Brainscape's Knowledge GenomeTM

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


See full index

Year 2 > Case 16 > Flashcards

Case 16 Flashcards

1
Q

What is urban defined as in the UK?

A

Built-up areas with a population of 10,000 or more usual residents

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

Why is occupation no longer seen as a primary criterion for the definition of rural?

A

There’s been a decline in the proportion of rural dwellers involved in agriculture

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

What are rural areas subdivided into?

A

Town and fringe
Village
Hamlet and isolated dwellings

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

What sort of intracranial haemorrhages can occur spontaneously?

A

Subarachnoid
Intracerebral
Intraventricular

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

What sort of intracranial haemorrhages result from head injury?

A

Extradural

Subdural

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

What is hydrocephalus?

A

Abnormally large amount of CSF within ventricles

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

What is the brain, blood, CSF composition of the head?

A

80% brain
10% blood
10% CSF

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

What is the classical triad of symptoms for raised ICP?

A

Headache
Nausea
Vomiting

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

What is Cushing’s triad?

A

Increased systolic blood pressure (with a widened pulse pressure), bradycardia and abnormal respiratory pattern

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

What are the symptoms and signs of raised intracranial pressure?

A

Triad: Headache, nausea, vomiting
Altered consciousness
Ophthalmoparesis (extraocular muscle weakness) due to CN III, IV or VI palsies
Vital sign changes
Cushing’s triad: increased systolic blood pressure (with a widened pulse pressure), bradycardia, abnormal respiratory pattern
Papilloedema – more chronic presentation

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

What does CN IV supply and what occurs in CN IV palsy?

A

Superior oblique

Diplopia when looking medially and downwards

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

What does CN VI supply and what occurs in CN VI palsy?

A

Lateral rectus

Convergent strabismus/ esotropia

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

What is esotropia?

A

Inward squint/ convergent strabismus

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

What is a lucid interval?

A

Temporary recovery of consciousness after a blow to the head before relapse into coma
Sign of intracranial arterial bleeding - extradural haematoma

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

What are the symptoms of subarachnoid haemorrhage?

A 
Blinding occipital pain 
Neck stiffness 
Photophobia 
Nausea/ vomiting
Diplopia 
Brief loss of consciousness 
Stroke-like symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can cause subarachnoid haemorrhage?

A

Cerebral aneurysm (most-likely non-trauma cause)
Hypertension
Anticoagulants
Ateriovenous malformation

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

What can cause hydrocephalus?

A

Obstructive: tumour/ abscess/ cyst/ congenital aqueduct stenosis/ chiari malformation (lower brain pushed towards spinal cord)
Non-obructive: intracranial haemorrhage/ infection/ post-traumatic - overproduction/ lack of CSF reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can non-obstructive causes of hydrocephalus be treated?

A

Ventriculoperitoneal shunt - CSF reabsorbed via abdominal lining

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

How can obstructive causes of hydrocephalus be treated?

A

Endoscopic 3rd ventriculostomy - opening created in floor of 3rd ventricle

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

How is subdural empyema treated?

A

Urgent craniotomy to remove empyema (pus)

Antibiotics for 6-12 weeks

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

What passes through the transverse foramina?

A

Vertebral artery and vein

Sympathetic plexuses

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

What passes through the vertebral foramina?

A

Vertebral canal - spinal cord/ meninges/ fat/ spinal nerve roots/ vessels

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

What does the carotid sheath contain?

A 
Common and internal carotid arteries
Internal jugular vein 
Vagus nerve CN X
Some deep cervical lymph nodes 
Carotid sinus nerve 
Sympathetic nerve fibres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does the carotid sheath communicate with superiorly and inferiorly and how could this be problematic?

A

Superiorly: Cranial cavity
Inferiorly: Mediastinum
Potential pathways for spread of infection and extravasated blood

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

What nervous structure lies behind the carotid sheath?

A

Sympathetic trunk

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

What is the role of thyroid hormone?

A

Control the rate of metabolism

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

What is the role of calcitonin?

A

Controls calcium metabolism

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

What is the role of parathyroid hormone (PTH)?

A

Controls metabolism of phosphorus and calcium in the blood

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

What does the thyroid gland secrete?

A

Thyroid hormone

Calcitonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q 
What are the changes seen in cranial nerve III palsy and from lack of innervation to what? 
Eye direction 
Eyelid 
Pupillary size 
Accommodation
A

Eye points down and out - superior/ medial/ inferior rectus/ inferior oblique
Ptosis - levator palpebrae superioris
Pupil dilation - sphincter pupillae
Unresponsive to accommodation - ciliary muscle

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

When would a patient need to be intubated?

A

When GCS is less than 8

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

What supply the thyroid and parathyroid glands?

A

External carotid artery - Superior thyroid artery

Subclavian artery - Inferior thyroid artery

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

What does the brachiocephalic trunk bifurcate into?

A

R subclavian

R common carotid

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

What does the sternocleidomastoid muscle attach to?

A

Superior nucal line, occipital bone
Mastoid process, temporal bone
Has a clavicular and sternal head

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

What innervates the sternocleidomastoid?

A

CN XI

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

Which spinal segments/ roots does the brachial plexus arise from?

A

Anterior rami of C5, C6, C7, C8 and T1 spinal nerves

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

What is the rima glottidis?

A

Vocal folds

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

What are the extrinsic laryngeal muscles?

A

Infrahyoid
Suprahyoid
Stylopharyngeus

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

What are the intrinsic laryngeal muscles?

A 
Cricothyroid 
Thyroarytenoid 
Posterior and lateral cricoarytenoids 
Transverse and oblique arytenoids 
Vocalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What nerve supplies the intrinsic laryngeal muscles?

A

Recurrent laryngeal nerve (from CN X)

Except for cricothyroid - external laryngeal nerve (from CN X)

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

Which extrinsic laryngeal muscle depresses the hyoid and larynx?

A

Infrahyoid

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

Which extrinsic laryngeal muscles elevate the hyoid and larynx?

A

Suprahyoid

Stylopharyngeus

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

What is the action of the transverse and oblique arytenoids?

A

Adduct arytenoid cartilages and intercartilaginous portion of vocal folds - closing rima glottidis

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

What is the action of vocalis?

A

Relaxes posterior vocal ligament while maintaing/ increasing tension of anterior part

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

What is the action of posterior cricoarytenoid?

A

Abducts vocal folds - opening airway

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

What is the action of lateral cricoarytenoid?

A

Adducts vocal folds - closing airway

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

What is the action of thyroarytenoid?

A

Relaxes vocal ligaments - decreasing pitch

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

What is the action of cricothyroid?

A

Stretches and tenses vocal ligament - increasing pitch

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

Which muscles are involved in closing the airway/ rima glottidis?

A

Lateral cricoarytenoid

Transverse and oblique arytenoids

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

Which 4 bones make up the palate?

A

Maxilla
Palatine
Vomer
Sphenoid

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

Which 3 bones make up the calvaria (skullcap/ vault of skull)?

A

Frontal
Parietal
Occipital

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

Which 7 bones make up the orbit?

A 
Frontal 
Sphenoid
Zygomatic 
Maxilla
Ethmoid 
Lacrimal 
Palatine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Which 3 bones make up the anterior cranial fossa?

A

Frontal
Ethmoid
Sphenoid

54
Q

Which 3 bones make up the middle cranial fossa?

A

Sphenoid
Temporal
Parietal

55
Q

Which 3 bones make up the posterior cranial fossa?

A

Temporal
Occipital
Parietal

56
Q

Which 10 bones make up the facial skeleton?

A 
Frontal 
Parietal 
Temporal
Sphenoid 
Nasal
Zygomatic
Ethmoid 
Lacrimal
Maxilla 
Mandible
57
Q

Which 4 bones form the pterion?

A

Frontal
Parietal
Temporal
Sphenoid

58
Q

Compare the dura mater to the pia

A

Dura - tough, thick, external, fibrous

Pia - delicate, thin, internal, vascular

59
Q

If the cavernous sinus became infected, which structures are liable to damage?

A 
(O TOM CAT)
O TOM: lateral wall from top to bottom
CA: inside sinus
Oculomotor nerve 
Trochlear nerve
Ophthalmic nerve (CN V1)
Maxillary nerve (CN V2)
Internal carotid artery 
Abducens nerve
60
Q

What are the symptoms of a venous thrombus in the cavernous sinus?

A

Internal jugular vein drains the cavernous sinus
Thrombus - restricts blood flow from brain
Severe headache/ sweeling of eyes and surrounding tissue/ eye pain/ double vision

61
Q

What is the name of CN VIII?

A

Vestibulocochlear

62
Q

What is the name of CN IX?

A

Glossopharyngeal

63
Q

What is the name of CN XII?

A

Hypoglossal

64
Q

What foramen does CN I exit through?

A

Foramina in cribriform plate

65
Q

What foramen does CN II exit through?

A

Optic nerve through Optic canal

66
Q

What foramen does CN XII exit through?

A

Hypoglossal nerve through hypoglossal canal

67
Q

Which cranial nerves exit through the superior orbital fissure?

A

Oculomotor III
Trochlear IV
Ophthalmic branch of Trigeminal V1
Abducens VI

68
Q

Which cranial nerves exit through the internal acoustic meatus?

A

Facial VII

Vestibulocochlear VIII

69
Q

Which cranial nerves exit through the jugular foramen?

A

Glossopharyngeal IX
Vagus X
Accessory XI

70
Q

What foramen does CN V2 exit through?

A

Foramen rotundum

71
Q

What foramen does CN V3 exit through?

A

Foramen ovale

72
Q

What arises from the internal carotid arteries?

A

Middle and anterior cerebral arteries

73
Q

What arises from the basilar artery?

A

Posterior cerebral arteries
Pontine arteries
Superior and anterior inferior cerebellar arteries

74
Q

What connects the basilar artery to the internal carotids?

A

Posterior communicating arteries

75
Q

What does the vertebral arteries give rise to?

A

Basilar artery

Posterior inferior cerebellar arteries (PICA)

76
Q

Where do the vertebral arteries join to form the basilar artery?

A

Caudal border of pons

77
Q

What sort of rash appears in meningitis?

A

Non-blanching

78
Q

What arises directly from the arch of the aorta?

A

Brachiocephalic trunk (1st)
L common carotid artery (2nd)
L subclavian artery (3rd)

79
Q

What lies between the clavicle and sternal heads of the sternocleidomastoid?

A

Internal JVP

80
Q

Which muscles lie in the posterior triangle of the neck?

A

Splenius captitis
Levator scapulae
Anterior, middle. posterior scalene
Inferior belly of omohyoid

81
Q

What are the 3 pontine branches of the basilar?

A

Paramedian
Short circumferential
Long circumferential

82
Q

What does the paramedian pontine branch supply?

A

Anterior middle part of pons

83
Q

What does the long circumferential pontine branch supply?

A

Most of the pons

84
Q

What sort of impulses do the dorsal columns carry?

A

Impulses concerned with proprioception and fine/ discriminative touch

85
Q

Where do third-order neurons of dorsal column project to?

A

Somatosensory cortex, postcentral gyrus, parietal lobe

86
Q

Where do second-order neurons of dorsal column decussate?

A

Medulla

87
Q

What do second-order neurons of dorsal column ascend the brainstem as?

A

Internal arcuate fibres in medial lemniscus

88
Q

Is the dorsal column an ascending or descending spinal tract?

A

Ascending

89
Q

What sort of impulses does the spinothalamic tract carry?

A

Pain, thermal sensations, course/ non-discriminative touch and pressure

90
Q

What sort of impulses do the lateral spinothalamic tracts generally carry?

A

Pain and temperature

91
Q

What sort of impulses do the ventral spinothalamic tracts generally carry?

A

Touch and pressure

92
Q

Is the spinothalamic tract an ascending or descending spinal tract?

A

Ascending

93
Q

Spinothalamic tract fibres decussate via what?

A

Ventral white commissure

94
Q

Where do third-order neurons of the spinothalamic tract project to?

A

Somatosensory cortex, postcentral gyrus, parietal lobe

95
Q

What are the spinothalamic tract fibres referred to in the brainstem?

A

Spinal lemniscus

96
Q

Is the corticospinal tract an ascending or descending spinal tract?

A

Descending

97
Q

What does the corticospinal tract control?

A

Voluntary, discrete, skilled movements

98
Q

Corticospinal tract neurons arise from cells bodies located in…?

A

Cerebral cortex in motor and sensory cortices

99
Q

What do corticospinal tract neurons pass through before entering the brainstem?

A

Subcortical fibre systems: corona radiata and internal capsule

100
Q

What region of the midbrain do corticospinal tract neurons pass through?

A

Crus cerebri

101
Q

What is the name of the 2 columns formed by the corticospinal tract neurons in the medulla?

A

Pyramids

102
Q

What occurs when corticospinal tracts subtotally decussate at caudal medulla?

A

75-90% of fibres decussate to contralateral lateral corticospinal tract
10-25% remain ipsilateral and enter ventral corticospinal tract

103
Q

Where do corticospinal tracts decussate?

A

Subtotal decussation at caudal medulla
Fibres that have not decussated do so further down near site of termination
So fibres of pyramidal/ corticospinal tract effectively innerve the contralateral side of the spinal cord

104
Q

Where are dorsal columns located within the spinal cord?

A

Between the dorsal median sulcus and dorsal horn

105
Q

Where are spinothalamic tracts located within the spinal cord?

A

Lie lateral and ventral to ventral horn

106
Q

Where are the motor and somatosensory cortices?

A

Motor: Precentral gyrus
Somatosensory: Postcentral gyrus

107
Q

What ion movements are carried out by energy-dependent active transport mechanisms present in the choroid plexus?

A

Transporting Mg2+ into CSF

Removing K+ and Ca2+

108
Q

What are the concentration of Na+ and K+ like in the CSF?

A

High Na+

Low K+

109
Q

What comes off the vertebral arteries?

A

Meningeal artery
Anterior and posterior spinal arteries
Posterior inferior cerebellar artery (PICA)

110
Q

What’s the brainstem structure that controls consciousness?

A

Ascending reticular activating system

111
Q

Which vessel is occluded in lateral medullary syndrome?

A

Posterior inferior cerebellar artery (PICA)

112
Q

What functions are lost in lateral medullary syndrome?

A

Contralateral pain and temp of body - spinothalamic
Ipsilateral pain and temp of face - trigeminal
Gag reflex (Dysphagia, hoarseness) - nucleus ambiguous, CN IX and X roots
Ipsilateral horner’s syndrome - hypothalamic
Vertigo, diplopia, fall to ipsilateral side - vestibular nuclei
Ipsilateral ataxia - spinocerebellar

113
Q

What happens in Horner’s syndrome?

A

Constricted pupil
Ptosis
Inability to sweat on 1 side of face

114
Q

Do neurons and glial cells retain the ability to divide throughout life?

A

Neurons - no

Glial cells - yes

115
Q

What are oligodendrocytes?

A

Schwann cells of CNS

116
Q

What do microglia act as?

A

White blood cells of brain - attack/ phagocytose organisms/ damaged cells

117
Q

How fast do axons of the PNS regrow?

A

About a mm a day

118
Q

In axonal damage of PNS what stimulates break down of the cytoskeleton?

A 
Calcium entering the cytosol 
Activating caplain (protease) that breaks down the cytoskeleton
119
Q

What prevents axonal regrowth in the CNS?

A

Physically blocked by glial scars

Chemically blocked by release of inhibitory molecules released by glial cells and macrophages

120
Q

What produces the axonal regrowth inhibitory molecule NogoA?

A

Oligodendrocytes

121
Q

What produces the axonal regrowth inhibitory molecule chondroitin sulphate proteoglycans (CSPG)?

A

Astrocytes

122
Q

What is petechial haemorrhage within the brain? What does it suggest?

A

Blood leakage at interface of grey and white matter

Indicative of severe brain injury (even with our midline shift)

123
Q

What is the extracellular glutamate concentration normally?

A

0.6 micromol/L

124
Q

At what concentrations does glutamate become excitotoxic?

A

2-5 mircomol/L

125
Q

How can ischaemia damage astrocytes?

A

Astrocytes can metabolise glucose anaerobically

but not if lactic acid build up has created a pH of less than 6.6 - as glycolysis ceases and irreversible damage occurs

126
Q

What can raise extracellular levels of glutamate to excitotoxic levels?

A

Compromised astrocyte metabolism of glutamate

Neuronal rupture from traumatic brain injury

127
Q

What blocks the glutamate NMDA receptor during resting potential?

A

Mg2+

128
Q

How does increased intracellular calcium via glutamate receptors lead to excitotoxicity?

A

Reduced mitochondrial ATP synthesis - causing outward glutamate leakage
Osmotic swelling - cell rupture
Activate calcium-dependent enzymes that cause cell necrosis
Upregulate pro-apoptotic genes

129
Q 
Describe the role of the following calcium-dependent enzymes in causing cell necrosis:
Calpains 
Proteases
Phospholipases 
Endonucleases
A

Calpains - degrade neuronal cytoskeleton
Proteases - digest structural proteins
Phospholipases - break down cell membranes
Endonucleases - cause DNA fragmentation

130
Q

What scavenges reactive oxygen species?

A

Antioxidants: vitamin C and E

Superoxide dismutase, catalase and glutathione peroxidase enzymes

Year 2 (13 decks)

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