Neuro 4 Flashcards
Signs of normal pressure hydrocephalus?
3 W’s = wet [incontinent], wacky [mental decline] and wobbly [gait difficulties]
Structure damaged in epidural hematoma?
middle meningeal artery
Structure damaged in subdural hematoma?
bridging veins [cerebral veins emptying into superior sagittal sinus]
How do you age subdural hematomas?
acute blood is white [hyperdense] on CT; isodense in 1-2 weeks and hypodense after that
Structure damaged in subarachnoid hemorrage?
vessels in or around the circle of willis
Contents of cisterna magna?
vertebral artery, CN IX, X, XI and XII, choroid plexus
Contents of prepontine cistern?
basilar artery, CN VI
Contents of cerebellopontine cistern?
CN V, VII, VIII
Contents of interpeduncular cistern?
CN III
Contents of the ambient cistern?
CN IV
Structure comprising the lateral wall of the lateral ventricle?
caudate nucleus
Structure(s) comprising the lateral wall of the 3rd ventricle?
thalamus, hypothalamus
Structure at floor of 4th ventricle?
pons [facial colliculus], medulla [hypoglossal trigone]
Signs of injury to facial colliculus?
facial colliculus (genu of facial nerve and abducens nucleus) = IL facial paralysis + IL CN VI palsy
Signs of injury to the reticular formation?
coma
Components of the diencephalon?
thalamus, hypothalamus, epithalamus (pineal), subthalamus
Deficits in ALS?
UMN and LMN signs, sensation intact
Deficits in MS?
multiple (motor, sensory, special sensory, cognitive) deficits in time and lesions in space
Deficits in Guillan-Barre?
typically follows viral illness or vaccination, ascending paralysis (LE then UE), some sensory, autonomic effects
Signs of radiculopathy?
pain/sensory loss in a dermatomal pattern
What is tabes dorsalis?
demyelination of posterior columns from syphillis
Signs/symptoms of tabes dorsalis?
decreased muscle stretch reflexes, loss of discriminitve touch, proprioception and vibratory sense, + Romberg, ataxia (not from cerebellum)
Structures innervated by posterior rami?
deep back muscles and overlying skin
Dermatome for C2?
back of the scalp; greater occipital nerve [posterior ramus of C2]
Signs of injury to musculocutaneous nerve in axilla?
decreased bicep reflex, weakness in flexion at elbow, supination, sonsory loss along lateral forearm
Signs of injury to median nerve at elbow?
severe weakness in forearm flexion, paralysis of thenar muscles, sensory loss over palmar aspect and tips of digits 1 - 3, lateral half of digit 4
Signs of injury to median nerve at carpal tunnel?
paralysis of thenar muscles, sensory loss over palmar aspect and tips of digits 1 - 3, lateral half of digit 4
Signs of injury to ulnar nerve at cubital tunnel?
weakness in flexion of digits 4 and 5, sensory loss in 5th digit (palmar and dorsal), weakness in ab/adduction of fingers, hypothenar muscles, adductor pollicis , Froments sign, slight ulnar claw
Signs of ulnar nerve injury at Guyon’s tunnel?
sensory loss in 5th digit (palmar only), weakness in ab/adduction of fingers, hypothenar muscles, adductor pollicis , Froments sign, ulnar claw
Signs of injury to radial nerve with midshaft humeral fracture?
wrist drop, weak supination, sensory loss on dorsum of hand, triceps normal
Signs of injury to radial nerve in axilla?
paralyzed triceps, decreased triceps reflex, decreased brachioradialis reflex, wrist drop, weak supination, sensory loss on dorsum of hand
Signs of lesion to upper roots of brachial plexus?
Erb-Duchenne palsy, decreased biceps + brachioradialis reflexes; arm is medial rotated and extended [cant abduct, laterally rotate of flex at elbow], sensory loss over lateral arm
Signs of lesion to lower roots of brachial plexus?
Klumpke palsy, complete claw, sensory loss over 5th digit and medial arm, forearm
Signs of thoracic outlet syndrome?
weakness in intrinsic hand muscles, sensory loss over 5th digit and medial arm, forearm
Signs of injury to C5 nerve root?
weakness in abduction, lateral rotation and flexion at elbow, decreased bicep reflex, sensory loss over lateral arm
Signs of injury to C6 nerve root?
weakness in wrist extension, flexion at elbow, decreased brachioradialis reflex, sensory loss over lateral forearm
Signs of injury to C7 nerve root?
weakness in finger extension, elbow extension, wrist flexion, decreased tricep reflex, sensory loss over middle finger
Signs of injury to C8 nerve root?
weakness in finger flexion, sensory loss over 4th + 5th digit, medial forearm
Signs of injury to T1 nerve root?
weakness in finger ab/adduction, sensory loss over medial forearm/arm
Signs of injury to lateral femoral cutaneous nerve?
sensory loss over anterior and lateral thigh; aka meralgia paresthetica
Signs of entrapment/injury to saphenous nerve?
sensory loss along anterior and medial leg, medial malleolus and foot
Signs of injury to femoral nerve?
paralysis of quadriceps, decreased patellar reflex, sensory loss along anterior and medial thigh, leg, medial malleolus and foot
Signs of piriformis syndrome?
decreased achilles reflex, weakness in knee flexors, dorsiflexors, plantar flexors, sensory loss over lateral leg, lateral malleolus, dorsum of foot
Signs of injury to common fibular nerve?
foot drop, weakness in dorsiflexion, eversion, sensory loss over lateral leg and dorsum of the foot
Signs of injury to superficial fibular nerve?
weakness in eversion, sensory loss over dorsum of foot
Signs of injury to deep fibular nerve?
foot drop, weakness in dorsiflexion, eversion, sensory loss in the web between 1st and 2nd toes
Signs of injury to tibial nerve in popliteal fossa?
weakness in plantar flexion, toe flexion, weakness in intrinsic foot muscle, sensory loss on plantar surface of foot
Signs of injury to the tibial nerve in tarsal tunnel?
weakness in intrinsic foot muscles, sensory loss on plantar surface of foot
Signs of injury to superior gluteal nerve?
Trendelenburg sign: pelvis drops to good side during gait, paralysis of gluteus medius, minimus and tensor fascia lata
Signs of injury to inferior gluteal nerve?
Paralysis of gluteus maximus, weakness in extension and lateral rotation of thigh
Signs of injury to L2 nerve root?
weakness in leg flexion, knee extension, adduction, sensory loss over anterior thigh
Signs of injury to L4 nerve root?
weakness in knee extension, decreased patellar reflex, sensory loss over anterior medial leg, medial malleolus
Signs of injury to L5 nerve root?
weakness in dorsiflexion, toe extension, abduction of thigh, sensory loss over anterior leg, dorsum of foot, digits 1 and 2
Signs of injury to S1 nerve root?
weakness in plantar flexion, eversion, hip extension, decreased achilles reflex, sensory loss over posterior leg, digits 3-5
Signs of injury to S2 nerve root?
weakness in toe flexion, decreased anal wink, sensory loss over posterior thigh, perineum
Structure infected in herpes zoster?
posterior root ganglion
Reflex for C5?
biceps [via musculocutaenous n]
Reflex for C6?
brachioradialis [via radial n]
Reflex for C7?
triceps [via radial n]
Reflex for L1?
cremaster [ilioinguinal and genitofemoral ns.]
Reflex for L4?
patellar tendon [quadriceps, via femoral n]
Reflex for S1?
Achilles/calcaneal tendon [gastroc, via tibial n]
