Clinical neuroanatomy Flashcards

1
Q

Where do spinothalamic tracts decussate?

A

cross over 1-2 segments above within spinal cord

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2
Q

Where do posterior columns decussate?

A

travel up spinal cord and cross over within medulla

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3
Q

Where do corticospinal tracts decussate?

A

at medulla

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4
Q

Which info does spinothalamic tract carry?

A

pain/temp

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5
Q

Which info does posterior column carry?

A

vibration/proprioception

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6
Q

What is the difference between UMN and LMN in terms of location?

A

UMN starts in motor cortex and terminates in brainstem motor nuclei or anterior horn cell within spinal cord

LMN starts at motor nucleus within brainstem and terminates in muscle

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7
Q

State three patterns of weakness in UMN lesion

A
increased tone (clasp knife)
little atrophy
brisk tendon reflexes
ankle clonus
extensor plantar response
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8
Q

State three patterns of weakness in LMN lesion

A
wasting/fasciulations
reduced tone
absent/decreased reflexes
no clonus seen
flexor plantar response
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9
Q

Name two signs/symptoms associated with cerebral cortex lesion?

A

contralateral sensory disturbance and weakness

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10
Q

Damage to internal capsule?

A

hemiplegia- face/arm/leg

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11
Q

Damage to thalamus?

A

hemi-sensory disturbance

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12
Q

Damage to midbrain?

A

occulomotor disorder

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13
Q

Damage to pons?

A

facial weakness, sensory disturbance, vertigo, deafness

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14
Q

Damage to medulla?

A

dysphagia, dysarthria (speech difficulty), dysphonia, weakness/wasting of tongue

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15
Q

How will a lesion to the brainstem affect cranial nerve palsies, hemiparesis, and sensory loss?

A

crossed signs

ipsilateral cranial nerve palsies and contralateral spastic hemiparesis + sensory loss

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16
Q

What is the most common cause of cauda equina syndrome?

A

lumbar disc herniation

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17
Q

Name three causes for spinal cord syndrome

A

infection, tumour, trauma

18
Q

What lesion of the spinal cord arises in brown-sequard syndrome?

A

hemi-section

19
Q

What is the sensory pattern in brown-sequard syndrome?

A

light touch, vibration and proprioception lost ipsilaterally

pain/temp lost on contralateral side

20
Q

How are motor function and reflexes affected in brown sequard syndrome?

A

ipsilateral spastic hemiparesis

ipsilateral brisk reflexes

21
Q

Name two pathologies which affect the posterior columns

A

Vit B12 deficiency
Vit E deficiency
Fiedreich’s ataxia
Tabes dorsalis

22
Q

How does posterior column pathology present?

A

loss of vibration and proprioception

sensory ataxia

23
Q

Which sign is positive in posterior column pathology?

A

romberg’s sign

24
Q

What are bulbar symptoms?

A

linked to impairment of function of the glossopharyngeal nerve (CN IX), the vagus nerve (CN X), the accessory nerve (CN XI), and the hypoglossal nerve (CN XII).

25
Q

How does motor neuron disease present?

A

asymmetric limb weakness, bulbar symptoms

26
Q

How is a diagnosis of motor neurone disease made?

A

clinical, EMG changes support diagnosis

27
Q

What does having respiratory/bulbar symptoms imply for the prognosis of motor neurone disease?

A

poorer prognosis

28
Q

What is the prognosis of motor neurone disease?

A

2-3 years median survival

29
Q

List three examples of mononeuropathy

A
radial nerve
ulnar nerve
median nerve
common peroneal nerve
mononeuritis multiplex
30
Q

What is known as Saturday night palsy?

A

radial nerve

31
Q

Which muscles does the median nerve supply?

A

LOAF

32
Q

Which nerve is associated with foot drop?

A

common peroneal nerve

33
Q

What is mononeuritis multiplex?

A

Mononeuritis multiplex is a painful, asymmetrical, asynchronous sensory and motor peripheral neuropathy involving isolated damage to at least 2 separate nerve areas

34
Q

What are two causes of mononeuritis multiplex?

A
diabetes
lymphoma
RA
Lupus
HIV
Sarcoidosis
35
Q

What is the pattern of weakness in length dependent axonal neuropathy?

A

starts in toes/feet
symmetrical
slowly progressive

36
Q

List three causes of length dependent axonal neuropathy

A
diabetes
alcohol
vitamin deficiency
Drugs
HIV, hep B and C
Myeloma
Charcot marie tooth
renal failure
HYPOTHYROIDISM
37
Q

Name two vitamin deficiencies assocaited with length dependent axonal neuropathy

A

B6, thiamine, folate, B12

38
Q

Name one drug associated with length dependent axonal neuropathy

A

amiodarone

isoniazid

39
Q

List two organisms that cause GBS

A

campylobacter
CMV
EBV

40
Q

What is the treatment of GBS?

A

IV immunoglobulin

steroids

41
Q

List three blood tests you would conduct to investigate neuropathy

A
FBC
Glucose
U+Es
LFTs
TFTs
B12/folate