neuro key notes part 2 Flashcards
astrocytes key roles
- remove excess K+ ions from cerebrospinal fluid
- physical support for neurons
- BBB
abduction of eye performed by which nerve
- muscle lateral rectus
- supplied by 6th cranial nerve
- abducens nerve
A 7-year-old boy presents to the emergency department with general malaise, difficulty swallowing and weakness of limbs. The onset of symptoms follows a recent upper respiratory tract infection. On examination, neck muscles, as well as both proximal and distal arm and leg muscles, are noted to be weak. Tendon reflexes are reduced bilaterally (upper and lower limbs) but the sensation is only mildly affected. Which of the following options describes the most likely underlying condition?
Characteristic Guillain-Barre syndrome
- involvement of all four limbs
- more severe prox muscle involvement
- preceding infection
- muscle fatigue
- abnormalities of ocular muscles
A 67-year-old female presents to the emergency department with hemiparesis. When you talk to her you find that her speech is fluent but her repetition is poor. She is unable to correctly repeat words but is aware of this and continues to try. You suspect a stroke may have caused this.
Which area of the brain has the stroke affected?
conduction aphasia
- usually resulting from storke affecting the arcuate fasiculus
- arcuate fasiculus connects Wernicke’s and Broca’s
what nerve is at risk in a shaft fracture of the humerus?
radial nerve
- thus patient may struggle with wrist extension
51 y/o, heart racing in chest, very warm, visibly sweating, tachycardic, her eyes exhibit lid retraction.
thyrotoxicosis
A young man is involved in a car accident and sustains a spinal cord injury where he has a hemisection of his spinal cord.
Which of the following clinical features, below the level of injury, will he have on examination?
Brown-Sequard
Sensory and MOTOR loss below the lesion on the SAME side and PAIN loss below the lesion on the OPPOSITE side.
A 32- year female patient presents to her General Practitioner complaining of being easily fatigued, lethargic and suffering from severe headaches. She claims she has lost her sexual drive and her periods have become irregular and sporadic. Eye examination reveals a problem of bitemporal hemianopia and magnetic resonance imaging reveals a large non-functional pituitary tumour. Which structure does her pituitary tumour press on to cause her visual symptoms?
bitemporal hemianopia thus optic chiasm affected.
A 73-year-old lady is admitted with brisk rectal bleeding. Despite attempts at resuscitation the bleeding proceeds to cause haemodynamic compromise. An upper GI endoscopy is normal. A mesenteric angiogram is performed and a contrast blush is seen in the region of the sigmoid colon. The radiologist decides to embolise the vessel supplying this area. At what spinal level does it leave the aorta?
Inferior mesenteric artery leaves at L3.
IMa supplies
- ———-> left colon
- ———-> sigmoid
A young man is attacked in a bar fight and develops a neck injury. When he is seen in the emergency department he has a drooping left eyelid, a constricted and non-reactive left pupil and he has visible sweat over the right side of his face but none on the left.
Which of the following nervous structures are most likely to have been injured in the attack?
Horners syndrome
- drooping left eyelid
- constricted non reactive LHS pupil
- visible sweat over RHS face
Cervical sympathetic chain affected.
A 58-year-old male presents to the neurology clinic with his wife. She tells you she has noticed changes to her husband’s speech over the past four months. When speaking to him you note that his speech is slurred. You then examine him and note that he has nystagmus and an intention tremor. He is also found to have dysdiadochokinesia.
Which of the following is most likely to have caused these features?
- changes to speech
- slurred speech
- nystagmus
- intention tremor
- dysdiadochokinesia
CEREBELLAR SYNDROME
Alcohol is a cause of cerebellar syndrome
Lambert-Eaton syndrome
- autoimmune antibodies against VG[Ca2+] channels
- muscular weakness
- BUT repeated muscle contractions lead to increased muscle strength (unlike in myasthenia gravis)
young male, shot, LHS spastic weakness, ipsilateral loss of propioception and vibration and contraleral loss of pain and temperature sensation. sensory deficits start from umbilicus.
nature and location of this mans condition
LHS Brown-Sequard syndrome at T10
The ventromedial nucleus of the hypothalamus contains
satiety centres
thus lesions here will cause increased insatiable appetite.
The paraventricular nucleus produces oxytocin and ADH, so lesions cause
diabetes insipidus
