Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Misc. Notes Year 3 > Neuro-Surgery Delta > Flashcards

Neuro-Surgery Delta Flashcards

1
Q

What level does the spinal cord begin and end at?

A

Begins at the medulla oblongata and ends at L1-2 to form the cauda equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the spinal cord in terms of where the white and grey matter is

A

Gray matter H-shape, surrounded by white matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which horns receive somatosensory information

A

Dorsal (posterior) horns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which horns contain motor neurons for muscle innervation

A

Ventral (anterior) horns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When are lateral horns present and what is their function

A

T1-L2

Contain autonomic sympathetic neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the central canal

A

Cerebrospinal fluid-filled space that runs longitudinally through the length of the entire spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the three main ascending tracts

A

Dorsal Column-Medial Lemniscus tract (DCML)
Spinothalamic tract
Spinocerebellar tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What information does the DCML pathway transmit

A

Fine touch, pressure, and vibration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What information does the Spinothalamic tract transmit

A

Pain and temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What information does the Spinocerebellar pathway transmit

A

Unconscious proprioceptive information to the cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the function of the Spinocerebellar tract

A

To help coordinate posture and the movement of the lower limb and upper limb musculature.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the gracile fasciculus

A

The part of the DCML pathway which transmits information from T6 and below
Lies medially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the other fasciculus apart from gracile

A

Cuneate Fasciculus
Transmits information from upper trunk and arms (above T6)
Lies more laterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where do the DCML fibres decussate

A

Medulla

decussate to the contralateral medial lemniscus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do DCML fibres go after the medial lemniscus

A

Synapse at thalamus

Then signals are relayed via the internal capsule to the primary somatosensory cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is located at the precentral gyrus

A

Primary somatomotor cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where do spinothalamic tract fibres decussate

A

At a segmental level as they enter the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which tract do spinothalamic fibres go through before synapsing at the dorsal horn

A

Tract of Lissauer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 2 main pyramidal tracts

A

Corticospinal tract

Corticobulbar tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name the 4 main extra-pyramidal tracts

A

Vestibulospinal
Rubrospinal
Reticulospinal
Tectospinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the difference between the pyramidal and extrapyramidal tracts

A

Pyramidal tracts control voluntary movements and originate from the primary somatomotor cortex
Extrapyramidal tracts control involuntary movements and originate from the brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where do all the corticospinal tract fibres decussate

A

85% of the corticospinal tract fibres decussate at the medullary pyramids where they become the lateral corticospinal tract
The other 15% travel down via the anterior corticospinal tract and decussate at a spinal level via the anterior white commissure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What muscles does the lateral corticospinal tract innervate

A

The distal extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What muscles does the anterior corticospinal tract innervate

A

Proximal and axial muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the function of the corticobulbar tracts

A

Contain the upper motor neurone of the cranial nerves, to provide innervation of the face, head and neck. They innervate cranial motor nuclei bilaterally
Two exceptions are the hypoglossal nuclei and lower facial nuclei which are innervated contralaterally only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the clinical significance of the corticobulbar tracts

A

An upper motor lesion affecting the facial nerve causes paralysis of the lower half of one side of the face only and the forehead muscles remain unaffected
a lower motor neurone lesion would cause a paralysis of the ipsilateral one-half of the face including the forehead (Bell’s palsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where does the vestibulospinal tract originate and what is it’s function

A

Originates from the vestibular nucleus in the pons

Controls balance and posture by innervating the anti-gravity muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the anti-gravity muscles

A

Extensors in the lower limbs and flexors in the upper limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where does the reticulospinal tract originate

A

Originates from the reticular formation in the medulla and pons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the difference in function between the pontine and medullary reticulospinal tract

A

Pontine - facilitates reflexes + increases tone

Medullary - inhibits reflexes + decreases tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Where does the rubrospinal tract originate and what is its function

A

Originates from the red nucleus(in midbrain)

Excites flexors and inhibits extensors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Where does the tectospinal tract originate and what is its function

A

Originates from the superior colliculus in the midbrain

Co-ordinates movements of head and neck to vision stimuli (think ecto)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the 2 parts of the intervertebral discs called

A

Outer Annulus Fibrosus

Inner Nucleus Pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which ligament connects the anterolateral aspects of vertebral bodies and IV discs

A

Anterior longitudinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which ligament runs within the vertebral canal posterior to the vertebral bodies

A

Posterior longitudinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which ligament helps maintain an upright posture and assists straighten the spine after flexion

A

Ligamentum Flavum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Where does the Ligamentum Flavum run

A

Runs vertically connecting the lamina of adjacent vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Where does the supraspinous ligament run

A

Along the tips of the spinous processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Where does the interspinous ligament run

A

Between the spinous processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What can occur when facet joints are hypertrophied

A

Patients get referred pain from the nerve supplying the facet joint that mimics sciatica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the difference between facet joint referred pain and sciatic pain

A

Facet joint referred pain does not spread below the knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are red flags for lower back pain

A 
Age: >60 or <20 years old
Pain not improved by rest
Pain that wakes the patient up at night
Urinary retention/incontinence and faecal incontinence
Saddle anaesthesia
History of malignancy
Unexplained weight loss.
Fever, immunosuppression or IV drug abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Which nerve root is being compressed if there is pain along the posterior thigh with radiation to the heel

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Which nerve root is being compressed if there is weakness of dorsiflexion of the toe or foot

A

L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which nerve root is involved if there is wasting of the quadriceps muscle and a reduced knee-jerk

A

L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What urgent investigations must be performed in suspected cauda equina

A

MRI lumbosacral spine

PR exam to check anal tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Which cord syndrome would cause a “cape-like” spinothalamic sensory loss

A

Central cord syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Why is there predominantly bilateral upper limb weakness rather than lower limb weakness in central cord syndrome

A

Fibres supplying the upper limbs in the lateral corticospinal tracts are more medial to the fibres supplying the lower limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which part of the body will lose its dorsal column input in central cord syndrome

A

None

The DCML pathway is typically preserved in central cord syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What might cause anterior cord syndrome

A

Cord infarction by the area supplied by the anterior spinal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the presentation of anterior cord syndrome

A

Paralysis and loss of pain and temperature below the level of injury with preserved proprioception and vibration sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the presentation of Brown-Sequard syndrome

A

Ipsilateral loss of motor function and proprioception below the lesion
Contralateral loss of pain and temperature below the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Name the 6 lobes of the cerebral hemispheres

A 
Frontal 
Temporal 
Parietal 
Occipital 
Insular 
Limbic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Damage to which area results in expressive aphasia

A

Broca’s area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is expressive aphasia

A

When a patient can understand a language but cannot produce it properly

56
Q

Where is Broca’s area found

A

Inferior frontal gyrus

57
Q

Which lobes contain the pre and postcentral gyri

A

Precentral gyrus –> Frontal lobe

Postcentral gyrus –> Pareital lobe

58
Q

Which structure separates the frontal and parietal lobes

A

Central sulcus

59
Q

Which structure separates the parietal and temporal lobes

A

Lateral fissure (Sylvian fissure)

60
Q

Which structure separates the frontal and temporal lobes

A

Lateral fissure (Sylvian fissure)

61
Q

Which lobe contains the primary visual cortex

A

Occipital lobe

62
Q

Which structure separates the parietal and occipital lobes

A

Parieto-occipital sulcus

63
Q

Damage to Wernicke’s area would cause which condition

A

Receptive aphasia

64
Q

What is receptive aphasia

A

When a patient can produce words and sentences properly but has impaired comprehension of a language

65
Q

Where is Wernicke’s area located

A

Superior temporal gyrus

66
Q

What is a pneumonic for remembering the parts of the limbic system

A

Hippo with a HAT

67
Q

What does Hippo with a HAT stand for

A

Hippocampus
Hypothalamus
Amygdala
Thalamus

68
Q

What are the 3 components of the cerebellum

A

Vestibulocerebellum
Spinocerebellum
Cerebrocerebellum

69
Q

What is the function of the Vestibulocerebellum

A

Receives input from the vestibular organs for the maintenance of balance and coordinating vestibule-ocular reflexes

70
Q

What is the function of the Spinocerebellum

A

Maintains muscle tone and participates in posture and gait

71
Q

What is the function of the Cerebrocerebellum

A

Coordination of voluntary motor activity and correct any error in the movements

72
Q

Name the parts of the basal ganglia

A 
Caudate nucleus
Putamen
Globus pallidus
Subthalamic nucleus
Substantia nigra
73
Q

What are the 3 layers of the cerebellum

A

Molecular layer (outer)
Purkinje cell layer (middle)
Granule cell layer (inner)

74
Q

Where do afferent projections come into the cerebellum

A

Granule cell layer

75
Q

Where do efferent projections from the cerebellum originate from

A

Purkinje cell layer

76
Q

Which common disease affects the pars compacta of the sunstantia nigra

A

Parkinson’s

77
Q

What is the triad associated with Parkinson’s

A

Rigidity (cogwheel)
Brady/Akinesia
Resting (pill rolling) tremor

78
Q

What are the three main arteries supplying the brain’s anterior circulation

A

Internal carotid
Anterior cerebral
Middle Cerebral

79
Q

Where does the internal carotid artery originate

A

Bifurcates from the common carotid

80
Q

Where does the internal carotid terminate

A

Terminates into a bifurcation as the middle cerebral artery and anterior cerebral artery

81
Q

Which artery is larger, the anterior cerebral or the middle cerebral

A

Middle cerebral

82
Q

Where do the anterior and middle cerebral arteries originate

A

From the bifurcation of the internal carotid

83
Q

How are the right and left anterior cerebral arteries connected

A

Via the anterior communicating artery

84
Q

Which 4 arteries make up the posterior circulation

A

Vertebral artery
Basilar artery
Posterior cerebral artery
Posterior communicating artery

85
Q

Where does the vertebral artery originate

A

Arises from the subclavian artery and extends through the transverse foramen of the cervical vertebrae

86
Q

What do the right and left vertebral arteries join to make

A

The basilar artery

87
Q

What is the origin of the basilar artery

A

Arises from the two vertebral arteries joining

88
Q

What is the origin of the posterior cerebral artery

A

Arises from the termination of the basilar artery

89
Q

What is the origin of the posterior communicating artery

A

Arises from the internal carotid artery

90
Q

What is the function of the posterior communicating artery

A

Connects the anterior and posterior circulations

91
Q

What are the 2 divisions of the venous system of the brain

A

Cerebral veins

Dural venous sinuses

92
Q

What are the dural venous sinuses

A

Large venous channels that are contained within the dura which contain arachnoid granulations, allowing CSF to be absorbed

93
Q

What is the function of the cerebral veins

A

Cerebral veins drain blood into the sinuses

94
Q

What is the difference between the superficial and deep cerebral veins

A

Superficial veins mainly drain into the superior sagittal sinus
Deep veins mainly drain into the straight sinus

95
Q

What is a typical presentation of a subarachnoid haemorrhage

A

Sudden onset of a thunderclap headache

96
Q

Which symptoms may be present due to any cause of meningeal irritation

A

Neck stiffness

Photophobia

97
Q

A third nerve palsy would suggest an aneurysm in which vessel

A

Posterior communicating artery

98
Q

How is the diagnosis of subarachnoid haemorrhage made

A

CT scan

99
Q

What would a lumbar puncture, performed a few hours after a subarachnoid haemorrhage, show

A

Xanthochromia

A yellow discolouration of the CSF

100
Q

What is the most common electrolyte disturbance which can occur after a subarachnoid haemorrhage

A

Hyponatraemia

101
Q

What are the 4 types of stroke

A

Lacunar infarct
Total Anterior Circulation Infarct
Partial Anterior Circulation Infarct
Posterior Circulation Infarct

102
Q

How is a lacunar infarct defined

A

A pure motor or pure sensory stroke or an ataxic hemiparesis

103
Q

Which 3 symptoms must be present to classify a stroke as a Total Anterior Circulation Infarct

A
  1. Higher cerebral dysfunction (e.g. dysphasia).
  2. Homonymous visual field defect
  3. Ipsilateral motor and/or sensory deficit of at least two areas (out of the face, arm and leg)
104
Q

What is the difference between a Total and Partial Anterior Circulation Stroke

A

Partial only requires 2 out of 3 of:

  1. Higher cerebral dysfunction (e.g. dysphasia).
  2. Homonymous visual field defect
  3. Ipsilateral motor and/or sensory deficit of at least two areas (out of the face, arm and leg)
105
Q

A Posterior Circulation Infarct must have one of which four symptoms

A
  1. Ipsilateral cranial nerve palsy with contralateral motor and/or sensory deficit
  2. Bilateral motor and/or sensory deficit
  3. Cerebellar dysfunction
  4. Isolated homonymous visual field defect
106
Q

Where is the oculomotor nucleus located

A

In the dorsal midbrain at the level of the superior colliculus

107
Q

Where is the trochlear nucleus located

A

In the midbrain at the level of the inferior colliculus

108
Q

Which nerve travels through the cavernous sinus and where is its nucleus located

A

Abducens nerve

The nucleus is in the pontine tegmentum

109
Q

What is the pathophysiology of optic neuritis

A

Inflammation of the optic nerve

110
Q

Which two types of diseases can cause optic neuritis

A

Infective or demyelinating

111
Q

What is Charcot’s triad with regard to Multiple Sclerosis

A

Nystagmus
Intention tremor
Staccato speech

112
Q

What is L’Hermitte’s sign

A

Electrical shock sensation on neck flexion

113
Q

What is the Uhthoff phenomenon and which disease is it seen in

A

Worsening of symptoms due to increase in temperature, such as exercising or hot shower
Seen in MS

114
Q

What is a treatment for optic neuritis

A

Intravenous methylprednisolone followed by oral prednisolone

115
Q

What 3 drugs can be used for MS (not symptomatic treatment)

A

Interferon beta
Copaxone
Tecfidera

116
Q

What is the pathophysiology of Myasthenia gravis

A

Autoimmune disease of acetylcholine receptors at post-synaptic neuromuscular junctions

117
Q

How can myasthenia gravis typically present

A

Muscle fatiguability of:
Extraocular muscles
Facial muscles
Bulbar muscles

118
Q

What is the Cogan Lid twitch and which disease is it seen in

A

Brief upshoot of the lid elicited by making patient look downwards then upwards
Seen in ocular myasthenia gravis

119
Q

What is the ice test and what disease is it used to check for

A

Ptosis improve after applying ice to upper eyelid for 2 mins

Myasthenia gravis

120
Q

How does the ice test work in Myasthenia Gravis

A

The cold decreases the acetylcholinesterase break-down of acetylcholine at the NMJ, allowing more to accumulate and increasing muscle contraction

121
Q

What is the treatment of Myasthenia Gravis

A

Pyridostigmine (anticholinesterase)

122
Q

Hyperplasia of which body part is associated with Myasthenia Gravis

A

Thymus

123
Q

What does decorticate posturing suggest

A

Indicates severe brain damage where the midbrain is spared

124
Q

What is decorticate posturing

A

The patient presents with abnormal flexion of his arms, the hands are clenched into fists, and the legs extended and feet turned inward

125
Q

How does decorticate posturing occur

A

Lateral corticospinal tracts are disrupted so the rubrospinal tracts take over causing the abnormal flexion to the upper extremities and the reticulospinal tracts take over causing the extension of the legs

126
Q

What is decerebrate posturing

A

The patient presents with his head arches back and both arms and legs extended

127
Q

What does decerebrate posturing suggest

A

Indicates an even more severe brain damage and brainstem damage, specifically at a level below the red nucleus in the midbrain

128
Q

How does decerebrate posturing occur

A

Both the lateral cortical spinal tract and rubrospinal tract are damage so the reticulospinal tract takes over and causes extension of the whole body

129
Q

Which type of haematoma is the accumulation of blood in a space between the dura and the bone

A

Extradural Haematoma

130
Q

What is the most common source of bleeding in an extradural haematoma

A

Middle Meningeal artery

131
Q

What appearance will an extradural haematoma have on a CT scan

A

A lens-shaped appearance

132
Q

Which vessels rupture during a Subdural Haematoma

A 
Bridging veins 
(veins which drain the cortex and empty into dural sinuses)
133
Q

How can chronic subdural haematomas occur

A

Brain atrophy due to alcoholism, age or dementia

134
Q

How do acute subdural haematomas show up on CT

A

A crescent-shaped hyperdensity representing acute blood products

135
Q

How do chronic subdural haematomas show up on CT

A

A hypodense crescent-shaped appearance

Misc. Notes Year 3 (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions