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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
What detects changes in muscle tension
Golgi tendon organ. They are located in the junction of skeletal muscles and tendons
26
What process prevents muscle overload
Golgi tendon organs inhibit alpha motor neurons of the muscle they are found in
27
How is muscle tension related to output for golgi tendon organs
It is proportional
28
What is the RMP of neurones
-70mv
29
What ion has the greatest affect on the setting up of RMP
K+ (diffusing out)
30
How long is a refractory period
5-10ms
31
Where are most neurotransmitters synthesised
In the cell body
32
How is CNI commonly damaged
Fractures to the anterior cranial fossa
33
What is the order of 'optic ...'
Optic nerve, (chiasm), optic tract, (lateral geniculate nucleus of thalamus) optic radiation
34
Will damage of CNIII cause ptosis on the opposite or same eyelid
Same. Occulomotor is ipsilateral
35
When will damage to CNIV cause double vision
When they look down
36
What reflex will be lost if the trigeminal nerve is damaged
The corneal reflex (blink in response to touch) will be lost on the affected side. This is the sensory afferent - opthalamic v2
37
Innervation of the salivary glands
CNVII (facial) = Lacrimal, submandibular, sublingual CNIX (glossopharyngeal) = parotid --> facial passes through but doesn't innervate it
38
Are cranial nuclei generally in the tectum or tegmentum
in the tegmentum (in front of cerebral aqueduct)
39
What innervates sweat glands
Sympathetic innervation
40
CN) Facial sensation
CN V (trigeminal)
41
CN) Facial expression
CN VII (facial)
42
What innervates the pharyngeal muscles?
All innervated by vagus except the **stylopharyngeal** which is innervated by CNIX glossopharyngeal
43
How many roots does the CNXI accessory nerve have
2 - cranial and spinal
44
What vein is the accessory nerve close to
The internal jugular vein - both exit via the internal jugular foramen
45
What will damage to the accessory nerve cause
Ipsilateral loss of innervation to sternocleidomastoid and trapezius
46
What does 'licks the lesion' refer to
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
Does the spinothalamic tract cross at the level of entry
First ascends 2-3 levels then decussates
48
What types of joints connect the ossicles
synovial
49
What are the two muscles of the middle ear
The stapedius and tensor tympani
50
What do the muscles of the middle ear do
They tense to increase the stiffness of the ossicles to protect against loud noises
51
What connects the scala vestibuli and scala tympani
The helicotrema
52
How many coils are there in the cochlea
2.5
53
What part of the auditory system can antibiotics damage
The steriocilia of inner hair cells
54
Structure of basilar membrane
Base = high, narrower + stiffer Apex = low, wider + floppier
55
What is the ratio of inner to outer hair cells
1:3
56
How many semicircular canals are there
3
57
What are the otolithic organs
The utricle and saccule
58
What kind of acceleration do the semi-circular canals detect
Rotational/non-linear
59
What kind of acceleration do the utricle and saccule detect
Linear
60
What are the utricle and saccule filled with
Endolymph
61
What detects the position of the head at rest
The utricle and saccule (otolithic organs)
62
Is the cerebellum involved in the initiation of co-ordinated movement?
No, basal ganglia are involved in the initiation of movement
63
What is the main sensory input to the cerebellum
The vestibular system
64
Are cerebellar lesions ipsilateral or contralateral
Ipsilateral, all the spinocerebellar tracts are ipsilateral
65
Does damage to the cerebellum cause hypertonia or hypotonia
Hypotonia
66
Are olfaction and gustation contralateral or ipsilateral
Ipsilateral
67
Can vestibulocochlea lesions lead to nystagmus
yes
68
What is the only fully contralateral cranial nerve
CN IV - Trochlea. Innervates the contralateral superior oblique
69
What is CN VII's innervation of the face
Upper 1/2 of face = innervated by both hemispheres Lower 1/2 face =innervated by contralateral hemisphere only
70
What would be the facial symptoms of a right side stroke
Drooping of left lower half of face = central facial weakness
71
What are the afferent inputs to the cerebellum
- Cerebral cortex = Mossy and climbing fibres - Spinocerebellar pathways
72
Where do Mossy fibres originate and terminate
Originate: Various brainstem nuclei, except inferior olivary nucleus Terminate: Granule cell layer of cerebellum
73
Where do Climbing fibres originate and terminate
Originate: Inferior olivary nucleus of medulla Terminate: Molecular layer of cerebellum
74
What do Purkinje cells do
Send inhibitory signals to cerebellar nuclei. Only efferent pathway from cerebellar CORTEX
75
What do parallel fibres do
Convey information from the molecular layer to purkinje cell layer
76
Are outputs from the cerebellar cortex excitatory or inhibitory
Inhibitory
77
What is the function of cerebellum vs basal ganglia for movement
- Cerebellum compares actual vs intended movement (co-ordination of movement). Basal ganglia initiate movement

Medicine (15 decks)

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