Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine - Year 2 > Block 12 - Musculoskeletal and nervous system (nervous 2) > Flashcards

Block 12 - Musculoskeletal and nervous system (nervous 2) Flashcards

1
Q

What are the colours on a CT scan?

A

Black = fluid
Grey = brain
White = bone
Bright white = blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is an extradural bleed?

What shape is it?

A

In the extradural space (outside the dura)

Lens shaped bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is subdural bleed?

What shape is it?

A

Between the dura

Bioconcave shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give 3 examples of diffuse brain injuries

A

Swelling/inflammation
Hypoxia (neurones damages > reduced oxygen)
Axonal injury > decreased consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can sheering forces cause to happen after a brain injury?
2 other ways progressive damage occurs

A

Sheering forces tear the lipid bilayer at the BBB > flux of elements (Ca), inflammation and axon death
Metabolic changes
Free radical formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give 4 examples of secondary brain injuries

A

Increased intracranial pressure
Hypoxia/Ischaemia
Seizures/fits
Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which fracture has increased risk of infection?

Why?

A

Basal skull fracture

Bacteria enter through tympanic membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain what happens to cerebral blood flow after a brain injury

A

Increased ICP in the brain due to increased mass
Brain loses CSF > spinal cord and blood to SVC to balance pressure
Eventually you can balance no more and pressure rises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does death occur in a brain injury?

A

Uncus of brain herniates though tentorium causing pressure on the brainstem
Brainstem cones through the foramen magnum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which nerves will the brain push on first?

What will this do to the eye?

A

Push on the parasympathetic (they’re outside)

Eye will dilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why must you maintain blood pressure during a brain injury?

A

Blood Pressure - Intracranial Pressure = Cerebral Perfusion Pressure
Must maintain CPP and ICP is increased so BP needs to also increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Cushing’s reflex?

A

Increased blood pressure when the ICP increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define lucid

A

No symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long does an MRI scan take?

How expensive is it?

A

The scan is quick but there’s a little preparation time

The scanner is expensive but scans are cheap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the resolution and sensitivity like in an MRI scanner?

A

Poor time resolution but good spatial resolution

Poor sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define precission

When does it occur

A

Change in the orientation of the rotational axis of a rotating body
Happens to protons in an MRI scanner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you obtain an MRI image?

A
  • Apply an electromagnetic radiofrequency pulse at the precision frequency
  • Protons absorb energy and change their alignment in respect to the external field (same/opposite direction)
  • Remove the RF pulse > protons realign with the external field and emit energy to the scanner to form an image
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the difference between a T1 and T2 weighted MRI?

A

T1: white matter white, grey matter grey, CSF dark
T2: white matter dark, grey matter light, CSF very white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can you use MRI contrast to look specifically for? (4)

A

Blood flow and volume
Vessel permeability and extracellular volume
Cell density and water movement
Biochemistry and metabolite disruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What happens to blood vessel permeability as a tumour develops?

A

Vessels become more ‘leaky’ and haemorrhage more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does water motion tell you about a cell?

A

Increased water motion = increased cell density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does magnetic resonance spectroscopy look at?

A

Chemicals and metabolites in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the spacial resolution of MRS like?

A

Low spacial resolution as it targets a specific area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What do levels of choline and lactate indicate?

A

Choline shows normal cell division and density

Lactate indicates anaerobic respiration (tumour)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is PET?

How does it work?

A

Proton emission tomography
Patient injected with radioactive isotopes (e.g. glucose)
Brain uses lots of glucose so can see affected areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is PET dependent on?

A

The isotope half life
Long enough for scanning but short for the patient
(amino acids better than glucose but shorter half life)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Resolution, sensitivity and safety or PET

A

Low spacial resolution
High sensitivity
One scan a lifetime (risky)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is SPECT?

How does it work?

A

Single photon emission computed tomography

Same as PET but photon not positron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Resolution, expense and safety or SPECT

A

Low spacial resolution
Less expensive (isotopes have longer half lives)
Less invasive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How long does an EEG take?

A

A long time, has a long preparation time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the resolution of an EEG?

A

Good time resolution

Poor spatial resolution (don’t know where signals originate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is ECoG?

A

Electrocorticography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the resolution of an ECoG?

A

Good time resolution

Better spatial resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How does an MEG work?

A

Current flow from neurones > magnetic field on sensors > computer interpretation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the resolution of an MEG?
How much does it cost? (what does this mean?)
How long does it take?

A

Good time and better spatial resolution
Expensive (not clinically established)
Quicker (reduced prep time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the BOLD response?
What is its purpose?
Which imaging technique measures it?

A

Blood Oxygen Level Dependent response
Exploits the different magnetic properties of Hb and its oxygen status
fMRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is fMRI combined with?

A

EEG/MEG to improve information about neuronal actiivty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What imaging techniques does York University have?

A

MEG

fMRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is brain plasticity and when does it occur?

A

When the brain recovers from a tumour, other parts of the brain take over the role of the damaged brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is fNIRS?

Explain how it works

A

Function Near-Infrared Spectroscopy
Uses infrared light to measure blood flow by the different absorption properties of oxy / deoxy haemaglobin
Sensor detects the amount of infrared reflected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When is fNIRS used?

A

In research

In children who cannot stay still in an MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Define hyperpolarisation (MRI)

A

Increased protons aligning with the field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Explain the purpose of single shot hyperpolarised MRI

What is the sensitivity and resolution like (compared to normal MRI)

A

Enhances structural images based on proton distribution

Increased sensitivity and resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Define primary prevention

How can you do it?

A

Avoidance of disease before sign/symptoms develop

e.g. genome sequencing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Define secondary prevention

A

Avoiding progression in people who already have signs and symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

2 risk factors for cardioembolism in the young

A

Patent foramen ovale

Endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

2 recreational drugs which increase the risk of stroke

How?

A

Cocaine: vasoconstricts and increased bp
Amphetamine: increases blood pressure and irregular heart beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How do you measure stroke risk?

A

CHADS2-VASc score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

2 ways by which smoking increases the risk of stroke

A

Accelerates atherosclerosis

Increases platelet adhesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Explain why an effective large study may not actually benefit in a population?

A

1000 people = 100 benefit but in your 50 patients only 5 will benefit from the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What happens in a haemodynamic event?

2 symptoms

A

When you quicky stand up your blood pressure is not high enough to reach all of your arteries
Pale and clammy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is reducing lipids better at preventing than stroke?

A

Better at preventing heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What happens to the core of the plaque in atherosclerosis?

A

Becomes soft and unstable due to inflammation so parts break off`

54
Q

Which part of the homulculus does the middle and anterior cerebral artery supply?

A 
Cervical = middle
Sacral = anterior
55
Q

Define dysgraphasthesia

A

Can feel but cannot interpret what an object is

56
Q

Where is a lacunar stroke?

A

Basal ganglia

57
Q

Define ischaemia penumbra

A

The brain is short of blood but the cells are not dead yet

The brain is electrically silent but can be recovered

58
Q

What are the 3 main causes of ischaemic stoke and %

A

50% atheromatous plaque
25% heart related (e.g. AF and endocarditis)
25% small end arteries

59
Q

What are the 2 types of haemorrhages in strokes?

Which has the worse prognosis and why?

A

Subarachnoid

Parenchymal (poor prognosis as in the middle of the brain)

60
Q

6 causes of haemorrhagic stroke

A 
Aneurysm
Artero-venous malformation
Cerebral amyloid angiopathy (amyloid deposits weaken vessels)
Coagulation disorders/medication
Haemorrhage
Hypertension
61
Q

Explain the 4 types of stroke

A

TACI: Total anterior circulation infarct
PACI: Partial anterior circulation infarct
LACI: Lacunar infarct
POCI: Posterior circulation infarct

62
Q

What happens in a TACI?

A

Corticol dysfunction
Hemianopia
Hemi motor and sensory deficit

63
Q

What happens in a PACI?

A 
Corticol dysfunction 
(with or without hemianopia and hemi motor and hemi sensory deficit)
64
Q

What happens in a LACI?

A

Pure motor or sensory loss
Dysarthria (clumsy hand)
Ataxic hemiparesis (pyramidal signs on one side and cerebellar on the other)

65
Q

What happens in a POCI?

A

Ataxia (cerebellar syndrome)
A/Dyspraxia (lack of motor integration and sequencing)
Vertigo
Hemianopia

66
Q

Define hemiplegia

A

Paralysis (motor loss) in one side of the body

67
Q

Define pyramidal symptoms

A

Increase in the muscle tone in the lower limb
Hyperreflexia
Positive Babinski
Decrease in fine motor coordination

68
Q

What are the signs if there is a stroke in the middle cerebral artery?

A

Contralateral motor, sensory and vision loss
Agnosia (cannot integrate sensory information)

Dominant: Agraphia, Acalculia, Aphasia
Non-dominant: Neglect, dressing apraxia, cannot recognise faces

69
Q

What are the signs if there is a large vessel occlusion in the carotid?

A

Contralateral motor and sensory loss
Ipsilateral homonymous hemianopia
Global aphasia
Gaze palsy

70
Q

Hemianopia

A

Blindness in half the field of vision

71
Q

What are the 8 stages of stroke rehabilitation?

A

Admission > Assessment > Goal setting > Education > Reassessment (may go back) > Monitor progress > Plan discharge > Discharge

72
Q

Define early onset dementia

A

Diagnosed before the age of 65

73
Q

What does normal and abnormal amyloid do?

A

Normal: Protects nerves from Ca and glutamate toxicity
Abnormal: Ca influx and plaques around nerves > inflammation and death

74
Q

What does normal and abnormal tau do?

A

Normal: Maintains brain cell strcrure and communication
Abnormal: hyperphosphorylated tau disrupts cell integrity and function > reduced communication

75
Q

8 symptoms of Alzheimer’s

A 
Anxiety and withdrawal
Cannot perform everyday tasks or recognise faces
Disorientation in time and place
Frontal lobe problems 
Language difficulties
Mild symptoms which gradually worsen
Recall recent events but not past ones
Reduced spatial awareness
76
Q

4 risk factors for Alzheimer’s

Is it preventable?

A

Above 65 and Female
Poor physical health e.g. uncontrolled diabetes or heart disease
Lifestyle e.g. smoking, alcohol, exercise

It is preventable

77
Q

4 risk factors of Vascular dementia

A

Above 65 and Male

Family history and poor physical health

78
Q

What are Lewy bodies?

What do they do?

A

Proteins which disrupt how brain cells communicate by reducing nerve cell connections and reducing Ach/dopamine

79
Q

7 symptoms of dementia with lewy bodies

A 
Fluctuating alertness
Frontal lobe problems
Mood changes
Reduced memory 
Reduced spatial awareness
Sleep disturbance
Visual hallucinations and delusional beliefs (upsetting
80
Q

Which type of dementia has parkinson features?

A

Lewy Body

81
Q

2 risk factors for dementia with Lewy bodies

3 ways of prevention

A

Above 65 and equal
Rare genetic mutations
Can be prevented by being socially active, hearing/eye checks, sleep routine and physical health

82
Q

Which dementia is linked to genetics so cannot be modified?

What age does it occur at?

A

Frontotemporal dementia

Diagnosed between 45 and 65

83
Q

What causes frontotemporal dementia?

A

Mutation in tau gene

Nerves in the frontal and temporal lobes die> reduction in chemical messengers and lobe shrinkage

84
Q

What are the 3 main types of frontotemporal dementia?

A

Behavioural variant frontotemporal dementia
Primary progressive aphasia
- Semantic dementia
- Progressive non-fluent aphasia

85
Q

What is Behavioural variant frontotemporal dementia also known as?
What symptoms does it have?
5 examples

A

Pick’s disease
Frontal and temporal lobe changes
e.g. emotional blunting, withdrawal
e.g. rude, personality change, sweet tooth

86
Q

Main symptom in Primary progressive aphasia

3 examples

A

Speech and language difficulties

Cannot understand, speak gramatically correct or recognise objects/people

87
Q

Explain what happens in Semantic dementia (3)

A

Describe objects as they don’t know the name
Fluent speech but doesn’t understand meaning
Cannot recognise people

88
Q

Explain what happens in Progressive non-fluent aphasia (3)

A

Slow and hesitant speech with gramatical errors
Telegraphic speech (leave out linking words)
Know the words but not the sentences

89
Q

How many seizures do you need to have in a year to be diagnosed with epilepsy?

A

2

90
Q

4 characteristics of an epileptic seizure

A

Spontaneous, Brief, Stereotypical, Non-situational

91
Q

What is the most common origin of an epileptic seizure?

A

Temporal lobe

92
Q

3 characteristics of status epilepticus

A

Active part of the seiure lasts 5 mins or longer
Person goes into the 2nd seizure with no recovery from the 1st
Repeated seizures for 30 minutes or longer

93
Q

7 causes of epilepsy

A 
Cerebrovascular disease
Corticol development malformations
Genetic
Hippocampal sclerosis
Trauma
Tumour
Vascular malformations
94
Q

3 characteristics of a frontal lobe seizure

A

Twitching and shaking
Consciousness retained
Difficulty speaking

95
Q

2 characteristics of a parietal lobe seizure

A

Body tingling

Reduced motor control in the affected area

96
Q

4 characteristics of the visual disturbances in occipital lobe seizures

A

Unformed, circular, coloured and continued to 1 hemisphere

97
Q

11 symptoms which occur DURING a temporal lobe seizure

A 
Dejavu
Fear
Hallicuinations (all senses)
Lip smacking, fidgeting, undressing
Motionless stare
Pallor/flushed - heart rate increase/decrease
Speech arrest/repeitive speech
98
Q

4 symptoms which occur after a temporal lobe seizure

A

Confusion, headache, dysphasia, nose rubbing

99
Q

How long do seizures usually last?

How many happen a month?

A

2-5 minutes

2-10 times a month

100
Q

3 characteristics of visual disturbances in a migraine

A

Zigzag, black and white, transverse visual fields

101
Q

Define postural hypotension

A

Blood pressure decreases when you stand up

102
Q

7 red flags for epilepsy

A 
Auras/dejavu
Drugs/alcohol
Event sequence
Early morning myoclonic jerks
Family history 
Other medical problems
Trauma
103
Q

Explain the history of someone who experiences a single seizure

A 
Feeling strange for a few days
Aura for seconds > minutes
Tonic: cry and fall
Clonic movements for a minute
Altered consciousness
104
Q

4 investigations for epilepsy

A

Blood
CT (reliable)
MRI (reliable)
EEG (not reliable)

105
Q

What does the EEG look like in epilepsy?

A

Double wave

106
Q

What is the ‘pacemaker’ used to treat epilepsy called?

What does it do?

A

Vagus nerve stimulator

Controls brain electrical waves

107
Q

Define sleep

A

Period of rest with reduced bodily functions

Immune and reduced (but reversible) sensitivity to the environment

108
Q

Define sedation

When is it used?

A

Verbal contact maintained but reduced anxiety and discomfort
Toleration of unpleasant procedures

109
Q

Define coma

A

Extreme unresponsiveness

No voluntary behaviour

110
Q

4 characteristics of general anaesthesia

A

Coma, Hypnosis, Areflexia, Analgesia

111
Q 
What happened in anaesthesia development in the:
1500s
1700s
1800s
1900s
A

1500s Curare discovered
1700s NO discovered as laughing gas
1800s Curare if maintain ventilation, Ether, Chloroform (childbirth)
1900s Rapid development e.g. propofol

112
Q

What was discovered in the polio epidemic

A

Positive pressure ventilation

113
Q

Which receptors do GA target?

A

GABA - A

114
Q

4 side effects of anaesthesia

A

Reduced heart contractility and blood pressure
Sympathetic inhibition
Respiratory depression
Brain functions depressed

115
Q

What is the onset of volatile anaesthetics?

Why?

A

Slow - alveolar gas exchange

116
Q

What are the characteristics of A, B and C fibres?

A 
A = large and myelinated
B = small and myelinated
C = small and unmyelinated
117
Q

Which fibres do you lose first?

A

C fibres then B then A

118
Q

What are the 3 types of A fibres?

A 
alpha = motor and proprioception
beta = light touch and pressure
delta = pain and temperature
119
Q

What do you administer when you overdose on local anaesthetic?

A

Lipid solution to dissolve the anaesthetic

‘Intralipid’

120
Q

Which Ach receptor is blocked by NMJ blocking drugs?

A

Nicotinic (sympathetic)

121
Q

6 risks of GA

A

CNS, CVS, RS depression
Aspiration of gastric contents
Can be hard to ventilate (e.g. asthma/airway problem)
Post op nauesea, vomiting and resp problems
Continued awareness (rare)
Death (very rate)

122
Q

4 benefits of GA

A

Patient unconsciousness
Surgical access
Total control of the patient
Easily treated complications

123
Q

6 risks of LA

A 
Often not suitable
Contraindications
Anticoagulation
Nerve injury > paralysis (e.g. epidural)
Can fail
Toxicity
124
Q

5 benefits of LA

A 
Avoid GA risks
Post op analgesia
Reduced blood loss
Reduced DVT risk
Reduced death
125
Q

3 ways to know that someone is asleep

A

Clinical signs
Measure exhaled anaesthetic concentrations
Bispectral index monitor (EEG on the forehead)

126
Q

3 examples of reliable signs

4 examples of unreliable signs

A

Reliable: heart rate, resp rate and bp
Unreliable: movement, muscle tone, eye reflexes, lacrimation

127
Q

What are the 4 stages of anaesthesia

A
  1. Induction
  2. Excitement
  3. Surgical/Operative
  4. Overdose/Danger
128
Q

Explain what happens in induction

A

Analgesi > Amnesia
Patients can talk
Ends when patient unconscious

129
Q

Explain what happens in excitement

A

Excited after loss of consciousness
Irregular heart and resp rate
Uncontrolled movements e.g. vomiting, pupil dilation, holding breath
Can lead to airway compromise

130
Q

Explain what happens in surgical/operative

A

Muscles relax and vomiting stops
Resp depression
Eye movements slow and stop
- eyes roll > fixed
- loss of corneal and laryngeal reflex
- pupils dilate and lose light reflex
- intercostal paralysis > shallow abdominal resp

131
Q

Explain what happens in overdose/danger

A

Brain stem depression
Stop breathing
Cardiovascular collapse

Medicine - Year 2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions