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Medicine 1 Matched to MLA Content Map > Extra Neuro > Flashcards

Extra Neuro Flashcards

1
Q

Where is CSF made?

A

in the choroid plexus

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2
Q

Define hydrocephalus?

A

Excessive volume of CSF in ventricular system

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3
Q

Define the 2 main groups of hydrocephalus?

A

obstructive (non-communicating) - physical blockage to the flow of CSF

non obstructive (communicating) - imbalance in resorption or production of CSF

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4
Q

Describe examples of obstructive (non-communicating) hydrocephalus?

A

congenital anomalies:
congenital stenosis or atresia of the Sylvian aqueduct
atresia of the foramen of luschka or magendie
arnold chiari malformation (may be associated with spina bifida)

acquired:
posterior fossa and brainstem tumours
3rd ventricle colloid cyst
choroid plexus papilloma (rare)

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5
Q

What is Arnold Chiari malformation?

A

part of the cerebellum and medulla bulges through the foramen magnum

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6
Q

Describe examples of non-obstructive (communicating) hydrocephalus?

A

Descreased resorption e.g. meningitis or post haemorrhage
increased production - choroid plexus tumour (very rare)

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7
Q

Presentation of hydrocephalus in infants?

A

since sutures are not fused there is an increase in head circumference, failure of upward gaze and sunsetting eyes

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8
Q

Presentation of hydrocephalus in adults?

A

causes raised ICP so presents with headache with red flags, papilloedema, nausea and vomiting, coma

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9
Q

Investigations for hydrocephalus?

A

CT head
MRI
Lumbar puncture can be both diagnostic and therapeutic since it allows sampling of the CSF, measuring of opening pressure but also to drain and reduce some of the pressure

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10
Q

Management of hydrocephalus?

A

treat underlying cause
external ventricular drains
ventriculoperitoneal shunting

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11
Q

Cause of normal pressure hydrocephalus?

A

mainly unknown

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12
Q

Define normal pressure hydrocephalus?

A

non obstructive hydrocephalus characterised by large ventricles with normal intracranial pressure

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13
Q

Presentation of normal pressure hydrocephalus?

A

triad of gait disturbance, dementia and urinary incontinence

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14
Q

Management of normal pressure hydrocephalus?

A

ventriculoperitoneal shunt

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15
Q

What is syringomyelia / syringobulbia?

A

can be called syrinx for shot
collection of CSF in the spinal cord
if in the medulla it is called synrigobulbia

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16
Q

Causes of syringomyelia?

A

strong association with arnold chiari malformation
trauma, tumours, idiopathic

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17
Q

Presentation of syringomyelia?

A

cape like loss of temperature sensations, spastic weakness, in LL
upgoing planters

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18
Q

Investigations for syringomyelia?

A

MRI whole spine and brain (to rule out arnold chiari malformation)

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19
Q

Investigations for syringomyelia?

A

MRI whole spine and brain (to rule out arnold chiari malformation)

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20
Q

Management of syringomyelia?

A

may need a shunt

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21
Q

C5 Dermatome?

A

Badge patch

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22
Q

C6 Dermatome?

A

Thumb

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23
Q

C7 Dermatome?

A

middle finger

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24
Q

C8 Dermatome?

A

pinky

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25
Q

T1 Dermatome?

A

above and below elbow on anterior arm

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26
Q

T2 Dermatome?

A

medial top of arm

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27
Q

T3 Dermatome?

A

Just above the nipple

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28
Q

T4 Dermatome?

A

in line with the nipple

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29
Q

T10 Dermatome?

A

At the umbilicus

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30
Q

L1 dermatome?

A

at the groin

31
Q

L2 Dermatome?

A

upper anterior thigh

32
Q

L3 dermatome?

A

Knee

33
Q

L4 Dermatome?

A

Medial leg

34
Q

L5 Dermatome?

A

Lateral leg and big toe

35
Q

S1 Dermatome?

A

pinky toe

36
Q

Femoral nerve roots?

A

L2, L3, L4

37
Q

Sciatic nerve roots?

A

L4-S3

38
Q

Sciatic nerve divides into what 2 nerves?

A

tibial and common peroneal

39
Q

Anterior compartment of the thigh is supplied by and does what?

A

Femoral nerve, flexion at the hip, extension at the knee

40
Q

Posterior compartment of the thigh is supplied by and does what?

A

tibial nerve, extension at the hip, flexion at the knee

41
Q

The medial thigh is supplied by what and does what?

A

obturator nerve, adduction of the thigh

42
Q

The lateral leg is supplied by what and does what?

A

superficial peroneal nerve, eversion

43
Q

Anterior leg is suppled by what and does what?

A

deep peroneal nerve, dorsiflexion, extend toes, inversion and eversion

44
Q

Posterior leg is suppled by what and does what?

A

tibial nerve, plantar flexion of ankle and flexion of toes

45
Q

Lesion of the femoral nerve means?

A

won’t be able to flex hip or extend knee

46
Q

Lesion of sciatic nerve?

A

lose full leg extension, will get a foot drop

47
Q

Lesion of common peroneal nerve?

A

associated with fibula neck fractures, will get a foot drop

48
Q

lesion of obturator nerve?

A

loss of adduction

49
Q

Cutaneous nerve supply to the hand?

A

ulnar - pinky plus half the ring both sides
radial - dorsal side of hand (dorsal web spaces!) - thumb plus two and half fingers
median nerve - palmar side of hand - thumb plus two and half fingers

50
Q

Axillary nerve lesion?

A

dislocation of shoulder
loss of sensation to the badge patch
loss of shoulder abduction

51
Q

Radial nerve lesion?

A

wrist drop - humeral shaft fractures (loss of wrist extension)

52
Q

Median nerve lesions?

A

carpal tunnel syndrome

53
Q

Ulnar nerve lesions?

A

weakness of hand - loss of sensation in digits 4 and 5

54
Q

Ankle jerk reflex?

A

S1, S2 (buckle my shoe)

55
Q

Knee jerk reflex?

A

L3, L4 (kick the door)

56
Q

Biceps reflex?

A

C5, C6 (pick up sticks)

57
Q

Triceps reflex?

A

C7, C8 (lay them straight)

58
Q

Loss of sensation in big toe and no reflexes affected ?

A

L5

59
Q

L5 root damage?

A

loss of big toe sensation and big toe extension

60
Q

S1 root damage?

A

loss of ankle plantar flexion, ankle reflex may be affected, loss of sensation in little toe and potentially heel

61
Q

Hip replacement can damage?

A

The sciatic nerve

62
Q

Stenosis

A

narrowing of canal

lumbar spinal stenosis is the most common cause of neurogenic claudication

63
Q

Spondylosis

A

age related wear and tear of the intervertebral discs

can cause a myelopathy or a radiculopathy

64
Q

Spondylolithesis

A

vertebra falls forward and pushes on the spinal cord (anterior direction)

65
Q

Disc prolapse

A

= disc herniation = slipped disc
IV disc protrudes posteriorly and can compress the spinal cord

66
Q

Cauda equina syndrome?

A

syndrome from compression of cauda equine most commonly caused by disc prolapse but could be trauma, tumours, infections, etc

67
Q

Myelopathy

A

compression of spinal cord, UMN signs

68
Q

Radiculopathy

A

compression of spinal roots LMN signs

69
Q

What is raised 10-20 minutes after a true seizure?

A

raised serum prolactin

70
Q

What is a rare but serious side effect of lamotrigine?

A

Steven Johnson syndrome
patients must look out for the rash - seek medical help

71
Q

T1 myotome?

A

thumb adduction - T1 bring in the thumb

72
Q

Klumpkes palsy is what type of injurY?

A

a traction injury

73
Q

First line for absence seizures?

A

ethosuximide

Medicine 1 Matched to MLA Content Map (12 decks)

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