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MY NEURO > Kumar and clark > Flashcards

Kumar and clark Flashcards

1
Q

what can worsen symptoms of demyelination

A

warm baths

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2
Q

what stimuli can trigger epilepsy

A

sensory

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3
Q

headaches worse on waking and on lying flat suggests

A

raised ICP

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4
Q

3 inherited neurological disorders

A

Huntingtons chorea, myotonic dystrophy, Charctot Marie Tooth disease

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5
Q

global lesions typically affect

A

cognition and consciousness

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6
Q

focal lesions resultant signs may eb

A

asymmetric

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7
Q

is up going planters upper or lower motor neurone

A

upper

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8
Q

if upper motor neurone lesions have a pyramidal pattern where stronger muscles overwhelm weaker then which ones are stronger

A

upper limb flexors and lower limb extensors

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9
Q

if there is contralateral UMN signs then where is the lesion

A

cerebral cortex/ internal capsule

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10
Q

if got nystagmus where is the lesion

A

cerebellum

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11
Q

lesions in the brainstem cause what symptoms

A

impaired consciousness, global signs, cranial nerve abnormalities

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12
Q

spinal cord lesions presents as

A

UMN paraplegia/ quadriplegia with sensory level

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13
Q

nerve root lesion signs

A

LMN myotomal signs, dermatomal signs

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14
Q

single peripheral nerve lesion signs

A

LMN signs and sensory loss according to distributions of nerve

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15
Q

lesion in all peripheral nerves cause what signs

A

length dependent LMN signs ( worse in hands and feet) , glove and stocking sensory loss

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16
Q

what are signs of neuromuscular junction lesions

A

only motor signs present. fatiguability common, wasting and fasciculation

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17
Q

lesions in cerebral cortex ad spinal cord cause – signs and lesions in nerves cause — signs

A

UMN, LMN

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18
Q

spasticity is more pronounced in what kind of muscles

A

extensors

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19
Q

what is clonus

A

involuntary extensor rhythmic leg jerking

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20
Q

clonus can occur in

A

spasticity

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21
Q

what is the gait like in Parkinson

A

shuffling

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22
Q

what are uncommon in Parkinsons expcept in later stage disease and may indicate a Parkinson’s plus syndrome

A

falls

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23
Q

gait becomes broad based in what

A

lateral cerebellar lobe disease e.g when walking they veer towards the affected side of the cerebellar lobe

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24
Q

peripheral sensory loss(polyneuropathy) causes what kind of gait

A

stamping- broad based, high stepping

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25
Q

rombergs test is positive in what

A

sensory ataxia (peripheral sensory loss)

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26
Q

what can cause a slap noise when walking

A

common peroneal nerve palsy

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27
Q

walking becomes a waddle in what

A

weakness of Proximal leg muscles

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28
Q

what can show normal sensory and motor function on couch but when walking it can be shuffling with small steps, gait ignition failure and hesitancy with fear of falling

A

frontal lobe disease- diffuse cerebrovascular disease, normal pressure hydrocephalus

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29
Q

what tests joint position

A

small movements of DIP joints in toes and fingers

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30
Q

dysgraphaethesia and asterogenesis

A

cortical sensory loss

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31
Q

normal muscle power is grade

A

5

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32
Q

what are the 3 inhibitory neurotransmitters

A

GABA, histamine and glycine

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33
Q

synaptic transmission is mediated by

A

neurotransmitters released by action potentials passing down an axon

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34
Q

aphasia means what area of brain is not working

A

dominant frontal lobe

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35
Q

hemiparesis has what area of brain not working

A

internal capsule

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36
Q

synchronous discharge of neurones by irritate lesions cause

A

epilepsy

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37
Q

the dominant hemisphere and the one that for most people affects language is

A

left

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38
Q

temporal lesions effects

A

visual hallucinations, complex partial seizures, memory disturbance eg deja vu

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39
Q

brocas area is in what lobe

A

frontal

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40
Q

wernickes is in what area

A

temporo- parietal

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41
Q

words are muddled, insertion of a few incorrect or unnecessary words or profuse outpouring of jargon (non existent words)

A

wernickes

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41
Q

disjointed words and and failure to construct sentences

A

brocas

42
Q

what is nominal aphasia. It is an early detection in all types of aphasia

A

difficulty naming objects

43
Q

what aphasia includes brocas and werniceks and is the most common aphasia after a severe left hemisphere infarct

A

global aphasia

44
Q

what is dysarthria

A

slurred speech. language is intact

45
Q

gravelly speech in

A

pseudo bulbar palsy

46
Q

jerky speech of what lesions

A

cerebellar

47
Q

hypophonic monotone speech of

A

parkinsons

48
Q

speech that fatigues and dies away

A

myasthenia

49
Q

what disorders are difficult to recognise ins right handed patents

A

right hemisphere lesions

50
Q

semantic memory is

A

knowledge of word meaning

51
Q

what is implicit memory

A

not conscious eg riding a bike

52
Q

what lesions are necessary to cause amnesia

A

bilateral

53
Q

tumours of the olfactory groove can cause loss of smell eg

A

meningioma

54
Q

each — carries information from the contralateral visual hemifield

A

optic tract

55
Q

what is normal acuity

A

6/6

56
Q

white and red targets and fingers used to assess

A

visual fields(peripheral and central)

57
Q

difference between temporal and parietal lesion in visual pathway

A

temporal affects superior region and parietal affects inferior region

58
Q

what is the hallmark of an optic nerve lesion

A

unilateral visual loss, with a scotoma

59
Q

optic nerve lesions particularly affect what parts of vision

A

central vision and colour vision

60
Q

what does a total optic nerve lesion cause

A

unilateral blindness with loss of pupillary light reflex

61
Q

pale disc reflects

A

optic atrophy

62
Q

papilloedema is

A

swelling of the optic disc

63
Q

visual symptoms of papilloedema

A

few if any visual symptoms, other than momentary visual obscurations with changes in posture. the blind spot is enlarged but this is not noticed by the patient. however over time visual fields are affected and eventually leading to optic atrophy

64
Q

what is almost universal in optic neuritis

A

pain on eye movement

65
Q

how does disc usually appear in optic neuritis

A

normal

66
Q

most common cause of optic neuritis

A

plaque of demyelination within the optic nerve

67
Q

what should be done for optic neuritis

A

steriods

68
Q

common causes of bitemporal hemianopia/ quadrantanopia

A

pituitary tumours
meningioma
craniopharyngioma

69
Q

what lobe lesions causes upper quadratic defects and what causes lower

A

upper- temporal lobe lesions
lower- parietal lobe lesions

70
Q

what eye things can unilateral posterior cerebral artery infarction cause

A

homonymous hemianopia defects

71
Q

what causes a dilated pupil and a afferent pupillary defect

A

optic nerve lesion

72
Q

features of corners syndrome

A

constricted pupil (miosis)
partial ptosis
loss of sweating on the same side

73
Q

horners syndrome is damage to the

A

sympathetic nerve supply

74
Q

argyll robertson pupil is occassionalky seen in diabetes or MS and what is it

A

small and irregular pupil, it is fixed to light but constricts on convergence

75
Q

what cranial nerves supply the extraocular muscles

A

oculomotor, trochlear and abducens

76
Q

nystagmus can indicate what lesions

A

cerebellar or brainstem pathology

77
Q

occipital cortex is concerned with

A

tracking objects

78
Q

vestibular nuclei is involved with

A

linking eye movements with the position of head and neck

79
Q

what causes internuclear ophthalmoplegia

A

damage to one medial longitudinal fasciculus

80
Q

in internuclear ophthalmoplegia the other eye that is able to abduct develops nystagmus

A
81
Q

what is almost pathognomonic for MS

A

Bilateral INO

82
Q

what examination is of diagnostic value in coma

A

vestibulo ocular reflex

83
Q

failure of upgaze can be seen in

A

dorsal midbrain lesion,
progressive supranuclear palsy

84
Q

most common cause of trochlear nerve palsy ( two objects when looking down)

A

head injury

85
Q

what can damage the abducence nerve

A

MS or brainstem infarction, raised ICP, tumours

86
Q

what is the largest cn

A

trigeminal

87
Q

modalities of trigeminal

A

mainly sensory with motor component to muscles of mastication

88
Q

diminution of the corneal reflex can be a sign of

A

trigeminal nerve lesion

89
Q

in trigeminal lesion causes what to jaw when mouth opens

A

it deviates to side of pathology

90
Q

facial nerve main modality

A

mainly motor supplying muscles of facial expression. sensory to anterior 2/3 of tongue and motor to stapedius

91
Q

upper motor neurone lesions cause what to face

A

weakness of the lower part of the face on the opposite side. frontalis is spared. can furrow brow, close eyes and blink.

92
Q

complete unilateral lower motor neurone lesion causes

A

ipsilateral weakness of all facial expression muscles. frontalis and eye closure are weak

93
Q

most common cause of UMN lesion in face

A

hemispheric stroke

94
Q

lateral rectus nerve palsy and unilateral LMN facial weakness causes are

A

glioma, MS and infarction. This is at the PONS where the facial nerve loops around the abducens

95
Q

what virus causes bells palsy

A

herpes simplex

96
Q

what is common at onset with bells palsy

A

pain behind the ear

97
Q

vague altered facial sensation is often reported in bells palsy but what

A

examination of facial sensation id normal

98
Q

even though bells palsy is caused by virus what treatment

A

steriods as poor evidence for antivirals

99
Q

vesicles alongside bells palsy

A

Ramsay hunt syndrome

100
Q

treatment for Ramsay hunt

A

antiviral alongside steriods

101
Q

outside the skull, glossopharyngeal, vagus, spinal accessory and hypoglossal lie close to the

A

carotid artery and sympathetic trunk

102
Q

modalities of glossopharyngeal

A

largely sensory supply sensation and taste to posterior 1/3 of tongue and pharynx. motor to pharyngeal muscles and parasympathetic to parotid

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