neuro wrong Flashcards
encephalitis: cerebrospinal fluid constituents
lymphocytosis (inc wcc) and elevated protein
signs/symptoms of stroke of lateral medullary sydrome
ipsilateral: Dysphagia (Nucleus ambiguous) , facial numbness, horners (hypothalamic tract)
contralateral: limb sensory loss
cerebellar features: ataxia (spinocerebellar tract) & nystagmus & Vertigo (vestibular nucleus)
signs/symptoms of pons stroke
locked in syndrome
quadraplegia (corticospinal tract)
cant speak (corticobulbar tract)
bilateral damage to abducens = restricts horizontal gaze (abducens nuclei)
No loss of consciousness
signs/ symptoms of midbrain stroke
what is it also known as
contralateral weakness (corticospinal tract)
ipsilateral occulmotor palsy (CN3 nuclei)
aka webers
signs/symptoms of lateral pontine syndrome (also medulla affected)
same as wallenbergs syndrome except also ipsilateral deafness
wallenbergs (ataxia, nystagmus
ipsilateral: dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
contralateral: limb sensory loss)
lesion where results in lateral medullary syndrome
PICA (posterior inferior cerebellar artery)
what arteries supply the medulla
- vertebral arteries & pica (Posterior Inferior Cerebellar Arteries) (branches of vertebral arteries)
what arteries supply the pons
AICA (anterior inferior cerebellar artery)
pontine arteries
superior cerebellar arteries
^^ all branches of basilar artery
midbrain blood supply
posterior cerebRAL arteries ( branch of basilar)
drug induced parkinsonsim occurs when/how
tends to occur a few weeks after starting antipsychotics or dopamine antagonists
(chlorpromazine, haloperidol, lithium, valproic acid, metoclopramide)
progressive supranuclear palsy features
impairment of vertical gaze,
symmetrical parkinsonism,
cognitive impairment
postural instability/falls
poor response to l-dopa
vascular parkinonism features
primarily affect gait in the lower limbs and comes on slowly, and
there is a lack of autonomic dysfunction. It is caused by small strokes and
infarcts
what are some extrapyramidal side effects which occur from typical antipsychotics
Acute dystonic reaction, akathisia, parkinsonism, and tardive
dyskinesia
what does a painful nerve palsy suggest
that the nerve is compressed
common cause of a painful third nerve palsy
compression from posterior communicating artery anyuerysm
crutzfold-jakob disease
pathophysio and key features
prion proteins>amyloid folds= tightly packed beta sheets resistant to proteases
rapid onset dementia and myoclonus- uncontrollabe twitching
what is apraxia
inability to perform a movement spontaneously on command
what anti-emetic can be given to parkinsons patients
domiperidone- dopamine antagonist (used as it does not cross blood brain barrier)
syringomelia presentation
pain and temperature loss in neck arms and shoulders. as diseases progresses can cause weakness and spasticity in lower limbs
classically burn hands without realisng
subacute degenration of the cord symptoms
dorsal and lateral corticospinal tracts are affected therefore, weakness and loss of fine touch, propioception and vibration occurs
what nerve innervates adductor pollicis
ulnar
wernickes enceohalopathy symptoms
confusion, ataxia, nystagmus, opthalmoplegia
(+ history of acoholo misuse)
Where are lower motor neurones cell bodies
Anterior horn!
why is COCP contrindicated in thos with mirgraine with aura
significantly increased risk of ischaemic stroke
what palsy is caused by arm being pulled in abducted position. eg trying to grab a branch when falling or pulling a baby out the womb by arm
klumpkes palsy- causes damage to C8 and T1, so median nerve and ulnar nerves are damaged.- claw hand
ondenaston moa and action site
. Ondansetron is a selective 5-HT3 receptor antagonist. It works by blocking serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone (CTZ) located in the area postrema of the medulla oblongata.
what condition is associated witj vestibular shwannomas
Neurofibromatosis type 2
What is cushings triad and why is it bad
Widened pulse pressure
Bradyxhardia
Irregular respiration
Indicates increased intracranial pressure-last stop before brain herniation and death
Left homonomous hemaniopia, where is the lesion
Right optic tract
What are triptans and contraindications
5ht agonists
Contraindicated in ischaemic heart disease or cerebrovascular disease
Bppv ix and yx
Ix - dix halpike
Tx - epley
risk factors for raised intracranial hypertension
moon faced young obese woman trying to treat her acne
moon= steroids
young obese woman
treating acne- isotretinoin, tetracyclines, COCP
absent ankle and plantar reflex but knee jerk intact- what nerve has a defect
sciatic- innervates hamstrings down back of leg
