23/4 Flashcards
Cranial nerves and their exits through the skull
Olfactory (I) - cribiform plate
Optic (II) - optic canal
Occulomotor (III), trochlear (IV) and abducens (VI) and trigeminal (V1) - superior orbital fissure
Trigeminal (V2) - foramen rotundum
Trigeminal (V3) - formamen ovale
Facial nerve (VII) and vestibulocochlear (VIII) = acoustic meatus
Glossopharnngeal (IV), vagus (X), spinal accessory (XI) = jugular foramen
Hypoglossal (XII) = hypoglossal canal
V1,V2, V3 = Some Random hOle to remember where they go through
Look at notes for reminder of little saying
What is the pathology of SAH, SDH and EDH
What types need surgical intervention?
SAH
- rupture of anersym in the subarachnoid space - bit containing CSF
SDH
- rupture of the bridging veins between dura and arachnoid mater (venous blood)
- typically caused by some trauma
EDH
- skull fracture causing middle mengineal artery rupture
- trauma associated
EDH needs immediate surgical intervention - if surgery not avaliable burr hole has been used to relieve pressure
SDH - sometimes burr hole if progressing or neurological symptoms developing
SAH - endovascular coiling can be used but not always big surgery needed
How would acute vs chronic SDH appear on CT?
Chronic - dark - hypodense
Acute- white - hyperdense
What is the most common type of brain cancer?
What is the most common primary tumour of the brain?
Mets
Gliobastoma multiforme
What is the role of nimodipine in SAH?
Prevents vasospasm -> preventing ischaemia
How does a brain abscess appear on imaging?
Ring enchanced leison
Woman with bony mets - where is the cancer most likely to have come from?
Older man?
breast
prostate
What is ‘coning’?
What pysiological paramters are assoc. with this?
Increased pressure causees brain to herniate through the foramen magnum
Bradycardia and hypertension - slow and strong something in the brain is wrong
Uvula and tongue - what moves away/towards side of problem?
Uvula - moves AWAY
Tongue - moves TOWARDS (T=T)
Explain Weber and Reine
Weber - forehead
- CHL - louder in diseased ear
- SNHL - louder in normal ear
normal - both ears the same
Reine
- CHL - better bone conduction
- normal AC >BC
What are you looking for in inspection during limb neuro exams?
SWIFT
scars
wasting of muscles
involuntary movements
fasciculations
tremor
What’s one of the first signs of cervical myelopathy?
Loss of fine motor skills e.g. buttons
UMN = myelopathy = whole spinal cord
LMN = radiculopathy = nerve roots
Radiculopathy pain
Burning and hot pain
How to identify sciatic pain on examination?
Straight leg raise
