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Public Health > Neuro Nerves > Flashcards

Neuro Nerves Flashcards

1
Q

CN I Olfactory

A

Sensory : smell

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2
Q

CN II Optic

A

Sensory: Sight

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3
Q

CN III Occulomotor

A

Motor: MR, SR, IR, IO, LPS
Parasympathetic: sphincter pupillae (light constriction)

Signs= fixed dilated, ptosis, outward deviation (down + out)

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4
Q

CN IV Trochlear

A

Motor: SO
signs: vertical diplopia (up + out), tilt head to compensate for function loss

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5
Q

CN V Trigeminal

A

Sensory: ophthalmic V1 + maxillary V2
(touch, pain, pressure, temperature, muscles of mastication: face, scalp, cornea, nasal, oral cavity, anterior 2/3 of tongue)

Motor: ophthalmic + maxillary + mandibular V3
(muscles of mastication, tensor, tympani muscles)

Signs: reduced sensation or dysesthesia, weakness of jaw clenching, side to side movement, jaw deviates to weaker side if LMN lesion

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6
Q

CN VI Abducens

A

Motor: LR
signs: inability to look laterally, eye deviated medially

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7
Q

CN VII Facial

A

Sensory: taste anterior 2/3 tongue

Motor: muscles of facial expression, upper face bilaterally innervated, lower face contralaterally innervated by motor cortex

Parasympathetic: lacrimal, submandibular, sublingual salivary glands

Signs: facial weakness, forehead paralysed/spared in LMN/UMN

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8
Q

CN VIII Vestibulocochlear

A

Sensory: hearing + balance
Signs: deafness, tinnitus

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9
Q

CN IX Glossopharyngeal

A

Sensory:
- taste posterior 1/3 tongue,
- general sensation: touch, pain, temp in pharynx, eustachian tube posterior 1/3 tongue

Motor: 1 pharynx muscle

Parasympathetic: parotid gland

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10
Q

CN X Vagus

A

Sensory: general sensation to pharynx, larynx, oesophagus, external auditory meatus, tympanic membrane

Motor: muscles of soft palate, pharynx, larynx (swallowing)

Parasympathetic: thoracic and abdominal viscera

Signs: palatal weakness can cause “nasal speech”, palate assymetrical when patient opens mouth, “bovine cough”, hoarseness

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11
Q

CN XI Accessory

A

Motor: sternocleidomastoid + trapezius muscles

Signs: weakness and wasting of those muscles

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12
Q

CN XII Hypoglossal

A

Motor: tongue muscles

Signs: wasting of ipsilateral side of tongue, fasciculations, tongue deviated towards affected side (away from lesion)

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13
Q

Which nerve is affected in Carpel Tunnel Syndrome?

A

Entrapment of Median Nerve

Causes: hypothyroidism, DM, pregnancy, acromegaly

S+S:
- aching pain esp at night, relieved by dangling,
- paraesthesia in thumb, index finger, middle finger,
- sensory loss and weakness of abductor pollicis brevis and thenar eminent

I: EMG shows slowing of conduction, Phalens + Tinels Test (tapping)

M: wrist splint, steroids, decompression surgery

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14
Q

Reflexes

A

S1-S2: Ankle
L3-L4: Knee
C5-C6: Biceps (flex elbow)
C7-C8: Triceps (extend elbow)

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15
Q

Foot Drop?

A

L5: common peroneal nerve (L4-S1), cannot dorsiflex –> inversion foot

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16
Q

Motor Exam/Myotomes

A

C5: elbow flexion
C6: wrist extension
C7: elbow extension
C8: finger flexion
T1: finger abduction
L2: hip flexion
L3: knee extension
L4: ankle dorsiflexion
L5: toe extension
S1: ankle plantar flexion

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17
Q

Dermatomes

A

C4: clavicles
T1: medial side of arms
T4: nipples
T10: umbilicus
L2-3: anterior + inner thigh
L4: knee
L5, S1, S2: posterior + lateral leg
S4: perianal area

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18
Q

Median Nerve (C6-T1)

A

nerve of precision grip
wasting of muscles at base of thumb

19
Q

Ulnar Nerve (C7-T1)

A
  • vulnerable to elbow trauma
  • wasting of: medial wrist flexors, interossei (can’t cross fingers), medial 2 lumbricals (claw hand)
  • wasting of hypothenar eminence: weak little finger abduction
  • sensory loss over medial 1.5 fingers
  • flexion of 4th and 5th DIP joint weak
20
Q

Radial Nerve (C5-T1)

A
  • wrist + finger drop when elbow flex + pronated
  • dorsal aspect of thumb root sensory loss
  • damage at axilla = triceps affected
21
Q

Brachial Plexus (C5-T1)

A
  • pain/paraesthesia + weakness in affected arm
22
Q

Phrenic Nerve (C3-5)

A

phrenic palsy if orthopnoea with raised hemidiaphragm

23
Q

Sciatic Nerve (L4-S3)

A

damanged by pelvic tumour/fractures to pelvis/femur

24
Q

Tibial Nerve (L3-S3)

A

inability to tip toe, sensory loss over sole

25
Q

Syringomyelia: Causes

A

Chiari malformation, trauma, tumours, idiopathic

26
Q

Syringomyelia: S+S

A
  1. Impairment of lateral spinothalamic tracts:
    - Cape-like (neck, shoulders, arm) loss of sensation to pain and temperature
    - but preserved light touch, proprioception + vibration (due to crossing of spinothalamic tracts)
  2. Impairment of ventral horns
    - spastic weakness
    - neuropathic pain
    - upgoing planters
    - bladder bowel dysfunction
27
Q

Syringomyelia: I+M

A

MRI contrast to exclude tumour + tethered cord

MRI brain for chiari malformation

Treatment: shunt

28
Q

B12 Subacute Degeneration fo Spinal Cord

A

BILATERAL!
1. Impairment of dorsal column: (affected 1st)
- tingling, proprioception, vibration loss

  1. Impairment of lateral corticospinal:
    - UMN: muscle weakness, hyperreflexia, spasticity, brisk knee reflexes, absent ankle jerks, extensor plantars, legs first
  2. Impairment of spinocerebellar tracts:
    - sensory ataxia and +ve Rombergs
29
Q

Brown Sequerd Syndrome (spinal cord hemisection)

A

UNILATERAL!
1. Impairment of dorsal column: (affected 1st)
- (ipsilateral) tingling, proprioception, vibration loss

  1. Impairment of lateral corticospinal:
    - (ipsilateral below lesion) UMN: muscle weakness, hyperreflexia, spasticity, brisk knee reflexes, absent ankle jerks, extensor plantars, legs first
  2. Impairment of lateral spinothalamic tracts:
    - (contralateral) loss of pain and temp sensation
30
Q

Friedrich’s Ataxia

A

BILATERAL! (same as B12 DEF SCDOSC)
1. Impairment of dorsal column: (affected 1st)
- tingling, proprioception, vibration loss

  1. Impairment of lateral corticospinal:
    - UMN: muscle weakness, hyperreflexia, spasticity, brisk knee reflexes, absent ankle jerks, extensor plantars, legs first
  2. Impairment of spinocerebellar tracts:
    - sensory + cerebellar ataxia (intention tremor) and +ve Rombergs
31
Q

Neurosyphilis

A

SENSORY only: dorsal columns: loss of proprioception, vibration and sensation

32
Q

Parietal Lobe Lesions

A
  • sensory inattention
  • apraxia (can understand but can’t do)
  • tactile agnosia (can’t recognise things by touch)
  • inferior homonymous quadrantanopia

Gerstmann’s Syndrome: lesion of dominant parietal
- alexia, acalculia, finger agnosia, right-left disorientation

33
Q

Occipital Lobe Lesions

A
  • homonymous hemianopia (with macula spared)
  • cortical blindness
  • visual agnosia
34
Q

Frontal Lobe Lesions

A
  • Broco’s aphasia (inferior frontal gyrus- left superior MCA)
  • disinhibition
  • perseveration
  • anosmia
35
Q

Temporal Lobe Lesions

A
  • Werknicke’s aphasia (superior temporal gyrus- left inferior MCA)
  • auditory agnosia
  • prosopagnosia
36
Q

Cerebellum Lesions

A
  • midline lesions: gait + truncal ataxia
  • hemisphere lesions: intention tremor, past pointing, dysdiadokinosis, nystagmus
37
Q

Amygdala Lesions

A

Kluver Bucy Syndrome: hypersex, hyperoral, hyperphagia, visual agnosia

38
Q

Most common tumour causing brain metastases

A

(LBBSK)
Lung
Breast
Bowel
Skin
Kidney

39
Q

Most common tumour causing bone metastases

A

(LBPTK)
Lung
Breast
Prostate
Thyroid
Kidney

Most common site:
Spine
Pelvis
Ribs
Skull
Long bones

40
Q

Brain tumours

A

Glioblastoma Multiforme (most common): disruption of BBB
Meningioma (2nd most common): benign, compression sx, in falx cerebri or superior sagitttal sinus
Pituitary adenoma: ACTH/GH/prolactin/TSH producing
Pilocytic Astrocytoma: children
Medullablastoma: children, aggressive
Oligodendroma: benign, frontal lobe “fried egg”
Hemangioblastoma: cerebellum, von hippel lindau
Craniopharynglioma: children, Rathke’s pouch: early morning headache, vomiting, polydipsia, polyuria, and visual changes, benign tumor near the pituitary gland and hypothalamus.

41
Q

First order Horners causes

A
  • MS
  • tumours
  • Wallenberg’s Stroke

anhidrosis in face, arm, trunk

42
Q

Second order Horners causes

A
  • Pancoast tumours
  • Thyroid malignancies
  • Trauma

anhidrosis in face

43
Q

Third order Horners causes

A
  • Carotid artery dissections
  • Cavernous sinus thrombosis
  • Cluster headaches

no anhidrosis
failure to dilate if add hydroxyamphethamine

44
Q

Congenital Horners

A
  • Iris heterochromia

Public Health (5 decks)

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