neuro amk

Question 1

what is the anatomical order in which the needle passes in order to reach the CSF

Answer 1

skin - supraspinous ligament - interspinous ligament - ligmanetum flavum - epidural space - subdural - subarachnoid

Question 2

brocas area supplies by what artery

Answer 2

middle cerebral artery

Question 3

anterior cerebral artery supplies

Answer 3

frontal and parietal - olfactory bulb, corpus callous, medial surface of frantle and inferior surface of frontal

Question 4

what is lateral medullary syndrome

Answer 4

Lateral medullary syndrome (also called Wallenberg syndrome) is due to a lesion in the posterior inferior cerebellar artery. It can cause ipsilateral facial numbness and contralateral limb sensory loss. It can also cause cerebellar features of ataxia and nystagmus.

A middle cerebral artery stroke would cause contralateral hemiparesis with this patient presenting with no changes to his motor function. It can also cause aphasia which is an inability to use or comprehend words, which is not seen in this patient who has no problems with his speech.

Weber’s syndrome occurs due to a lesion in the branches of the posterior cerebral artery that supplies the midbrain. It causes contralateral weakness of the upper/lower extremity which is not seen in this patient. It can also cause a third nerve palsy which presents with the eye in a ‘down and out’ position.

Lateral pontine syndrome is due to a lesion in the anterior inferior cerebellar artery, leading to similar symptoms as seen in lateral medullary syndrome. However ipsilateral facial paralysis and deafness also occur and this patient has no changes to his hearing.

Bell’s palsy is a lower motor neuron facial palsy causing unilateral facial nerve paralysis. It does not cause hemisensory loss to upper/lower limbs which is seen in this patient.

Question 5

how many valves does the IVC have

Answer 5

0

there is a non functional valve between the right atrium and inferior vena cava.

Mnemonic for the Inferior vena cava tributaries: I Like To Rise So High:

Iliacs
Lumbar
Testicular
Renal
Suprarenal
Hepatic vein

Question 6

cortical plaques due to deposition of type-A beta amyloid protein and intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein
what is this describing

Answer 6

alzheimers disease

atherosclerosis of cerebral arteries suggests vascular dementia
abnormal accumulation of CSF in Brain ventricles suggests normal pressure hydrocephalus
lewy bodies just dementia

Question 7

what is the circle of papez

Answer 7

The Papez circuit is a fundamental component of the limbic system. It is a closed neural circuitry that starts and ends in the hippocampus. It is also known as the medial limbic circuit.

emotional expression , Memories, Arousal

Question 8

subdural haemorrhage caused by what

Answer 8

A subdural haemorrhage occurs when there is bleeding between the dura mater and the arachnoid mater and is caused by damage to the bridging veins between the cortex and venous sinuses

Question 9

The thalamus is a midline structure situated between the midbrain and cerebral cortex whose main function is to relay motor and sensory signals to the cerebral cortex.

damage to the lateral geniculate nucleus causes what

Answer 9

visual signals

Question 10

medial geniculate nucleus

Answer 10

auditory signals

Question 11

Medial portion of the ventral posterior nucleus (VML)

Answer 11

facial sensations

Question 12

netral anterior and lateral nuclei

Answer 12

motor

Question 13

lateral portion of the ventral posterior nucleus

Answer 13

Body sensation (touch, pain, proprioception, pressure, vibration)

Question 14

facial vein connected to cavernous sinus by what vein

Answer 14

The facial vein is of clinical importance as it is connected to the ophthalmic vein. This then connects to the cavernous sinus. Through this connection infections can spread from the face to the cranial cavity.

Question 15

Medial thalamus and mammillary bodies of the hypothalamus

associated conditions

Answer 15

Wernicke and Korsakoff syndrome

Question 16

Subthalamic nucleus of the basal ganglia

associated conditions

Answer 16

Hemiballism

Question 17

Striatum (caudate nucleus) of the basal ganglia

Answer 17

Huntington chorea

Question 18

Substantia nigra of the basal ganglia

Answer 18

parkinsons

Question 19

Amygdala

associated syndromes

Answer 19

Kluver-Bucy syndrome (hypersexuality, hyperorality, hyperphagia, visual agnosia

Question 20

cingulate gyrus lesions result in

Answer 20

Cingulate gyrus lesions can result in poor judgement and decision-making as well as impaired emotional function (eg loss of empathy).

Question 21

As the surgeons incise the carotid sheath a nerve is identified lying between the internal jugular vein and the carotid artery. Which one of the following is this nerve most likely to be?

Answer 21

vagus

Question 22

A 42-year-old woman attends the hypertension clinic for further review of her refractory hypertension. She was initially diagnosed with hypertension when she was 30 and has been on several anti-hypertensive agents which have failed to control the blood pressure. She has been having intermittent headaches, flushes, and palpitations.

On discussing further therapy, she reports that when she was prescribed an alpha-blocker, her blood pressure (BP) dropped to an average BP of 100/65 mmHg.

You suspect that this patient’s hypertension may have a secondary cause.

Where is the most likely anatomical location of the cause?

Answer 22

From the description, this patient is presenting with hypertension which is refractory to treatment. The patient is also young. This raises suspicion of a secondary cause for her hypertension. The cluster of features: flushing, headaches, palpitations, and sensitivity to alpha-blockers suggests that the likely underlying cause is a phaeochromocytoma. This is a neuroendocrine tumour that most commonly arises from the adrenal gland. More specifically, it arises from the adrenal medulla, the part of the adrenal gland which releases catecholamines (adrenaline, etc). However, 10% may arise outside the adrenal glands

Question 23

A 58-year-old with type II diabetes presents to his GP with anxiety, sweating and palpitations since this morning. On examination he appears pale and clammy with mydriasis and increased bowel sounds. He has recently been started on gliclazide, a sulphonylurea, for his diabetes was not controlled by metformin alone.

What is the primary biological site of synthesis of the hormone most likely responsible for this man’s symptoms?

Answer 23

chromaffin cells of the adrenal medulla

Question 24

adrenaline symptoms

Answer 24

headaches, palpitations, and heavy sweating

non intentional Weight loss due to malignancy