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neurology FA + STEP 2 > nerves > Flashcards

nerves Flashcards

1
Q

cranial nerves

A 
CN I – Olfactory
CN II – Optic
CN III – Oculomotor
CN IV – Trochlear
CN V – Trigeminal
CN VI – Abducens
CN VII – Facial
CN VIII – Vestibulocochlear
CN IX – Glossopharyngeal
CN X – Vagus
CN XI – Accessory
CN XII – Hypoglossal
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2
Q

CN V - function

A
  1. mastication
  2. facial sensation
  3. somatosensation from anterior 2/3 of tongue
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3
Q

CN V - facial sensation - divisions

A
  1. ophthalmic
  2. maxillary
  3. mandibular
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4
Q

CN VII - function

A
  1. facial movements
  2. taste from anterior 2/3 of tongue
  3. lacrimation
  4. salivation
  5. eyelid closing
  6. stapedius muscle of the ear
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5
Q

CN VII vs parotid gland

A

nerve courses through the parotid gland, but does not innervate it

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6
Q

CN IX - function

A
  1. taste and somatosensation from posterior 1/3 of tongue
  2. swallowing
  3. salivation
  4. monitoring carotid body and sinus chemo and baroreceptors
  5. elevates pharynx and larynx
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7
Q

CN X - function

A
  1. taste from epiglottic region
  2. swallowing
  3. soft palate elevation
  4. midline uvula
  5. talking
  6. coughing
  7. parasympathetics to thoracoabdominal viscera
  8. monitoring aortic arch body and chemo and baroreceptors
  9. tongue movement
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8
Q

tongue - main muscles (and innervation)

A
  1. hyoglossus (XII)
  2. genioglossus (XII)
  3. styloglossus (XII)
  4. palatoglossus (X)
    (12 +10)
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9
Q

cranial nerve reflex?

A
  1. corneal 2. lacrimation 3. jaw jerk

4. pupillary 5. Gag

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10
Q

corneal nerve reflex - afferent and efferent

A

afferent - V1 opthalmic (nasociliary branch)

effernt - VII (temporal branch - orbicullaris oculi)

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11
Q

Gag reflex - afferent and efferent (only CN)

A

afferent - IX

effernt - X

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12
Q

pupillary reflex - afferent and efferent (only CN)

A

afferent - II

effernt - III

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13
Q

Lacrimation reflex - afferent and efferent (only CN)

A

afferent - V1

effernt - VII

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14
Q

jaw jerk reflex - afferent and efferent (only CN)

A

afferent - V3 (sensory - muscle spindle from masseter)

effernt - V3 (motor - maseter)

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15
Q

CN X lesion - appearance

A

uvula deviates AWAY from side of lesion. Weak side collapses and uvula points away

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16
Q

CN XII lesion - appearance

A

tongue deviates toward side of lesion (“lick your wounds”) due to weakened tongue muscles on affected side (LMN lesion)

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17
Q

vertebra disc hernitation?

A 
nucleus polposus (soft central disc) herniates through annulus fibrosus (outer ring) 
usually posterolaterally
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18
Q

spinal cord tracts?

A
  1. dorsal column
  2. lateral spinothalamic
  3. anterior spinothalamic
  4. lateral corticospinal tract
  5. anterior corticospinal tract
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19
Q

spinal cord - dorsal column transfers

A
  1. pressure
  2. vibration
  3. fine touch
  4. propioception
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20
Q

spinal cord - lateral spinothalamic tract transfers

A

pain

temperature

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21
Q

spinal cord - anterior spinothalamic tract transfers

A 
crude touch (απροσδιόριστη) 
pressure
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22
Q

cavernous sinus syndrome present with

A
  1. variable ophthalmoplegia
  2. decreased corneal sensation
  3. Horner syndrome
  4. decreased maxillary sensation (occasionally)
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23
Q

….passes through cavernous sinus

A
  • CN III, CN IV, CN V1, CN VI
  • occasionaly V2
  • postganglionic sympathetic pupillary fibers
  • carvenous portion of internal carotid artery
24
Q

ALS pathophysiology

A

defect in superoxide dismutase 1 –> combined UMN and LMN deficits with NO sensory, occulomotor deficits, bowel, bladder or sensory deficits

25
Q

ALS - deficits

A

combined UMN and LMN deficits with no sensory or occulomotor deficits
NO SENSORY OR BOWEL BLADDER DEFICITS

26
Q

ALS - treatment

A

Riluzole

27
Q

spinal cord lesions - complete inclusion of anterior spinal artery

A

spares dorsal columns and Lissaeuer tract

28
Q

watershed area of anterior spinal cord (why)

A

upper throracic ASA territory, as Adamkiewicz artery supplies ASA below T8

29
Q

Adamkiewicz artery supplies ASA … (area)

A

below T8

30
Q

tabes dorsasis - spinal cord lesion?

A

degeneration (DEMYELINATION) of dorsal columns and roots

31
Q

Argyll Robertson pupils

A

are bilateral small pupils that reduce in size on a near object (accommodate) they do not “react” to light

32
Q

tabes dorasil - clinical examination

A
  1. absence of Deep Tendon Reflexes
  2. Romberg sign (+)
  3. Argyll Robertson
  4. Stroke without hypertension
33
Q

Syringomyelia - symptoms (and area) / seen with

A

bilteral loss of pain and temperature
usually C8-T1 –> cape - like
seen with Chiari I malformation

34
Q

vitamin B12 deficiency - spinal cord lesions

A

sabacute combined degeneration –> demyelination of dorsal column, lateral corticospinal tracts, and spinocerebellar tracts

35
Q

poliomyelitis - death of … cells

A

LMN

36
Q

poliomyelitis - signs and symptoms

A
  1. signs of infection –> malaise, headache, fever, nausea

2. LMN lesion signs –> weakness, hypotonia, flaccid paralysis, fasciculations, hyporeflexia, muscle atrophy

37
Q

poliomyelitis - labs

A
  1. CSF: increase WBCs and slight increase of protein, no change of glucose
  2. virus recovered from stool or throat
38
Q

poliomyelitis - glucose in CSF

A

no change

39
Q

Spinal mascular atrophy (Werding-Hoffman disease) - pathophysiology / mode of inheritance

A

congenital degeneration of anterior horns of spinal horn –> LMN lesion AR

40
Q

Spinal mascular atrophy (Werding-Hoffman disease) - common appearance

A

floppy baby with marked hypotonia and tongue fasciculations

41
Q

Spinal mascular atrophy (Werding-Hoffman disease) - prognosis

A

infantile type –> median age of death of 7 months

42
Q

Poliomyelitis vs Spinal mascular atrophy (Werding-Hoffman disease) according to weakness

A

polio –> asymmetric

SMA –> symmetric weakness

43
Q

Friedreich’s ataxia - gene / action of this gene

A

FRATAXIN –> iron binding protein

44
Q

Friedreich’s ataxia leads to (mechanism and findings)

A

problem of frataxin (iron binding protein) –> impairment in mitochondria functioning–> ROS –> degeneration of multiple spinal cord tracts –> muscle weakness, loss of DTRs, vibratory sense and proprioception

45
Q

Friedreich’s ataxia - symptoms/presentation

A
  1. Staggering gait 2. frequent falling 3. nystagmus
  2. dysarthria 5. per cavus 6. hammer toes
  3. diabetes mellitus 8. hypertrophic cardiomyopathy
  4. kyphoscoliosis (childhood)
  5. Loss of DTRs
46
Q

Friedreich’s ataxia - gait

A

Staggering gait

47
Q

Friedreich’s ataxia - appearance of foot (and definition of that

A
  1. per cavus: foot is distinctly hollow when bearing weight

2. hammer toes: toes that are bent permanently downwards

48
Q

Brown-Sequard syndrome findings

A
  1. ispilateral UMN signs below the level of lesion
  2. ipsilateral loss of tactile, proprioception, vibration below the level of lesion
  3. contralateral pain and temperature loss below the level of lesion
  4. Ipsilateral loss of all sensation AT LEVEL OF LESION
  5. ispilateral UMN sign at the level of lesion
  6. Horner syndrome (if lesion above T1)
49
Q

Landmark dermatomes - C2
Landmark dermatomes - C3
Landmark dermatomes - C4
Landmark dermatomes - C6

A

C2: posterior half of a skull cap
C3: high turtle-neck shirt
C4: low-collar shirt
C6: upper limb (includes thumbs)

50
Q

Landmark dermatomes - T4
Landmark dermatomes - T7
Landmark dermatomes - L1
Landmark dermatomes - L4

A

T4: at the nipple
T7: xiphoid process
L1: at the inguinal ligament
L4: includes the kneecaps

51
Q

Landmark dermatomes - S2, S3, S4

A

erection and sensation of penile and anal zone

52
Q

Landmark dermatomes - T10

A

at the umbilicus

53
Q

clinical reflex - mc and nerves

A

bicepts - C5, C6
tricepts - C7, C8
patella - L3, L4
achlles - S1, S2

54
Q

cremaster reflex - to check

A

L1, L2 (testicle move)

55
Q

anal wink reflex - to check

A

S3, S4

56
Q

anal wink reflex - mechanism

A

contraction of the external anal sphincter upon stroking of the skin around the anus

57
Q

penis dermatome

A

S3

neurology FA + STEP 2 (8 decks)

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