Extra bits Flashcards
C5
elbow flexion
biceps reflex
C6
wrist extension
biceps reflex
supinator reflex
C7
elbow extension
triceps reflex
C8
middle finger flexion
T1
little finger abdution
L2
hip flexion
L3
knee extension
L4
ankle dorsiflexion
L5
big toe extension
S1
ankle plantar flexion
ankle reflex roots
S1/S2
knee jerk roots
L3/L4
Broca’s aphasia
expressive aphasia
say words, lots of mistakes
comprehension and repetition impaired
Wernicke’s aphasia
receptive aphasia
speech is non-fluent, halting, laboured
comprehension is normal
function of kidney
Balance: water, electrolytes, acid base
Endocrine: EPO, Vit D, RAS, BP control
Excretion: waste, metabolites
LVH on ECG
R wave in V6 >25mm
R wave in V5/V6 + S wave in V1 >35mm
RVH on ECG
dominant R wave in V1
Deep S wave in V6
GCS voice
1: no response
2: sounds
3: words
4: confused
5: orientated
criteria for immediate CT spine
GCS <13 on initial assessment
Pt intubated
Ruling out needed (e.g. for surgery)
Clinical suspicion and age >65/focal neurology/high impact injury
T1DM insulin regimes
Basal bolus: OD long acting, quick at meals
Biphasic: mixed BD
T2DM insulin regime
normally OD long acting
SE of insulin
weight gain
cause of axillary (C5, C6) nerve damage
anterior shoulder dislocation
motor loss of axillary nerve damage
impaired arm abduction (deltoid)
impaired external rotation (teres minor)
sensory loss of axillary nerve damage
regimental patch
cause of radial (C5-T1) nerve problem
axilla: saturday night palsy
middle: fracture of humerus
wrist: dec grip strength
cause of median (C5-T1) nerve problem
supracondylar fracture of humerus
carpal tunnel
motor loss in median nerve problem
atrophy of thenar muscles
poor flexion of wrist, thumb, index, middle finger
sensory loss in median nerve problem
thenar eminence
palmar aspect of thumb, index, middle finger
cause of ulnar (C8-T1) problem
fracture of medial epicondyle
cubital tunnel syndrome
motor loss in ulnar nerve problem
ulnar claw
LLOAF muscles
sensory loss in ulnar nerve problem
palmar and dorsal aspects of little finger
medical half of ring finger
hypothenar eminence
what innervates suprascapular nerve
infraspinatus and supraspinatus
motor deficits in suprascapular nerve damage
limited adduction/abduction/ external rotation of arm
shoulder instability (rotator cuff muscle paralysis)
femoral nerve (L2-L4) motor injury
impaired hip flexion
impaired knee extension
dec knee jerk
femoral nerve (L2-L4) sensory injury
anteriomedial thigh
medial lower leg, knee, medial aspect of foot
common peroneal nerve (L4-S2) motor injury
impaired foot eversion, weak dorsiflexion
foot drop
common peroneal nerve (L4-S2) sensory injury
lateral surface of lower leg
dorsum of feet and toes
how is common peroneal nerve damaged
fracture of fibular head, compression
how is sciatic nerve injured
herniated disc
post hip dislocation
iatrogenic
sciatic nerve (L4-S3) motor injury
paralysis of hamstring = impaired knee flexion and hip adduction
sciatic nerve (L4-S3) sensory injury
lower leg and foot
tibial nerve (L4-S3) motor injury
can’t invert foot
tibial nerve (L4-S3) sensory injury
loss over sole of foot
how is tibial nerve injured
trauma of knee/leg
baker cyst
defect in optic nerve
ipsilateral monocular blindess
causes of a defect in optic nerve
optic neuritis
amourosis fugax
optic atrophy
defect in optic chiasm (central)
bitemporal hemianopia
causes of a central defect in optic chiasm
pituitary adenoma
suprasellar aneurysm
defect in optic chiasm (lateral)
ipsilateral monocular nasal hemianopia
causes of a lateral defect in optic chiasm
distension of 3rd ventricle, posterior communicating artery aneurysm
defect in optic tract
contralateral homonymous hemianopia
causes of an optic tract defect
MCA stroke
tumours
defect in optic radiation
contralateral homonymous quadrantopia
causes of a defect in optic radiation
MCA stroke
tumour
trauma
defect in occipital cortex
contralateral homonymous hemianopia with macular sparing
causes of an occipital cortex defect
PCA stroke
trauma
what is the visual pathway
retina
optic nerve
optic chiasm
optic radiation
visual centre in occipital lobe
ECG standard rate
25 mm/s
large and small square length
large = 5mm = 0.2 sec
small = 0.04 sec
PR length
actually PQ length
3-5 small squares
QRS length
3 small squares
normal axis
positive in I, II, III
RAD
negative I, positive II and III
LAD
positive I, negative II and III
RBBB on ECG
V1 - RSR
V6 - deep wide S wave
what is a bifasicular block?
RBBB and LAD
WPW on ECG
short PR interval
delta wave
atrial hypertrophy
broad bifid p waves
peaked p waves
RVH on ECG
V1 upright QRS (R wave exceeds height of S waves)
RAD
PE ECG signs
peaked p waves
RAD
RBBB
LVH
R wave >25mm in V5/V6
deep S wave in V1
Q wave infarction
> 1 small square width and >2mm depth
= infarction
post MI changes
dominant R waves
limits of normal
PR
QRS
QTc
PR = 200ms
QRS = 120ms
QTc = 480ms
lateral infarction leads
I, VL, V5-6
pacemaker 1st letter
chamber paced (A, V, D=dual)
pacemaker 2nd letter
chamber sensed (A, V, D)
pacemaker 3rd letter
response to a sensed event (A, V, D for pacing, 1 for pacemaker inhibition)
what to think about in PEA
4H’s and 4T’s
time limit of acute limb ischaemia
<14 days
PAD changes on exam
muscle atrophy
nail changes
absence pulses
hair loss
arterial ulers
investigations to do in PAD
stenting
endarterecotmy
grafts
bypass (fem-pop, aorta-femoral)
classes of acute limb ischaemia
complete
incomplete
irreversible
before compression bandaging do what
ABPI to exclude arterial disease
peripheral vertigo vs central nystagmus
peripheral: nystagmus = horizontal
central (cerebellum, brainstem): nystagmus = mutli-directional
