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Localisation In Clinical Neurology Flashcards

1
Q

What do we mean by localisation

A

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

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2
Q

Why is localisation important

A

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

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3
Q

What are the 4 types of localisation

A

Focal
Multi focal
Diffuse
Specific

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4
Q

What is a focal localisation

A

Single locus that accounts for patients symptoms and signs

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5
Q

What is multi focal localisation

A

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

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6
Q

What is diffuse localisation

A

Widespread dysfunction of a part of the nervous system

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7
Q

What is specific pattern- give an example

A

Parkinsons disease

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8
Q

What are the lobes of the brain

A
  1. Frontal
  2. Parietal
  3. Temporal
  4. Occipital
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9
Q

What is the role of the frontal lobe

A

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

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10
Q

What is the role of the parietal lobe

A

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

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11
Q

What is the role of the temporal lobe

A

Memory

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

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12
Q

What is the role of the occipital lobe

A

Control the vision

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13
Q

What are the 3 segments of the spinal cord

A

Cervical
Thoracic
Lumbar

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14
Q

At what segment does the spinal cord end in

A

L1

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15
Q

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

A

Cauda equina

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16
Q

In the spinal cord what roots are there

A

Dorsal root

Ventral root

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17
Q

What is the role of the dorsal root

A

Allow motor neurones to enter the spinal cord (sensory)

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18
Q

What is the role of the ventral root

A

Allow motor neurones to exit the spinal cord (motor)

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19
Q

What is the central nervous system made of

A

Brain
Spinal cord
Meninges

20
Q

What is the peripheral nervous system made of

A

Nerve roots
Nerves including the cauda equina
Neuromusclar junction
Muscle

21
Q

What are the signs in a UMN

A 
Increased tone (spasticity)
Weakness with no wasting 
Hyperreflexia
Upgoing plantars
Hypertonia 
Clonus
22
Q

What is UMN a sign of

A

Lesion in the CNS

23
Q

What are the LMN signs

A 
Hyporeflexia 
Hypotonia
Muscle wasting (atrophy)
Fasciculations 
Normal plantars
24
Q

Where is the lesion in LMN

25
Q

What are the 3 important spinal tracts

A

Spinothalamic tract
Corticospinal tract
Dorsal columns

26
Q

What are the sensory tracts

A

Spinothalamic tract

Dorsal columns

27
Q

What are the motor tracts

A

Corticospinal tract

28
Q

What sensation does the spinothalamic tract detect

A

Pain
Temperature
Coarse touch

29
Q

What sensartion does the dorsal column detect

A

Fine touch
Vibration
Position

30
Q

Where does the spinothalamic tract start

A

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

31
Q

Where does the dorsal column start

A

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

32
Q

Where does the corticospinal tract start and descend to

A

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

33
Q

What reflex does the biceps test for

34
Q

What reflex does the brachoradialis (supinator) reflex test for

35
Q

What reflex does the triceps reflex test for

36
Q

What refelx does the knee reflex test for

37
Q

What reflex does the ankle reflex test for

38
Q

What investigations can be carried out for a neuro disease

A

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

39
Q

What does an EEG look at

A

Routine, sleep eeg and epilepsy

40
Q

What is NCS used for

A

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

41
Q

What is an EMG and what is it used to assess

A

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

42
Q

When is a lumbar puncture contraindicated

A

In patients with symptoms and signs of increased ICP

43
Q

What are the indications for lumbar puncture

A

Meningits
MS
Encephalitis

44
Q

What does a CSF look at

A 
Glucose
Protein
Cells
Blood breakdown products
Oligolocal bands for diagnosis of MS
45
Q

What is a complication of lumbar puncture

A

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

Neurology (9 decks)

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