Clinical Localisation & Neuroanatomy ; Lecture Flashcards
What are the three steps of the neuro-diagnostic pathway?
Clinical syndrome.
Imaging/Investigation (e.g., CT, MRI, lumbar puncture, EMG).
Underlying pathology.
True/False: Neuro-clinical syndromes should always be separated from the underlying disease entity.
True.
List five examples of neuro-clinical syndromes.
Proximal myopathy.
Cerebellar syndrome.
Cranial nerve palsies.
Extrapyramidal syndromes.
Raised ICP syndrome.
_________ syndrome includes symptoms such as ataxia and nystagmus, which occur on the _________ side of the lesion.
Cerebellar; same (ipsilateral).
Match the syndrome to its typical symptom.
Myelopathy.
Raised ICP syndrome.
Parkinsonism.
Meningism.
Myelopathy: Treacle hands, Brown-Sequard.
Raised ICP syndrome: Headache, vomiting, visual disturbance.
Parkinsonism: Bradykinesia, rigidity, tremor.
Meningism: Neck stiffness, headache, photophobia.
What are the normal CSF production rate and total CSF volume?
Production: 500 mL/24 hours.
Total volume: 120 mL.
The _________ fissure separates the frontal and parietal lobes, while the _________ sulcus separates the parietal and temporal lobes.
Sylvian; central.
What is the most common presentation of stroke involving the internal capsule?
Sudden onset of contralateral hemiparesis.
Middle cerebral artery strokes typically result in _________ deficits, while anterior choroidal artery strokes cause _________ deficits.
cortical; internal capsule.
What are the components of a mini-neurologic examination?
Glasgow Coma Scale (GCS).
Lateralizing signs.
Pupil assessment.
True/False: Fixed, dilated pupils are commonly associated with 3rd nerve palsy.
true.
Match the spinal root to its corresponding reflex and sensory area:
C6.
C7.
S1.
C6: Biceps reflex, thumb sensation.
C7: Triceps reflex, middle finger sensation.
S1: Ankle jerk reflex, lateral foot sensation.
Cervical radiculopathy affecting the _________ root causes elbow flexion weakness, while _________ radiculopathy affects ankle jerk reflex.
C6; S1.
What are two symptoms and two signs of raised ICP?
Symptoms: Headache, visual disturbance.
Signs: Papilledema, limitation of upward gaze.
True/False: Hydrocephalus may occur in raised ICP due to infratentorial lesions.
true
Name the key structures involved in the descending motor pathway.
Pyramidal decussation.
Corticospinal tract.
Internal capsule.
The _________ tract carries sensory information for pain and temperature, while the _________ columns carry vibration and proprioception.
lateral spinothalamic; posterior.
What is the rule of thumb for differentiating spine and brain pathology?
Spine: Radiating limb pain, bilateral limb deficit, back pain.
Brain: Headache, visual disturbances, contralateral deficits.
A patient with “treacle hands” and _________ suggests a _________ lesion.
Brown-Sequard syndrome; myelopathy.
What are the key imaging modalities in the neuro-diagnostic pathway?
CT, MRI, lumbar puncture, EMG/nerve conduction studies, cerebral angiography.
What are dermatomes, and why are they clinically important?
Dermatomes are areas of skin innervated by a specific spinal nerve root, helping localize neurological lesions.
Myotomes refer to muscles innervated by a particular _________, and they can be assessed by testing _________.
spinal nerve root; specific movements.
What does the mnemonic “LOAF” stand for in relation to the median nerve motor supply?
Lateral 2 lumbricals.
Opponens pollicis brevis.
Abductor pollicis brevis.
Flexor pollicis brevis.
The axillary nerve (C5) innervates the _________, which is responsible for _________ of the shoulder.
deltoid; abduction.
True/False: The radial nerve innervates the triceps and finger extensors and arises from the posterior cord.
True.
What causes scapular winging?
Nerve lesions: Long thoracic (serratus anterior), accessory (trapezius), dorsal scapular (rhomboids).
Primary muscle pathology (e.g., myopathy).
Scapular winging caused by a _________ nerve lesion is most common and affects the _________ muscle.
long thoracic; serratus anterior.
A 68-year-old man has elbow extension weakness and numbness over the middle finger. MRI shows a nerve root lesion. What is the likely root affected?
C7.
A 52-year-old man has weak dorsiflexion and ankle inversion with normal knee extension. Where is the lesion?
L4/5 root or common peroneal nerve.
Wrist drop with normal elbow extension and numbness over the _________ suggests a _________ nerve lesion.
anatomical snuffbox; radial.
What are the possible causes of foot drop?
Muscle: Myopathy.
Nerve: Peroneal nerve, sciatic nerve.
Root: L4/5.
Anterior horn: Motor neuron disease.
Brain: Parasagittal meningioma.
True/False: L4/5 lesions often present with combined sensory and motor deficits, affecting dorsiflexion and inversion.
True.
