libby's cribsheet Flashcards
what might lesions in which lobe result in..?
- frontal
- parietal
- occipital
- temporal
- cerbellar
- personality change / Broca’s aphase (expressive ) / abnormal affecctive reactions / primitive reflexes (you regress…)
- apraxia / acalculia / agraphia (ALL THE A’s) + visual field
- occipital - cortical blindness/ homonymous hemianopia
- temporal - homonymous superior quandrantinopia / cortical deafness
- Cerebellar - DNAISH
Dysdiadokinesia & Dysmetria (past pointing)
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia
remember PITS for visual field defects in cerebral cortex - Parietal - homonymous inferior quantrantinopia
- Temporal - superior
causes of a small pupil
horner’s syndrome (central / peripheral…?)
argyll-robertson pupil (accomodation reflex present but pupillary reflex absent)
senile meiosis
causes of a large pupil
Holmes-adie pupil (idiopathic - reacts poorly to light) - benign - often unilateral
CN3 palsy… efferent pupillary defect..
drugs (amphet / antidepressants / atropine)
trauma
- describe the 4 key clinical findings of horner’s syndrome
2. causes of horner’s
- meiosis
- enopthalmos
- ptosis
- anhidrosis
the causes of horners can be split into central / pre-ganglionic / post ganglionic lesions
(nb - remember postganglionic are the neurons that connect the autonomic ganglion to the effector organs, and preganglionic connect the CNS to the autonomic ganglion)
CENTRAL - CAUSES ANHIDROSIS OF FACE / ARM / TRUNK
the S’s
Stroke / MS / syringomyelia (cyst in spinal cord)
PRE-GANGLIONIC - CAUSES ANHIDROSIS OF FACE
the T’s
pancoast Tumour / Thyroidectomy / Trauma / #cervical rib
POSTGALNGLIONIC - NO ANHIDROSIS The C's Carotid artery dissection / aneurysm Cav sinus thrombosis Cluster headache..
causes of:
- CN3 palsy
- CN4 palsy
- CN5 palsy
- Facial nerve palsy
ALL OF THEM: VASCULAR / DIABETES / DEMYELINATION / TRAUMA
- CN3 - cav sinus thrombosis / thyroid eye disease
- CN4 - cavernous sinus syndrome
- CN6 - cav sinus syndrome / raised ICP / orbital apex disease
- Facial nerve palsy - Bell’s palsy / Guillian-Barre syndrome / Ramsey-Hunt syndrome / Acoustic neuroma / Brainstem tumour
define vertigo?
what is it always worsened by..
an illusion of movement - often rotatory - of the patient and their surroundings.
Vertigo is always worsened by movement
brainstem death:
- No respiratory effort in reaction to turning off ventilator
- Fixed Pupils unreactive to light
- No corneal reflex
- No cough reflex
- No response to supra orbital pressure.
carpal tunnel syndrome:
- symptoms
- associations
- treatment
- numbness and dysarthria of radial three and a half fingers
(NB - if affecting the little finger - NOT CARPAL TUNNEL - probably cubital tunnel syndrome (ulnar)
weakness of the LOAF muscles
(lat 2 lumbricals / opponens pollicis / abductor pollicis / flexor polliciis brevis) - preganncy
obesity
RA
hypothyroidism - splinting
steroid injection
surgical decompression
how would a common peroneal nerve palsy present?
what might cause a common peroneal nerve palsy?
- foot drop /
wasting of anterior tibial and peroneal muscles
sensory loss on the outside of the calf
2. causes: compression at the neck of the fibula diabetes / vascular leprosy collagen-vascular diseases (ie falling asleep after being pissed)
causes of a radial nerve lesion?
and the common symptom?
saturday night palsy - falling asleep on the hand
wrist drop
ulnar nerve lesions?
weakness of hypothenar eminence
med two lumbricals
which anti-nausea medications for which indication..?
for chemotherapy-induced nausea
for intracranial causes (raised ICP, direct effect of tumour)
for vestibular causes
for gastrointestinal causes
Ondansetron for chemotherapy-induced nausea
Haloperidol for intracranial causes (raised ICP, direct effect of tumour)
Prochlorperazine for vestibular causes
Metoclopramide for gastrointestinal causes
