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58 Cards in this Set
- Front
- Back
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where does CN III originate?
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mid brain
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where does CN IV originate?
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midbrain
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where does CN V originate?
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pons
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where does CN VI originate?
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posterior margin of the pons
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where does CN VII originate?
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cerebellopontine angle
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where does CN VIII originate?
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cerebellopontine angle
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where does CN IX originate?
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medulla
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where does CN X originate?
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posterolateral sulcus of medulla
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where does CN XI originate?
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spinal roots
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where does CN XII originate?
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medulla
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where in the brain would a lesion occur to cause Cheyne-Stokes respiratory pattern?
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deep forebrain
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where in the brain would a lesion occur to cause central hyperventilation respiratory pattern?
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midbrain
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where in the brain would a lesion occur to cause apneustic respiratory pattern?
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rostral pons
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where in the brain would a lesion occur to cause cluster respiratory pattern?
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midpons
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where in the brain would a lesion occur to cause agonal (ataxic) respiratory pattern?
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caudal pons/rostral medulla
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where would a lesion occur to cause decorticate posture?
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above the red nucleus
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where would a lesion occur to cause decerebrate posture?
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below the red nucleus
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where it the red nucleus located?
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rostral midbrain
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define an acute confusional state/delirium?
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person is awake but not fully aware of what is going on around them
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what is locked in syndrome? what causes it?
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when a person has a fully functioning cortex (can feel, think, reason, etc) but absolutely no motor movement
a perfectly placed lesion to the pons |
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what are the only 2 things a person with locked in syndrome can do?
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vertical eye movements
blink |
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what is a minimally conscious state?
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everything between being awake and being in a coma
think waking from general anesthesia |
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what differentiates a coma from a minimally conscious state?
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people in a minimally conscious state respond to the environment around them while in a coma they do not
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what is a coma?
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a state when a person has absolutely no response to the environment around them (person may have reflex movements)
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how long can a person be in a coma?
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only a couple of weeks
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what is a persistent vegetative state?
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the stage after a person has been in a coma for more than a couple weeks and is now having day night behaviors such as eyes open during day and closed at night
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what are the 3 results of a coma?
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- patient wakes up
- patient dies - patient goes into a persistent vegetative state |
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what 3 areas of the brain must be functioning to be awake and alert?
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- reticular activating system (RAS)
- thalami - cortex |
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what must be damaged to cause a coma?
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- RAS
- bilateral thalami - bilateral cortex |
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what does the RAS do?
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receives info from the body which tells the brain it should be awak
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what part of the brain produces norepinephrine?
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locus ceruleus
(think locuses are loud and keeps you awake like NE) |
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what part of the brain produces dopamine?
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substantia nigra
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what part of the brain produces serotonin?
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raphe nuclei
(think the artist Raphael produced pleasing work that make people happy like serotonin) |
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what part of the brain produces acetylcholine?
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basal forebrain
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what part of the brain produces histamine?
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hypothalamus
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what part of the brain produces hypocretin?
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hypothalamus
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what does hypocretin do?
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it is important in sleep
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what is serotonin syndrome?
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person becomes delirious or agitated due to too much serotonin in the synapes; can be fatal
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what are the 5 respiratory patterns?
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- cheyne stokes
- central hyperventilation - apneustic - cluster - agnostic (ataxic) |
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person has periods where they breath deeply followed by periods where they breath shallow. This pattern repeats itself. What kind of breathing is this and where it the lesion?
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Cheyne-stokes
deep forebrain |
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what is ondine's curse?
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a lack of respiratory drive during sleep due to a rare medullary lesion
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describe decerebrate posture? where is the lesion?
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person lays with arms extended and wrists flexed and abducted
lesion is below the red nucleus |
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decribe decorticate posture? where is the lesion?
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person lays with arms flexed
lesion is above the red nucleus |
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what is localization?
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when a patient responds to a noxious stimuli by pushing it away with their hand
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what is withdrawal?
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when a patient responds to a noxious stimuli by trying to get away from it (such as turning head away)
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what is gegenhalten?
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when someone is doing the opposite of what you are trying to do to them
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what is worse: decorticate or decerebrate posture?
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decerebrate
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a patient has mass that pushes the right cingulate gyrus to the left hemisphere. what is this called?
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subfalcine (cingulate) herniation
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Cheyne-stoke breathing, small but reactive pupils, intact ciliospinal reflex and oculocephalic manuevers. what does the patient most likely have?
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Stage I central syndrome
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cheyne-stoke breathing, small but reactive pupils, oculocephalic and oculovestibular responses are intact, and decorticate rigidity. what does the patient have?
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Stage II central syndrome
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decerebrate rigidity, hyperventilation, pupils are large and irregular, no ciliospinal reflex, vestibulo-ocular response shows INO. what does the patient have?
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Stage III central syndrome
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irregular breathing patterns, pupils are mid position and fixed, no oculocephalic response, decerebrate rigidity. what does the patient have?
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Stage IV central syndrome
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what causes central syndrome?
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central (transtentorial) herniation
this is when both hemispheres cross under the tentorium in a symmetric fashion |
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what is uncal herniation?
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asymmetric herniation of the uncus below the tentorium
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what is tonsillar (cerebellar) herniation?
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when the tonsils of the cerebellum herniate and press on the medulla
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what is the main finding in uncal herniation?
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CN III problems
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patient has anisocoria (unequal pupils) and no pupil response when a bright light is shined into the eyes. What does the patient most likely have?
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Uncal herniation stage I
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patient has widely dilated pupils that are unreactive to bright light, ptosis, the eye looks down and out, and respiratory irregularities. what is the most likely diagnosis?
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Uncal herniation stage II
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