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Neurosurgery ROCA > Nerves > Flashcards

Nerves Flashcards

1
Q

What does a lesion of the optic chiasm cause?

A

Tunnel vision or bitemporal hemianopia

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2
Q

What does a lesion of the optic radiation cause?

A

Homonymous hemianopia

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3
Q

What are the Sx of a 3rd nerve palsy?

A

Ptosis
Mydriasis
Eye down & out

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4
Q

Where does the facial nerve gets its innervation?

A

Motor cortex from gyrus

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5
Q

What is the route of the facial nerve?

A

1) Leave nucleus at pons
2) Heads to internal acoustic foramen accompanied by vestibulocochlear nerve
3) Chorda Tympani leaves and travels to tongue
4) Continues through facial canal to the stylomastoid foramen
5) Passes over the parotid gland before splitting into 5 branches

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6
Q

What would be seen in a facial nerve lesion based in the CNS?

A

Weakness of lower part of the face with forehead sparing

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7
Q

What would be seen in a facial nerve lesion at the levels of the internal acoustic meatus?

A

Lower ipsilateral facial weakness
Loss of taste

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8
Q

What is the most common cause of a facial nerve lesion around the stylomastoid foramen?

A

Bell’s palsy

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9
Q

What are the signs of a lower motor neurone lesion?

A

Wasting
Fasciculations
Low tone
Absent reflexes

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10
Q

What are the signs of an upper motor neurone lesion?

A

Weakness
Increased tone/spasticity
Brisk reflexes

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11
Q

How does the pain pathway work?

A

1) Prostaglandins act on skin nociceptors
2) Carried through Delta & C fibres to posterior horn
3) Cross over and move in spinothalamic tracts
4) Ascends to thalamus
5) Post-central gyrus (where it hurts) & limbic system (how it hurts)
6) Endorphins released

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12
Q

What are the fibres that carry painful stimuli?

A

A Delta fibres: Myelinated, fast
C Fibres: Non-myelinated, intermediate speed

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13
Q

How do endorphins work?

A

Released in response to pain
Act on U receptors
Inhibit pain transmission in ascending pathway

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14
Q

How do different analgesics work?

A

NSAIDS: Reduced prostaglandin synthesis so reduced nociceptive stimulation
LA: Block transmission of nerve fibres
Opiates: Stimulate antinociceptive pathway
Morphine: Central action to reduce emotional component

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15
Q

What is the mechanism of referred pain?

A

General visceral afferents follow sympathetic fibres
Pain can be perceived in dermatome corresponding to spinal level where afferents join cord

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16
Q

What happens in Brown-Sequard Syndrome?

A

Hemisection of the cord
Ipsilateral motor fibres
Contralateral light touch/pain/vibration

17
Q

What happens in anterior spinal artery syndrome?

A

Vascular lesion in anterior spinal artery
All cord dies except posterior column

18
Q

What happens in central cord syndrome?

A

Ligamentum flavum folds
Compresses spinal cord
Fine motor loss in hands & upper limbs

19
Q

What happens in damage to the spinothalamic tracts in the spinal cord?

A

Contralateral loss of sensation

20
Q

What happens in damage to the corticospinal (pyramidal) tracts in the spinal cord?

A

Ipsilateral loss of motor function

21
Q

What happens in damage to the posterior column of the spinal cord?

A

Loss of vibration
Loss of joint position
On the same side

22
Q

What is the function of the pre central gyrus?

A

Primary motor cortex
Damage = motor issues on contralateral side

23
Q

What is the function of the pre-motor cortex?

A

Control of muscle groups
Modulation of posture

24
Q

What is the function of the frontal eye field? What happens if this is damaged?

A
  • Control eye movements
  • Damage causes eyes to look towards the side with the lesion
  • Eye field controls the contralateral side, if lost the good side predominates
25
Q

What is the function of the parietal association cortex?

A

Spatial awareness
Damage = neglect for contralateral side of body

26
Q

What does damage to Broca’s & Wernicke’s cause?

A

Broca: Expressive dysphasia
Wernicke: Receptive aphasia

27
Q
A
28
Q

What happens if the associated visual cortex is damaged?

A

Prosopagnosia (inability to recognise faces)

29
Q

What is the function of the hippocampus?

A

New memory formation
Ant = Short term memory
Post = Long term memory

30
Q

What is the function of the Amygdala?

A

Reactions to fear & anger
Sexual & social behaviour

31
Q

What is the function of the cingulate gyrus?

A

Modulates pain emotions from the Amygdala

32
Q

What does the basal ganglia consist of?

A
  • Caudate nucleus
  • Lentiform nucleus: Putamen, globus pallidu
33
Q

What receptors are found in the basal ganglia?

A

GABA

34
Q

Where in the brainstem are the cranial nerve nuclei, other centres found?

A
  • Midbrain: 3 & 4
  • Pons: 5 & 8 & respiratory centre
  • Medulla: Pyramidal tracts, Respiratory, vasomotor, gag/cough/vomiting reflexes
35
Q
A

Neurosurgery ROCA (4 decks)

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