Neurology Flashcards
What are the motor functions of the median nerve?
Thumb flexion and opposition
Digits 2 + 3 flexion
Wrist flexion and abduction
Forearm pronation
What are the motor functions of the ulnar nerve?
Thumb + finger abduction
finger adduction
Digits 4-5 flexion
Wrist flexion and adduction
What are the motor functions of the radial nerve?
What are the 4 sensory branches?
Extension - elbow, wrist, PIPs
Forearm supination
Thumb abduction (posterior interosseus nerve)
Lower lateral cutaneous nerve of arm
Posterior cutaneous nerve of arm
Posterior cutaneous nerve of forarm
Superficial branch (dorsal digital nerves)
What are the motor functions of the axillary nerve?
Shoulder abduction of arm beyond first 15 degrees
What are the motor functions of the musculocutaneous nerve?
What is the sensory branch called?
Elbow flexion
Forearm supination
Lateral cutaneous nerve of forearm
What are the motor functions of the femoral nerve?
What are the sensory branches?
Hip flexion
Knee extension
Femoral nerve - anterior thigh
Sapehenous nerve - medial calf/foot
What is the motor function of the obturator nerve?
Where is the sensory innervation?
Hip adduction
Proximal medial thigh
What are the branches of the sciatic nerve? What are there motor and sensory function?
Common peroneal:
Superficial peroneal - foot eversion; lateral foot + calf
Deep peronal - foot DF, toe extension; patch between toes 1 and 2
Tibial nerve: foot PF, inversion, toe flexion; lateral aspect of foot
What nerves are branches of the lumbar plexus?
What nerves are branches of the sacral plexus?
Lumbar - femoral, obtural, lateral femoral cutaneous nerve (sensation to lateral thigh)
Sacral - sciatic nerve, posterior femoral cutaneous nerve (posterior thigh sensation)
What feature differentiates ulnar neuropathy at the wrist from ulnar neuropathy at the elbow?
Both will cause cause motor weakness with clawing of digits 4 + 5
Compression at the elbow cause sensory loss of both dorsal + palmar ulnar surfaces however at the wrist sensory loss will be limited to palm + digits 3 + 4
List the genes associated with early onset dementia
Which gene is associated with late onset dementia. What chromosome?
Early onset AD:
- APP gene (amylid precursor protein)
- PSEN 1/2
Also trisomy 21
Late onset AD:
- APOE4 (homozygous). Chromosome 19.
Gene affected in CADASIL
NOTCH3 gene pathogenic variant (ch. 19)
Upper trunk plexopathy
- signs
- spinal levels
C5,C6
- loss of shoulder movements and elbow flexion
- sensory loss over lateral aspect of arm AND forearm
Lower trunk plexopathy
- signs
- spinal levels
C8, T1
- Claw hand
- Horners
- senosry loss of ulnar side of hand AND forearm
Foot drop with absent ankle jerk.
Where is the lesion?
Sciatic neuropathy.
NOTE - peroneal nerve often more affected than tibial; may have sparing of PF despite weak AJ
Which antibiotic significantly reduces therapeutic levels of valproate?
Carbapenems
Which nerve root supplies brachioradialis reflex?
C5, C6
Which 2 conditions are Anti-GAD65 antibodies associated with?
Stiff person syndrome
T1DM
List the alpha synucleinopathies
MSA
Parkinsons disease
Lewy body dementia
Signs of gerstmanns syndrome
Where is the lesion?
Dominant (left) inferior parietal lobe (left angular gyrus)
Acalculia - can’t do math
Agraphia - can’t write
Agnosia (of the fingers) - can’t name fingers
Right-left disorientation
Key features of Parinauds syndrome
Where is the lesion?
Dorsal midrain lesion
Commonly caused by pineal tumors, hydrocephalus
Results in:
- dilated pupils sluggishly responsive to light (EWN)
- impaired upgaze (dorsal vertical centre)
- convergance-retraction nystagmus
- retracted eye lids (sub-oculomotor nucelus)
- intact accomodation
Ipsilateral CNIII palsy
Contralateral hemiataxia
Where is the lesion? What is this syndrome?
Claude sundrome
Dorsomedial midbrain (PCA and baslar branches)
Poor prognostic features in bells
severe (complete) paralysis - MAJOR prognostic factor
older age; patients with moderately severe dysfunction should have valaciclovir + steroids
Other poor features - hyperacusis, altered taste, electromyographic evidence of axonal degeneration.
Pure motor stroke (hemiparesis) - where is the lesion?
Posterior limb of internal capsule
EEG findings in alzheimers dementia
Frontal slowing
Increased delta and theta activity
Decreased alpha and beta activity
EEG in depression
Frontal alpa asymmetry No slowing (unlike in dementia)
Mechanism of Atogepant and indication
CGRP antagonist (calcitonin gene related pepetide)
Used in migraine
Treatment of JME.
What AED exacerbates it?
Valproate
Exacerbated by lamotrogine
Two parkinsons plus syndromes that are tauopathies
PSP
Corticobasal degeneration
Knee jerk reflex spinal cord level, muscle and nerve
L2, 3, 4
Quardriceps
Femoral
Ankle jerk reflex spinal cord level, muscle and nerve
S1-2
Tibial nerve (branch of sciatic)
Triceps surae
Triceps jerk reflex spinal cord level, muscle and nerve
C7
Radial nerve
Triceps muscle
Biceps jerk reflex spinal cord level, muscle and nerve
C5/6
Biceps
Musculocutaneous
L) facial weakness
L) abducens weakness
R) hemiplegia
Where is the lesion?
Left ventral pons - “Millard-Gubler syndrome”
Affecting CNVI/VIII + corticospinal tracts
Basily artery
