neuro key notes Flashcards
which cranial nerves carry parasympathetic fibres?
1973
10 - Vagus (heart and abdnominal viscera)
9 - Glossopharyngeal (parotid)
7 - Facial (lacrimal gland, submandibular and sublingual)
3 - Oculomotor (pupillary constriction and accommodation)
34 y/o female, severe headache, both sides, blurring vision RHS. RHS papilloedema and CNVI palsy. Hypertensive
classic presentation of:
Idiopathic intracranial hypertension
mneumonic for branches off the posterior cord of the brachial plexus
Andy you’re a….
Subscapular (upper and lower)
Thoracodorsal
Axillary
Radial
Common peroneal nerve lesion
The common peroneal nerve provides sensation and motor function to the lower leg.
When compressed or damaged it can cause foot drop.
Other features include:
1. weakness of foot dorsiflexion
- weakness of foot eversion
- weakness of extensor hallucis longus
- sensory loss over the dorsum of the foot and the lower lateral part of the leg
- wasting of the anterior tibial and peroneal muscles
A young woman presents with right-sided loss of fine-touch and vibration sensation. She also exhibits ipsilateral loss of proprioception. Which anatomical structure has likely been damaged?
- Right Dorsal Column,
- involved in fine touch, vibration sensation and proprioception
- patients symptoms RHS, right dorsal column ipsilateral innervation
Dorsal column lesions commonly caused by
vitamin B12 deficiency
A 48-year-old man presents to the neurology clinic with a right sided intention tremor. He is also found to have right sided dysdiadochokinesia.
Which part of the brain is a lesion most likely to be located?
right cerebellum.
Unilateral cerebellar lesions cause ipsilateral signs. what signs are consistent with cerebellar disease
- unilateral dysdiadochokinesia
- unilateral intention tremor
- patients may appear drunk
- Hypotonia
- Ataxia
- Nystagmus
lesion in basal ganglia would cause patient to likely have
resting tremor
38 y/o unilateral drooping of LHS of mouth, can’t smile LHS. Can frown, lift eyebrows.
asthma and four previous miscarriages, non-smoker, drinks alcohol moderately.
Sparing of forehead: UMN
Stroke
- patient is young, although multiple miscarriages suggestive of anti-phospholipid syndrome which is major risk factor for stroke
innervation of scrotum
anterior and posterior
anterior: ilioinguinal nerve
posterior: pudendal nerve
what cells provide the inner lining of ventricles in brain and are responsible for CSF production?
Ependymal cells
cells important in forming the blood brain barrier
astrocytes
which cells form the myelin sheath in the CNS and which form the myelin sheath in the PNS?
CNS ————–> oligodendrocytes
PNS ————–> schwann cells
what are microglia?
central nervous system macrophage cells.
first line of active immune defence in CNS.
A 43-year-old woman is being reviewed on the ward one day post-op from a thyroidectomy. She has been generally well, but her voice sounds hoarse.
What nerve has been damaged during the surgery?
we know its recurrent laryngeal but is it right or left!
right recurrent laryngeal
—-> crosses neck diagonally
—-> more prone to injury during surgery
eclampasia
high blood pressure in pregnancy
A 53-year-old male attends the neurology clinic with his wife. She tells you that she has noticed changes to his speech over the past four months. She tells you it is loud and jerky and he pauses between syllables. However he is able to understand everything that he hears. When you speak to him, he is able to understand what you say but his speech is jerky with pauses. He has no problems with repetition and you find no weakness or changes to the sensation in any of his limbs. You suspect a lesion in his brain may be causing this pattern of speech.
Lesion in cerebellar disease:
- scanning dysarthria (jerky loud speech with pauses)
- dysdiadochokinesia
- nystagmus
- intention tremor
Lesion in superior temporal gyrus may cause?
Wernicke’s aphasia
- sentences that do not make sense
- comprehension impaired
as opposte to broca’s aphasia
- defective production of language
- intact understanding
Damage to tibial nerve results in
loss of plantar flexion,
loss of flexion of toes
weakened inversion
neuropraxia
nerve intact
but electrical conduction affected
A 31-year-old man presents to the emergency department with left sided chest pain after falling from a ladder whilst doing some DIY. A chest X-ray is ordered and reveals no fractures but an incidental finding of a cervical rib. He is told that this increases his risk of developing thoracic outlet syndrome (TOS).
What is the most accurate information about this condition to relay to the patient?
involves compression of brachial plexus
subclavian artery or vein at the site of thoracic outlet.
vagus nerve passes through what foramen
jugular foramen
A 25-year-old patient presents to GP with wasting of the leg muscles, foot drop, and a high-arched foot. The patient has a past medical history of type 1 diabetes mellitus. The GP notices the patient’s leg resemble ‘champagne bottles’. The patient denies any sensory deficits, recent trauma or back pain.
What is the most likely diagnosis?
Charcot-Marie-Tooth disease
- High arched foot
- foot drop
- chronic —-> muscular atrophy —-> high arched foot and champagne bottle appearance
A patient becomes deplete in one particular hormone and consequently develops cranial diabetes insipidus.
In which part of the hypothalamus is this particular hormone normally secreted?
SADH
ADH produced in the supraoptic nucleus in the hypothalamus
A 54-year-old male, who is known to have high blood pressure, presents with a stroke. On examination, he has right sided facial and arm weakness and an expressive dysphasia. He is diagnosed with a stroke and thrombolysis is arranged. Which artery is most likely to have been occluded?
middle cerebral artery.
if patient RHS affected we know artery is on LHS.
Left middle cerebral!
