deviates toward the
>episcleral veins. lesion lesion.

12. Arcuate Connects Brocas area to Wernickes area. 27. CN XI weakness in turning head away from lesion and
fasciculus lesion shoulder drop on side of lesion

13. Area Has no blood brain barrier--vomiting center. 28. CN X lesion Uvula deviates away from side of lesion
postrema
29. complete spares dorsal columns and lissauers tract. 44. Dorsal Fasciculus cuneatus (upper body) and
occlusion of Motor problems. columns Fasciculus gracilis (lower body). Decussates
Anterior in caudal medulla. For pressure, vibration,
spinal artery touch, and proprioception. Goes to VPL
30. Complex Recordable in one area of the brain and 45. Dorsal motor Goes to heart, lungs, and upper GI (X)
partial result in an alteration of consciousness, aura nucleus of
seizure is common vagus
31. Conduction Poor repetition but fluent speech. intact 46. End of spinal L1/L2 in adult can do lumbar puncture L3-L5
aphasia comprehension. Can be caused by damage cord
to Arcuate Fasciculus. Can't repeat "no, ifs,
47. Epidural Rupture of Middle meningeal artery due to
ands, or, buts."
Hematoma fracture of pterion. Can cause CN III palsy.
32. Corneal Afferent V
48. Facial nerve Bells Palsy. Ipsilateral facial paralysis.
reflex Efferent VII
palsy Because of facial motor nucleus damage.
33. Corticobulbar Will result in contralateral lower face
49. Flow of CSF made in Lateral and third ventricles by
lesion drooping but forehead will be normal.
choroid plexus. Lateral ventricle ->foramen
34. C Pain fibers Are slow, unmyelinated fibers for pain and of monro->3rd ventricle->cerebral
temperature. aqueduct->4th ventricle->foramin of lushcka
and foramen of magendie. Reabsorbed in
35. Creutzfeldt- Rapidly progressive dementia with
Arachnoid granulations.
Jakob disease myoclonus
PrPC->PrPSC which is resistant to proteases. 50. Friedreichs Autosomal recessive tri-nucleotide repeat
prion disease. ataxia disorder (GAA) in gene that codes for
spongiform brain frataxin. staggering gait, frequent falling,
nystagmus, dysarthria, hammer toes, and
36. Damage to disinhibition and deficits in concentration,
hypertrophic cardiomyopathy.
frontal lobe change in judgement (almost like a different
person). reemergence of primitive reflexes 51. GABA Made in Nucleus Accumbens (pleasure
(moro, rooting, sucking, palmar, plantar, center). Decrease leads to anxiety. Decrease
galant). leads to Huntingtons.
37. Damage to Will result in anterograde amnesia... unable 52. Gag reflex Afferent IX
Hippocampus to form new memories Efferent X
38. Damage to Often seen with Wernickes korsakoff 53. Glaucoma Caused by increased ocular pressure due to
Mamillary syndrom. Confusion opthalmoplegia, ataxia, less aqueous humor being absorbed in
bodies memory loss with confabulation and canal of Schlemm. peripheral then central
personality changes. Associated with low B1 vision loss. Optic disc atrophy.
(thiamine) and alcoholics.
54. Glioblastoma Most common brain tumor. Found in
39. Damage to Reduced levels of wake fullness. Can even cerebral hemispheres. Tumor of glial cells
RAS cause narcolepsy and coma if it is too far (astrocytes so stain for GFAP)
down regulated.
55. Global Can't speak or understand. Both Wernicke's
40. Damage to hemispatial neglect syndrome. Neglects the aphasia and Broca's areas are affected
right parietal contralateral side of the body.
56. Guillan Barre Auto-immune disease that destroys
lobe
Schwann cells (PNS myelin). symmetric
41. Deep nuclei Fastigial, Globose, Emboliform, and Dentate. ascending muscle weakness beginning in
of (F=GED). Medial to lateral. lower limbs.
Cerebellum
57. Hemiballismus sudden wild flinging of limbs due to
42. diencephalon thalamus damage of subthalamic nucleus and effects
the contralateral side
43. Dopamine Made in Ventral tegmentum and substantia
nigra. Increase leads to schizophrenia.
Decrease leads to Parkinsons. Decrease also
leads to depression
58. holoprosencephaly failure of right and left hemispheres to 76. Limbic system Structures include the hippocampus,
separate. usually occurs during weeks amygdala, fornix, mammillary bodies,
5-6. may be related to SHH. moderate and cingulate gyrus. Responsible for
forms are cleft lip and palate. severe is Feeding, Fleeing, Feeling, and Fuc-king.
cyclopia Involved in emotion, long term memory,
olfaction, behavior modulation and
59. Horners syndrome Damage to sympathetics. Will cause
ANS fxn.
Ptosis, Miosis, and Anhidrosis of the
face 77. LMN lesion Atrophy, fasciculations, hypo reflexia,
dec tone, flaccid paralysis.
60. Huntington's Autosomal dominant (CAG repeats
disease 40+). characterized by chorea, 78. Locus Ceruleus Makes NE. Located in the pons.
agression, depression, and dementia. Increase will cause anxiety, decrease
glutamate toxicity. atrophy of the will cause depression.
caudate, so no caudate visible on
79. Marcus gun pupil When there is a damage to the Afferent
imaging.
limb of pupillary light reflex.
61. Hyperopia Small eye. image converges behind
80. Mastication Innervated by CN V.
retina. HFX. Far sighted, Convex lens
muscles Close Jaw: Massester, temporalis and
corrects
medial pterygoid
62. Intention tremor Slow, zigzag motion when Open Jaw: lateral pterygoid
pointing/extending toward a target due
81. Medial Satiety (fullness). Destruction will lead
to damage of the cerebellum (dentate
hypothalamus to over eating.
nucleus)
82. Medial Pair of tracts that allows VI to
63. Jaw Jerk reflex Afferent V
longitudinal communicate with III and gives us
Efferent V
fasciculus (MLF) conjugate eye movements (in
64. Kluver Bucy damage to Amygdala and is associated horizontal direction). When it is
syndrom with hyper-sexulaity and disinhibited damaged it is called internuclear
behavior. opthalmoplegia. Highly myelinated--so
damaged when patient has MS
65. L1 Inguinal canal
83. Meissners Large myelinated fibers for light/fine
66. L4 Knees
corpuscles touch (adapt quickly)
67. Lacrimation reflex Afferent V
84. Meningioma Second most common brain tumor.
Efferent VII
Arises from arachnoid cells, Extra-axial
68. Lateral Decussates in caudal medulla. Used for (external to brain parenchyma), and
corticospinal tract voluntary motor from shoulders down. may have a dural attachment. typically
69. Lateral Hunger. destruction will lead to failure benign.
hypothalamus to thrive (anorexia) 85. meningocele meninges herniate through spinal canal
70. Lateral Decussates 2 levels up in spinal cord. defect
spinothalamic tract Used for pain and temp. Goes to VPL 86. meningomyelocele meninges and spinal cord herniate
71. Left hemianopia PCA infarct. through spinal canal defect
with macular 87. mesencephalon midbrain
sparing
88. metencephalon pons and cerebellum
72. Left Homonymous Damage to the right optic tract
89. MGN Receives info from Superior olive and
hemianopia
inferior colliculus of tectum for
73. Left lower Damage to the right dorsal optic HEARING. sends info to temporal lobe
quadrant anopia radiation through the Parietal lobe
90. Microglia made from mesoderm. they act as
74. Left upper Damage to the right Meyers loop... macrophages in the brain. Get infected
quadrant anopia Temporal lobe by HIV
75. LGN Receives info from CN II and is used 91. Midriasis Sympathetics dilate pupil
for VISION. Sends info to the calcarine SD in PC
sulcus
92. Miosis Parasympathetics Constrict pupil
SD in PC
93. Multiple Sclerosis Destroys Oligodendrocytes (CNS 108. Perineurium Surrounds a fascicle of nerves and must be
myelin). random asymmetric lesions, sewed back together when a attaching a
due to (autoimmune) demyelination. severed limb.
scanning speech, intention tremor, and Epi-outer
nystagmus. Cause internuclear Peri-middle
opthalmoplegia. most often affects Endo-inside
women in 20s and 30s. Oligoclonal
109. Picks Disease Dementia, aphasia, change in personality.
bands are diagnostic in CSF. -
only effect the frontal temporal region of
interferon used to treat.
brain. Pick bodies: sperical tau prtoein
94. Myelin Central: oligodendrocytes aggregates.
Peripheral: schwann cells
110. Poikilotherm Damage to the posterior hypothalamus...
increase conduction velocity (saltatory
makes you cold blooded. like a snake.
conduction)
111. poliomyelitis LMN lesion, destruction of anterior horn
95. myencephalon medulla
cells. flaccid paralysis. Caused by poliovirus.
96. Myoclonic Recordable in multiple areas of brain,
112. Posterior Controls heating and sympathetics.
generalized sudden jerk, happens normally in sleep
hypothalamus
seizure but not while awake
113. presbyopia Decrease in elasticity of lens. Can't
97. Myopia Big eye. Image converges in front of
accommodate as well. needs reading
retina. MNV. nearsightedness, Concave
glasses.
lens corrects
114. Pupillary Afferent II
98. Nucleus Motor innervation of pharynx, larynx,
reflex Efferent III
Ambiguous trachea, SCM and Trapezius (IX, X, XI).
II->pretectal nuclei->edinger westphall
99. Nucleus Solitarius Visceral Sensory Information. Taste. nuclei->bilateral III to cause both pupils to
(VII, IX, X) constrict.
100. oligodendroglioma Relatively rare. Slow growing. Most 115. Right anopia Damage to right optic nerve
often in frontal lobes. Looks like fried
116. Rinne test If conductive loss Bone > Air
eggs.
If normal Air > Bone
101. Pacinian Large myelinated fibers for deep
117. S2, S3, S4 Penis
corpuscles touch/vibration
118. Schwannoma Third most common brain tumor. Schwann
102. papilledma increased inter cranial pressure puts
cell origin often localized to CN VIII
pressure on optic nerve decreasing
(acoustic schwannoma) usually found in
vision.
cerebellopontine angle. Can affect CN VII &
103. Paraventricular makes oxytocin CN V.
nucleus
119. Seizures Characterized by synchronized, high
104. Parinaud's paralysis of conjugate vertical gaze frequency neuronal firing.
syndrome due to lesion in superior colliculi
120. Simple partial Recordable in one area of the brain and do
105. Parkinson's disease Lewy bodies composed of -synuclein. seizure not have loss or alteration of consciousness,
loss of dopamine neurons of the aura common, may become secondarily
substantia nigra. Tremors at rest, generalized
cogwheel rigidity, akinesia, and
121. spina bifida failure of bony spinal canal to close. there is
postural instability. Causes dementia.
occulta no herniation--tuft of hair.
106. partial seizure Affects 1 area of the brain. Most
122. Subarachnoid Rupture of an aneurysm (berry aneurysm
commonly the temporal lobe. Often
hemorrhage Ant communicating artery) seen in Marfans
preceded by an Aura.
and Ehlers Danlos. Rapid time course,
107. Patella reflex L4 nerve root causes worst headaches of their lives.
123. Subdural Rupture of bridging veins. Slow venous
Hematoma bleeding. seen in elderly and alcoholics (b/c
of many falls). crescent shaped on imaging
124. Supraoptic Makes ADH
nucleus
125. syringomyelia enlargement of central canal of spinal cord 142. Wernickes Can't understand but can speak... speaks
forming a syrinx. crossing fibers of aphasia gibberish. Damage to Wernickes area
spinothalamic tract are damaged first-
143. What forms Tight Jxns b/w nonfenestrated capillary
ussualy associated with cape like loss of
the Blood endothelial cells, basement membrane, and
pain and temp on bilateral shoulders. later
brain astrocyte foot process. It is absent at
on can be bilateral weakness.
barrier circumventricular organs.
126. T4 Nipples
144. when do 4th week of pregnancy
127. T7 Xiphoid process neuropores
fuse?
128. T10 Umbilicus
145. Pain Are fast, myelinated fibers for pain and
129. Tabes demyelination of dorsal columns and roots.
fibers temperature.
Dorsalis Impaired sensation and proprioception. with
(tertiary progressive ataxia. argyll robertson pupils
syphilis) (prostitutes pupils) accomodate but dont
react to light. Absence of DTRs and Positive
Rombergs test.
130. telencephalon cerebral hemispheres
131. tongue Taste: anterior 2/3 (VII) posterior 1/3 (IX, X).
innervation Sensory: anterior 2/3 (V) posteror 1/3 (IX,
X).
Motor: XII
132. Tonic-Clonic Recordable in multiple areas of brain,
generalize Characterized by stiffening and movement.
seizure
133. Tonic Recordable in multiple areas of brain.
generalized Results in sudden stiffining of muscles and
seizure fall over like a tree.
134. Triceps reflex C7 nerve root
135. UMN lesion hyper-reflexia, inc tone, positive babinski,
spastic paralysis, positive clasp knive.
136. Vascular Occurs step-wise due to many TIAs
dementia
137. VL Receives info from basal ganglia for motor
movement initiation and goes to the motor
cortex.
138. VPL of Receives sensory info from spinothalamics
thalamus and DCML for Pain/temp and touch for
body. Sends info to the primary
somatosensory cortex of brain
139. VPM of Receives sensory info from trigeminal and
thalamus gustatory pathway for face sensation and
taste. Sends info to the primary
somatosensory cortex of the brain
140. Wallenbergs PICA artery is blocked. Patient has
syndrom nystagmus, vertigo, dec pain and temp,
dyspahgia, and hoarsness, dec gag reflex,
ipsilateral horners.
141. Weber test if senurineural loss it will lateralize to good
ear
if conductive loss it will lateralize to bad ear