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Medicine > Neuro formative assessment questions > Flashcards

Neuro formative assessment questions Flashcards

1
Q

Where do berry aneurysms most commonly occur

A

The circle of Willis,
1) Anterior communicating artery
2) Posterior communicating artery

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2
Q

What does the internal carotid artery directly become

A

The middle cerebral artery

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3
Q

What supplies blood to the cerebellum

A

Superior cerebellar artery, anterior inferior cerebellar artery, posterior inferior cerebellar artery

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4
Q

What can a stroke affecting the circulation of the occipital lobe cause

A

Contralateral homonymous hemianopia = vision loss on same side of both eyes, contralateral side to lesion

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5
Q

What strokes most commonly affect the internal capsule

A

Haemorrhagic

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6
Q

Are left handers more likely to be left/right hemisphere dominant for speech

A

Left, only 15% are R hemisphere dominant

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7
Q

Where are the motor and sensory cortexes

A

Primary motor = precentral gyrus
Sensory cortex = post central gyrus

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8
Q

How are locations of muscle represented in the primary motor cortex

A

Medial = lower limbs
Lateral = upper limbs/face

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9
Q

What is the M1 in the brain

A

The primary motor cortex

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10
Q

Will a stroke affecting the motor cortex or the internal capsule cause a greater defficit

A

Internal capsule

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11
Q

Will a stroke affecting the pons cause a contralateral or ipsilateral deficit for the lateral corticospinal tract

A

Contralateral. The lateral corticospinal tract decussates in the medullary pyramids

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12
Q

What is the substantia nigra

A

Part of the basal ganglia found in the midbrain, produces dopamine

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13
Q

What structures are affected by parkinsons

A

the basal ganglia

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14
Q

Where are the cell bodies of lower motor neurones found

A

In the ventral horn of the spinal cord

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15
Q

What is unique about the decussation of the corticospinal tract

A

80% of fibres decussate in the pyramids of the medulla = lateral corticospinal tract
20% decussate in the spinal cord at level = anterior corticospinal tract

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16
Q

What are functions of anterior vs lateral corticospinal tract

A

Anterior = gross movements of the trunk and shoulders (15%)
Lateral = movement of the limbs (85%) - lateral, limbs

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17
Q

Function of the tectospinal tract

A

Turning towards auditory stimuli (inferior colliculus) and towards visual stimuli (superior colliculus)

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18
Q

Function of the vestibulospinal tract

A

Maintaining balance/keeping head upright

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19
Q

Function of the reticulospinal tract

A

Gross movements eg reaching + can act to inhibit descending tracts

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20
Q

Function of the rubrospinal tract

A

Grabbing, muscle tone + fine hand movements

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21
Q

Hemiplegia vs Hemiparesis

A

Hemiplegia = 1 side complete paralysis
Hemiparesis = 1 side partial weakness

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22
Q

How are fibres of the corticospinal tract organised

A

Somatotopically. Lower extremities are located laterally. Upper extremities and head are more medial

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23
Q

What do muscle spindles detect

A

Muscle contraction AND extension - stretch

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24
Q

What is the distribution of tissue in the muscle spindle

A

Central portion = non contractile
Two ends = contractile

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25
Q

What detects changes in muscle tension

A

Golgi tendon organ. They are located in the junction of skeletal muscles and tendons

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26
Q

What process prevents muscle overload

A

Golgi tendon organs inhibit alpha motor neurons of the muscle they are found in

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27
Q

How is muscle tension related to output for golgi tendon organs

A

It is proportional

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28
Q

What is the RMP of neurones

A

-70mv

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29
Q

What ion has the greatest affect on the setting up of RMP

A

K+ (diffusing out)

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30
Q

How long is a refractory period

A

5-10ms

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31
Q

Where are most neurotransmitters synthesised

A

In the cell body

32
Q

How is CNI commonly damaged

A

Fractures to the anterior cranial fossa

33
Q

What is the order of ‘optic …’

A

Optic nerve, (chiasm), optic tract, (lateral geniculate nucleus of thalamus) optic radiation

34
Q

Will damage of CNIII cause ptosis on the opposite or same eyelid

A

Same. Occulomotor is ipsilateral

35
Q

When will damage to CNIV cause double vision

A

When they look down

36
Q

What reflex will be lost if the trigeminal nerve is damaged

A

The corneal reflex (blink in response to touch) will be lost on the affected side. This is the sensory afferent - opthalamic v2

37
Q

Innervation of the salivary glands

A

CNVII (facial) = Lacrimal, submandibular, sublingual
CNIX (glossopharyngeal) = parotid –> facial passes through but doesn’t innervate it

38
Q

Are cranial nuclei generally in the tectum or tegmentum

A

in the tegmentum (in front of cerebral aqueduct)

39
Q

What innervates sweat glands

A

Sympathetic innervation

40
Q

CN) Facial sensation

A

CN V (trigeminal)

41
Q

CN) Facial expression

A

CN VII (facial)

42
Q

What innervates the pharyngeal muscles?

A

All innervated by vagus except the stylopharyngeal which is innervated by CNIX glossopharyngeal

43
Q

How many roots does the CNXI accessory nerve have

A

2 - cranial and spinal

44
Q

What vein is the accessory nerve close to

A

The internal jugular vein - both exit via the internal jugular foramen

45
Q

What will damage to the accessory nerve cause

A

Ipsilateral loss of innervation to sternocleidomastoid and trapezius

46
Q

What does ‘licks the lesion’ refer to

A

Damage to the hypoglossal nerve will cause paralysis to the ipsilateral half of the tongue. So the tongue deviates towards the side of lesion

47
Q

Does the spinothalamic tract cross at the level of entry

A

First ascends 2-3 levels then decussates

48
Q

What types of joints connect the ossicles

A

synovial

49
Q

What are the two muscles of the middle ear

A

The stapedius and tensor tympani

50
Q

What do the muscles of the middle ear do

A

They tense to increase the stiffness of the ossicles to protect against loud noises

51
Q

What connects the scala vestibuli and scala tympani

A

The helicotrema

52
Q

How many coils are there in the cochlea

A

2.5

53
Q

What part of the auditory system can antibiotics damage

A

The steriocilia of inner hair cells

54
Q

Structure of basilar membrane

A

Base = high, narrower + stiffer
Apex = low, wider + floppier

55
Q

What is the ratio of inner to outer hair cells

A

1:3

56
Q

How many semicircular canals are there

A

3

57
Q

What are the otolithic organs

A

The utricle and saccule

58
Q

What kind of acceleration do the semi-circular canals detect

A

Rotational/non-linear

59
Q

What kind of acceleration do the utricle and saccule detect

A

Linear

60
Q

What are the utricle and saccule filled with

A

Endolymph

61
Q

What detects the position of the head at rest

A

The utricle and saccule (otolithic organs)

62
Q

Is the cerebellum involved in the initiation of co-ordinated movement?

A

No, basal ganglia are involved in the initiation of movement

63
Q

What is the main sensory input to the cerebellum

A

The vestibular system

64
Q

Are cerebellar lesions ipsilateral or contralateral

A

Ipsilateral, all the spinocerebellar tracts are ipsilateral

65
Q

Does damage to the cerebellum cause hypertonia or hypotonia

A

Hypotonia

66
Q

Are olfaction and gustation contralateral or ipsilateral

A

Ipsilateral

67
Q

Can vestibulocochlea lesions lead to nystagmus

A

yes

68
Q

What is the only fully contralateral cranial nerve

A

CN IV - Trochlea. Innervates the contralateral superior oblique

69
Q

What is CN VII’s innervation of the face

A

Upper 1/2 of face = innervated by both hemispheres
Lower 1/2 face =innervated by contralateral hemisphere only

70
Q

What would be the facial symptoms of a right side stroke

A

Drooping of left lower half of face = central facial weakness

71
Q

What are the afferent inputs to the cerebellum

A
  • Cerebral cortex = Mossy and climbing fibres
  • Spinocerebellar pathways
72
Q

Where do Mossy fibres originate and terminate

A

Originate: Various brainstem nuclei, except inferior olivary nucleus
Terminate: Granule cell layer of cerebellum

73
Q

Where do Climbing fibres originate and terminate

A

Originate: Inferior olivary nucleus of medulla
Terminate: Molecular layer of cerebellum

74
Q

What do Purkinje cells do

A

Send inhibitory signals to cerebellar nuclei. Only efferent pathway from cerebellar CORTEX

75
Q

What do parallel fibres do

A

Convey information from the molecular layer to purkinje cell layer

76
Q

Are outputs from the cerebellar cortex excitatory or inhibitory

A

Inhibitory

77
Q

What is the function of cerebellum vs basal ganglia for movement

A
  • Cerebellum compares actual vs intended movement (co-ordination of movement). Basal ganglia initiate movement

Medicine (15 decks)

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