Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Localisation In Clinical Neurology > Flashcards

Localisation In Clinical Neurology Flashcards

1
Q

What are the 4 different types of localisation? Give a brief definition and example?

A

Focal
-single, discrete neuroanatomical locus is responsible for patients symptoms
Eg stroke

Multi focal
-involves more than one locus but loci are discrete
Eg MS

Diffuse
-widespread dysfunction of part of nervous system (effects region of brain in diffuse pattern)
Eg Encephalopathy

Specific pattern
Eg Parkinson disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the main functions of the frontal lobe?

A

Precentral gyrus= motor cortex for opposite side of body

Inferior frontal gyrus = Broca’a area (DOMINANT HEM)
-speech production (motor component of speech)

Emotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the main functions of the parietal lobe?

A

Postcentral gyrus= Sensory cortex for opposite side of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the main functions of temporal lobe?

A

Memory

Superior temporal gyrus= Wenricke’s area (dominant hemisphere)
-controls speech comprehension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the main functions of the occipital lobe?

A

Controls vision

I.e. can have cortical blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which hemisphere is dominant in most people?

A

LEFT (±90%)

I.e. tends to correlate with opposite side to dominant hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 segments of the spinal cord? How many vertebrae are in each part of the spinal colume? At what level does the spinal cord terminate?

A 
Cervical= C1-7
Thoracic= T1-12 
Lumbar= L1-5

Spinal cord terminates are L1-> becomes CAUDA EQUINA after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 2 nerve roots associated with spinal nerves? What is their function?

A

Anterior/ventral

  • motor neurones exit (ventral= “vehicle” which has motor in the front i.e. anterior)
  • cell body in the ventral horn (grey matter)

Posterior/dorsal

  • sensory neurone enters the spinal cord
  • associated with dorsal root ganglia= cell body of sensory neurone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the components of the CNS and PNS?

A

CNS:

  • brain
  • spinal cord
  • meninges

PNS

  • nerve roots incl cauda equina
  • plexus (brachial and lumbrosacral)
  • nerves
  • NMJ
  • muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How would you differentiate between a lesion in CNS and PNS?

A

NOTE: 1st step of trying to localise the lesion

CNS= UMN lesion:

  • Increased tone i.e. spasticity
  • weakness with no wasting
    • look for wasting in 1st interosseous space on UL
  • brisk reflexes and clonus
  • up going plantar

PNS= LMN lesion:

  • reduced tone (flaccid)
  • weakness + wasting
  • fasciculation
  • reduced/absent reflexes
  • Downgoing plantars (normal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the main motor spinal tract? What are the major landmarks along its course?

A

Corticospinal

  • starts in precentral gyrus = motor cortex
  • internal capsule
  • decussates in MEDULLA
  • terminates by synapsing with anterior horn cell (LMN)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 2 main sensory spinal tracts? How do they differ?

A

Spinothalamic

  • modality= pain and temp i.e. COARSE TOUCH
  • decussates at spinal level via white commissure which neurone associate with nociceptor enters

Dorsal column

  • modality= position (proprioception) and vibration
  • decussates in medulla via medial lemniscus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why might temperature sensation be lost preferentially to pain? What condition can cause this? (Think about the arrangement of spinal tracts)

A

Temperature

  • Spinothalamic carries pain and temperature fibres BUT temperature fibres are located nearer to the central canal when decussates in central commissure
  • leads to temperature fibres >risk of compression

Eg Syringomyelia= fluid-filled cyst in SC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which receptors are associate with each of the sensory spinal tracts?

A

Spinothalamic= nociceptors

Dorsal column= proprioceptors + mechanoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does an absent reflex indicate?

A

Lesion at level associated with reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What nerve roots are associated with the following reflexes?

Biceps 
Supinator 
Triceps 
Knee 
Ankle
A 
Biceps= C5/6
Supinator= C6
Triceps= C7
Knee= L3/4 (kick the door)
Ankle= S1/2 (in the shoe
17
Q

You have localised the lesion to the CNS (i.e. UMN lesion). How would you further localise the lesion?

A

Cerebral= Unilateral presentation-> only one side effected
I.e. stroke

Basal ganglia= Extrapyramidal
-Parkinsonisms= Bradykinesia/resting tremor/rigidity

Cerebellum

  • ataxia
  • nystagmus
  • loss of coordination

Spinal cord
-weakness or parathesia below lesion

18
Q

You have localised the lesion to the PNS (LMN lesion). How would you localise the lesion further?

A

Roots= all nerves from root effected
-radiculopathy= dermatomes/muscles/sensation
-unilateral
Eg Sciatica

Plexus
-associated with all nerves of plexus

Nerves

  • look at reflexes
  • atrophy in associated muscle group

NMJ

  • fatigability i.e. MG
  • affects proximal muscles

Muscles

19
Q

What are the 4 different time-intensity profiles a disease might have? Give possible examples.

A

Acute= minutes to hours
Eg stroke

Subacute= days to weeks
Eg encephalitis/meningitis/subdural haemorrhage

Recurrent-remittent= episodic attacks with degree of recovery of healthy
Eg MS

Chronic-progressive = months to years
Eg Neurodegenerative

20
Q

How might a patient suffering with a paroxysmal disorder present? Which conditions are classified this way?

A

NORMAL in presentation-> episode likely to have passed and patient recovered by time presenting for examination or investigation

Headache and facial pain
Seizure and syncope
Transient ischaemic attack
Vestibular disorders

21
Q

What are the 4 different types of symptoms associated with neurological conditions?

A

Negative symptoms

  • reduction or complete loss of function
  • due to partial or complete failure of impulse

Positive symptoms
-exaggeration of physiological phenomenon
Eg seizures/tremor/trigeminal neuralgia

Secondary symptoms
-mass effect symptoms i.e. symptoms to associate with primary lesion
Eg tumour can induce oedema leading to mass effect= raised ICP

Behavioural symptoms
-complexes changes to behaviour or personality

22
Q

What are the pros and cons of CT/CTA/CTV?

A

Pros:

  • easily available
  • easy to use in emergency
  • good at detecting intracranial bleeds
  • can demonstrate intracranial abnormalities
  • can visual arterial aneurysm or venous thrombosis (CTA/CTV)
  • can reduce the need for invasive angiography

Cons:

  • radiation
  • not helpful for demyelinations plaques or spinal cord pathology
23
Q

What are the pros and cons of MRI/MRA/MRI?

A

Pros:

  • no radiation
  • can detect various brain and spinal pathology
  • can demonstrate abnormalities in intracranial blood vessels

Cons:

  • claustrophobic
  • cannot be used for patients with metallic foreign bodies
24
Q

What is an EEG used for?

A

Classification of epilepsy NOT diagnosis

Can be routine to look for abnormalities in brain electrical activity

25
Q

What is a NCS used for?

A

Nerve conduction study
-electrical stimulate of different peripheral nerves to measure motor and sensory function
Eg Can be used to assess for peripheral neuropathy or entrapment

26
Q

What is EMG?

A

Electromyography

  • fine needle into muscle to assess for spontaneous activity and motor unit potential
  • Used:
    • peripheral neuropathy
    • neuromuscular disorder i..e MG
    • MND by looking for fibrillation potentials
27
Q

What are the indications and contraindications for LP?

A

Indications:
Acute headache
Meningitis or encephalitis

Contraindications:
Patients with signs or symptoms of raised ICP (change in pressure induced by lumbar puncture can lead to herniation through the foramen magnum= tentorial herniation + coning)

28
Q

What can be done to CSF if SAH is suspected?

A

Spectrophotometry= looks for blood breakdown products

29
Q

What can be looked for in CSF to aid with MS diagnosis?

A

Oligoclonal bands

-antibody associated with MS

30
Q

What can occur as complication of LP?

A

Post-LP headache

  • caused by reduction in intracranial pressure
  • headache worse on sitting or standing but not when lying down i.e. low pressure headache
  • resolves w/i 7-10 days spontaneously

Neurology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions