USMLE | Nervous System & Special Senses

Normal Processes

Embryonic development, fetal maturation, and perinatal changes, including neural tube derivatives, cerebral ventricles, and neural crest derivatives

Organ structure and function

• • spinal cord
    • gross anatomy and blood supply spinal reflexes
  • brain stem (eg, cranial nerves and nuclei, reticular formation, anatomy and blood supply, control of eye movements)
  • brain
    • gross anatomy and blood supply
    • higher function: cognition, language, memory, executive function hypothalamic function
    • limbic system and emotional behavior
    • circadian rhythms and sleep
  • sensory systems
    • general sensory modalities, including sharp, dull, temperature, vibratory, and proprioception
    • special sensory modalities, including vision, hearing, taste, olfaction, and balance
  • motor systems
    • brain and spinal cord (upper motoneuron)
    • basal ganglia and cerebellum autonomic nervous system peripheral nerves

Cell/tissue structure and function, including neuronal cellular and molecular biology

• • axonal transport
  • excitable properties of neurons, axons, and dendrites, including channels
  • synthesis, storage, release, reuptake, and degradation of neurotransmitters and neuromodulators
  • presynaptic and postsynaptic receptor interactions, trophic and growth factors brain metabolism glia, myelin
  • brain homeostasis: blood-brain barrier, cerebrospinal fluid formation and flow, choroid plexus

Repair, regeneration, and changes associated with stage of life

Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

Infectious, immunologic, and inflammatory disorders

• • infectious disorders: meningitis: bacterial (Actinomyces israelii; Haemophilus influenzae;
    • Listeria monocytogenes; Mycobacterium tuberculosis; Neisseria meningitidis; Staphylococcus aureus, epidermidis; Streptococcus agalactiae; Streptococcus pneumoniae); viral (adenovirus, arboviruses, echovirus and coxsackie A & B viruses, polioviruses, herpes simplex virus, varicella zoster, human immunodeficiency virus, lymphocytic choriomeningitis virus, measles virus, mumps virus, St. Louis encephalitis virus, California encephalitis virus, Western equine encephalitis virus); fungal (Blastomycosis dermatitidis, Cryptococcus neoformans/gattii); spirochetal (Borrelia burgdorferi; Leptospira; Treponema pallidum, including neurosyphilis); protozoal/helminths (Acanthamoeba, Naegleria fowleri, Strongyloides stercoralis, Angiostrongylus cantonensis, Baylisascaris procyonis); encephalitis (herpesvirus [HSV- I], varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, mumps virus, enterovirus, West Nile virus, St. Louis encephalitis virus, rabies virus, Eastern and Western equine encephalitis virus, poliovirus, Taenia, Toxoplasma gondii); prion disease (eg, Creutzfeldt-Jakob disease); botulism (Clostridium botulinum), tetanus (Clostridium tetani); CNS disorders associated with AIDS (eg, progressive multifocal leukoencephalopathy)
  • immunologic and inflammatory disorders: myasthenia gravis, including thymoma;
    • multiple sclerosis; transverse myelitis

Neoplasms (cerebral, spinal, and peripheral): benign (meningioma, neurofibromatosis);

• • malignant (glioblastoma multiforme, astrocytoma, medulloblastoma, primary CNS
    • lymphoma); metastatic (eg, breast, lung, pancreatic, testicular, melanoma)

Cerebrovascular disease: arteriovenous malformations, ectatic cerebral vessels; transient ischemic attack; stroke, thrombotic: cerebral artery occlusion/cerebral infarction;

• • stroke, embolic: cerebral embolism; stroke: intracerebral hemorrhage, including subarachnoid hemorrhage, traumatic intracranial hemorrhage; cerebral artery aneurysm; carotid artery stenosis/atherosclerosis/occlusion/dissection; vertebral artery deficiency/dissection; subclavian steal syndrome; vascular dementia; hypertensive encephalopathy; posterior reversible encephalopathy syndrome; venous sinus thrombosis

Disorders relating to the spine, spinal cord, and spinal nerve roots: cauda equina syndrome; spinal artery thrombosis/embolus/infarct; spinal cord compression; spinal cord transection, paraplegia and quadriplegia, acute and chronic effects (eg, autonomic dysreflexia); spinal stenosis (cervical, lumbar)

Cranial and peripheral nerve disorders

• • cranial nerve injury/disorders: cranial nerve injury; Bell palsy; anisocoria, miosis, mydriasis; internuclear ophthalmoplegia; nystagmus and other irregular eye movements; vestibular neuritis, labyrinthitis; ptosis of the eyelid; Horner syndrome
  • peripheral nerve/plexus injury/disorders: peripheral nerve injury, including brachial plexus; carpal/cubital/tarsal/peroneal tunnel syndrome; mononeuritis, Guillain-Barré syndrome; Miller Fisher syndrome; neuropathy (eg, Charcot-Marie-Tooth disease); herpes zoster

Neurologic pain syndromes: complex regional pain syndrome (reflex sympathetic dystrophy, causalgia); fibromyalgia; postherpetic neuralgia; phantom limb pain; thalamic pain syndrome; trigeminal neuralgia

Degenerative disorders/amnestic syndromes: Alzheimer disease; frontotemporal dementia, including Pick disease, progressive supranuclear palsy, Lewy body disease

Global cerebral dysfunction: altered states of consciousness; delirium; coma/brain death

Neuromuscular disorders: amyotrophic lateral sclerosis/spinal muscular atrophy; muscular dystrophy; muscle channelopathies

Movement disorders: acute dystonia; adult tic disease; essential tremor; Huntington disease; Parkinson disease, including Parkinson dementia

Metabolic disorders: adrenoleukodystrophy; metabolic encephalopathy

Paroxysmal disorders: headache, including migraine, mixed, tension, ice-pick, cluster, medication withdrawal, caffeine withdrawal; seizure disorders, including generalized tonic-clonic, partial, absence, febrile

Sleep disorders: cataplexy and narcolepsy; circadian rhythm disorders; insomnia, primary; sleep terror disorder and sleepwalking; REM sleep behavior disorder; restless legs syndrome

Traumatic and mechanical disorders and disorders of increased intracranial pressure: anoxic brain damage, cerebral hypoxia; epidural, subdural hematoma (cerebral and spinal); intraparenchymal hemorrhage, traumatic subarachnoid hemorrhage; cerebral edema; pseudotumor cerebri (idiopathic intracranial hypertension); torticollis/cervical dystonia; hydrocephalus, including normal-pressure; traumatic brain injury (concussion)/postconcussion syndrome (dementia pugilistica); traumatic brain syndrome

Congenital disorders: Friedreich ataxia; neural tube defects (eg, spina bifida, holoprosencephaly, anencephaly); microcephaly; Sturge-Weber syndrome; tuberous sclerosis, von Hippel-Lindau disease; hydrocephalus, obstructive (Arnold-Chiari)

Adverse effects of drugs on the nervous system: acute dystonic reaction; drug-induced meningitis (eg, NSAIDs, sulfa drugs); drug-induced neuropathy (eg, vincristine, isoniazid, metronidazole); extrapyramidal adverse effects (eg, akathisia, dystonia, drug-induced parkinsonism); neuroleptic malignant syndrome; poisoning by psychotropic agents, including antidepressants; serotonin syndrome; tardive dyskinesia

Disorders of the eye and eyelid

• • infectious and inflammatory disorders of the eye: blepharitis/eyelid inflammation; chalazion; chorioretinitis; conjunctivitis (adenovirus)/keratoconjunctivitis; dacryocystitis; endophthalmitis; hordeolum; iridocyclitis; optic neuritis; periorbital cellulitis; uveitis
  • neoplasms of the eye: melanoma; retinoblastoma
  • disorders of the eye and eyelid, structural: cataract; glaucoma; lacrimal system disorders; pterygium; refractive disorders (presbyopia, myopia, hyperopia, astigmatism)
  • disorders of the pupil, iris, muscles (extraocular): amblyopia; strabismus
  • disorders of the retina: hypertensive retinopathy; macular degeneration; papilledema; retinal detachment; retinitis pigmentosa; vascular disorders affecting the retina, including central retinal artery embolus, retinal hemorrhage, amaurosis fugax, embolus, carotid artery stenosis, central retinal vein occlusion; visual impairment/blindness, night blindness
  • traumatic and mechanical disorders: black eye; burn of the eye and adnexa; corneal abrasion, ulcer; dislocated lens; foreign body in eye; hyphema; injury to optic nerve and pathways; laceration of the eye and eyelid; ocular open wounds; orbital fracture; subconjunctival hemorrhage
  • adverse effects of drugs on the eyes: ethambutol; hydroxychloroquine; prednisone

Disorders of the ear

• • infectious and inflammatory disorders of the ear: chondritis; mastoiditis; otitis, externa, media, interna, serous, suppurative, malignant otitis externa
  • neoplasms: acoustic neuroma, neurofibromatosis type 2; cholesteatoma
  • hearing loss/deafness: hearing loss, including noise induced; otosclerosis; tinnitus
  • disorders of balance and spatial orientation: Ménière disease; motion sickness; vertigo, including benign positional vertigo
  • traumatic and mechanical disorders: barotrauma; foreign body in ear; impacted cerumen; laceration, avulsion; perforation of tympanic membrane; eustachian tube disorders
  • adverse effects of drugs on the ear: antineoplastic agents, including cisplatin; aminoglycosides; furosemide; salicylates

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