Localisation In Clinical Neurology

Question 1

What do we mean by localisation

Answer 1

Where the lesion is responsible for patients that the symptoms and signs are based on

Question 2

Why is localisation important

Answer 2

We cant image every patient so we need to have an ideo of where the lesion is localised to decide on what imaging to carry out

Question 3

What are the 4 types of localisation

Answer 3

Focal
Multi focal
Diffuse
Specific

Question 4

What is a focal localisation

Answer 4

Single locus that accounts for patients symptoms and signs

Question 5

What is multi focal localisation

Answer 5

Involves more than one locus but loci remain discrete i.e you cant localise the lesion to one part of the brain

Question 6

What is diffuse localisation

Answer 6

Widespread dysfunction of a part of the nervous system

Question 7

What is specific pattern- give an example

Answer 7

Parkinsons disease

Question 8

What are the lobes of the brain

Answer 8

1. Frontal
2. Parietal
3. Temporal
4. Occipital

Question 9

What is the role of the frontal lobe

Answer 9

Motor function (pre-central gyrus)- motor function of the opposite side of the body
Brocas area which controls the speech output
Emotions

Question 10

What is the role of the parietal lobe

Answer 10

Post-central gyrus- sensation of the opposite side of the body

Question 11

What is the role of the temporal lobe

Answer 11

Memory

Dominant hemisphere contains the wernickes area which controsl the comprehension of speech

Question 12

What is the role of the occipital lobe

Answer 12

Control the vision

Question 13

What are the 3 segments of the spinal cord

Answer 13

Cervical
Thoracic
Lumbar

Question 14

At what segment does the spinal cord end in

Answer 14

L1

Question 15

After l1 what is the structure that comes at the end of the spinal cord

Answer 15

Cauda equina

Question 16

In the spinal cord what roots are there

Answer 16

Dorsal root

Ventral root

Question 17

What is the role of the dorsal root

Answer 17

Allow motor neurones to enter the spinal cord (sensory)

Question 18

What is the role of the ventral root

Answer 18

Allow motor neurones to exit the spinal cord (motor)

Question 19

What is the central nervous system made of

Answer 19

Brain
Spinal cord
Meninges

Question 20

What is the peripheral nervous system made of

Answer 20

Nerve roots
Nerves including the cauda equina
Neuromusclar junction
Muscle

Question 21

What are the signs in a UMN

Answer 21

Increased tone (spasticity)
Weakness with no wasting 
Hyperreflexia
Upgoing plantars
Hypertonia 
Clonus

Question 22

What is UMN a sign of

Answer 22

Lesion in the CNS

Question 23

What are the LMN signs

Answer 23

Hyporeflexia 
Hypotonia
Muscle wasting (atrophy)
Fasciculations 
Normal plantars

Question 24

Where is the lesion in LMN

Answer 24

PNS

Question 25

What are the 3 important spinal tracts

Answer 25

Spinothalamic tract Corticospinal tract Dorsal columns

Question 26

What are the sensory tracts

Answer 26

Spinothalamic tract | Dorsal columns

Question 27

What are the motor tracts

Answer 27

Corticospinal tract

Question 28

What sensation does the spinothalamic tract detect

Answer 28

Pain Temperature Coarse touch

Question 29

What sensartion does the dorsal column detect

Answer 29

Fine touch Vibration Position

Question 30

Where does the spinothalamic tract start

Answer 30

In the peripheral nerve into the dorsal root and crosses at the level of the spinal cord entry and crosses close to the central canal

Question 31

Where does the dorsal column start

Answer 31

In the peripheral nerve through the dorsal nerve root and goes up to the medulla to cross

Question 32

Where does the corticospinal tract start and descend to

Answer 32

Starts in the motor cortex and descends and crosses at the medulla and ends up in the anterior cell

Question 33

What reflex does the biceps test for

Answer 33

C5/6

Question 34

What reflex does the brachoradialis (supinator) reflex test for

Answer 34

C6

Question 35

What reflex does the triceps reflex test for

Answer 35

C7

Question 36

What refelx does the knee reflex test for

Answer 36

L4

Question 37

What reflex does the ankle reflex test for

Answer 37

S1

Question 38

What investigations can be carried out for a neuro disease

Answer 38

CT, CTA, CTV- has radiation MRI, MRA,MRV- no radiation Angiography

Question 39

What does an EEG look at

Answer 39

Routine, sleep eeg and epilepsy

Question 40

What is NCS used for

Answer 40

This is stimulation of different peripheral nerves that measures both sensory and motor function. It assess peripheral neuropathy and diagnosing entrapment

Question 41

What is an EMG and what is it used to assess

Answer 41

This is a fine needle inserted into the muscle to look for spontanoue activity and motor unit potential you assess for peripheral neuropathy and neuromuscular disorders

Question 42

When is a lumbar puncture contraindicated

Answer 42

In patients with symptoms and signs of increased ICP

Question 43

What are the indications for lumbar puncture

Answer 43

Meningits MS Encephalitis

Question 44

What does a CSF look at

Answer 44

``` Glucose Protein Cells Blood breakdown products Oligolocal bands for diagnosis of MS ```

Question 45

What is a complication of lumbar puncture

Answer 45

Post lumbar puncture headache: due to decreased ICP. Headache is worse on standing and usually resolves spontanously after 7 days