Neuro 2 Flashcards
Biceps reflex dermatome
C5, C6 PICK UP STICK
Triceps reflex dermatome
C7, C8 Shut the gate
Dermatomal patch covering the regimental pat h
C5
dertmatome to thumb
C6
Dermatome to middle finger
C7
dermatome to little finger
C8
dermatome to medial elbow
T1
Where must you touch for UL dermatomal sensation
axilla (c5)
thumb (C6)
middle (C7)
little finger (C8)
inside of elbow (T1)
what nerve roots make up the mussculocutaneous nerve
C5-C7
fuction of musculocutaenous
innervates biceps, brachialis, coracobrachialis > flexion of arm at elbow
nerve roots of median nerve
C7-T1
function of median N
SENSORY to lat 3.5 fingers
MOTOR to anterior forearm and LOAF muscles of hand (flexion of wrist, thenar eminence)
nerve roots of axillary
C5, C6
functions of Axillary N
Motor to teres minor and deltoid (abduction of arm beyond first 15 degrees)
Sensory to reegimental patch
Radial nerve roods
C5-T1
function of radial nerve
posterioor arm and forearm muscles
cutaneous to possterior arm / forearm and dorsal lat 3.5 fingers
How do you check radial, median and ulnar nerve sensation in the hand
Radiial: side of thumb
median: medial 3.5 fingers
ulnar: at 1.5 fingers
how od you commonly damage musculocutaenous nerve
breast surgery
cause of lateral medullary syndrome
OCCLUSION of POSTERIOR INFERIOR CEREBELLAR AARTERY
sx lateral medullary syndrome
cerebellum:
- ataxia
- nystagmus
brainstem:
- ipsilat: dysphagia, facial numbness, HOrners
- contralat: limb sensory loss
when should you refer for specialist review someone with TIA
<24h if within 7 days since FIRST TIA
><7 days if more than 7 days from first TIA
what should you do if pt presents with more than one TIA
CRESCENDO TIA > you need to admit and invesitgatw
when should you admit and investigate someone with TIA
- crescendo TIA (more than 1)
- suspected cardioembolic source
- severe carotid stenosis
- patient on warfarin / doac or with bleeding disoorder
what must you do if hhaemorrhagic transformation in TIA
STOP all anticoagulants
lower BP
what does a contralateral homonymous hemianopia with macular sparing suggest?
that the lesion is in the occipital cortex
how can you tell the difference between prolactimona and craniopharyngioma causing a bitemporal hemianopia
prolactinoma: UQ> LQ
craniophharyngioma: LQ>UQ
features of neuroleptic malignant syndrome
Confusion
Autonomic lability (hypertension, tachycardia and tachypnoea)
Rigidity
Pyrexia
what investigations must you do for BELL’s
NONE - usually clinical dx
what does WHITE on head CT mean
HYPERDENSE region = acute clotted blood, from haemorrhage
what does BLACK on head CT mean
HYPODENSE (dark) region = ishaemic infarct, chronic clotted blood
differentials for cerebellar disease
V- stroke (vertebrobasilar)
i - encephalitis, abscess
T - Trauma (raised ICP)
A - MS, Paraneoplastic cerebellar dege
M - ethanol, poisons,
N- Posterior fossa tumour
ix for cerebellar disease
Bloods: ETOH, FBC, UE, LFT, CLotting, Ceruloplasmin (Wilson)
ECG (arrythma)
CSF (oligoclonal bands for MS)
MRI (posterior cranial fossa)
what do you see on NC CT for ischaemic stroke
hyperdense artery
loss of grey white matter interface
hypodense area
how do you treat trigeminal neuralgia
carbamazepine
complex regional pain sydrome fts
PORTS:
Pain
Oedema
Restriction of Movement
Temperature/ colour change
Stiffness
what is pituitary aapopexy
sudden enlargement of the pituitary gland
usually due to haemorrhage or infarction of tumour
fts of pituitary apopexy
sudden onset headache similar to that seen in subarachnoid haemorrhage
vomiting
neck stiffness
visual field defects: classically bitemporal superior quadrantic defect
extraocular nerve palsies
features of pituitary insufficiency
e.g. hypotension/hyponatraemia secondary to hypoadrenalism
how do you manage pituitary apopexy
steroids URGENTLY to replace lack of AACTH
fluid balance > surgery
