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3rd year self made > Neurology > Flashcards

Neurology Flashcards

1
Q

What are the 2 types of stroke

A

ischemic and haemorhagic

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2
Q

What is the most common type of stroke

A

ischemic

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3
Q

what are the 2 main arteries supplying the brain

A

vertebral arteries (posterior supply)internal carotid arteries (anterior supply)h

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4
Q

what do the vertebral arteries arise from and then form in the brain

A

arise from subclavian arteriesform the basilar artery

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5
Q

what is a TACS

A

total anterior circulation stroke

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6
Q

what happens in TACS

A

large cortical stroke, affecting parts of the brain supplied by middle and anterior cerebral arteries

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7
Q

what is the criteria for diagnosing TACS

A

all 3 must be present:1. unilateral weakness (and/or) sensory deficit of face/ arm or leg2. homonymous hemianopia3. higher cerebral dysfunction

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8
Q

what is PACS

A

partial anterior circulation stroke

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9
Q

what occurs in PACS

A

large cortical stroke, affecting parts of the brain supplied by middle and anterior cerebral arteries (Sae as TACS)

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10
Q

what is the criteria for diagnosing PACS

A

only 2/3 must be present:1. unilateral weakness (and/or) sensory deficit of face/ arm or leg2. homonymous hemianopia3. higher cerebral dysfunction

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11
Q

what is POCS

A

posterior circulation syndrome

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12
Q

what is the criteria for diagnosing POCS

A

1 or more needs to be present:1. cerebellar or brain stem syndromes (ataxia, nystagmus, vertigo)2. loss of consciousness3. isolated homonymous hemianopia

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13
Q

what is LACS

A

lacunar syndrome

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14
Q

what happens in LACS

A

subcortical stroke- due to small vessel disease

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15
Q

what is the criteria for diagnosing LACS

A

1 or more needs to be present1. unilateral weakness/ sensory deficit (arm, face, leg or all 3)2. pure sensory stroke3. ataxic hemiparesis

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16
Q

what is chorea

A

movement disorder that causes sudden, unintended, and uncontrollable jerky movements of the arms, legs, and facial muscles(dance like)

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17
Q

what conditions would you see chorea in

A

Huntingtons diseaseSLE

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18
Q

what is ataxia

A

term for a group of disorders that affect co-ordination, balance and speech

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19
Q

what conditions would you see ataxia in

A

stroke, MS, brain tumour

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20
Q

what is nystagmus

A

Rhythmical, repetitive and involuntary movement of the eyes. It is usually from side to sidePerson has no control over their eye movements

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21
Q

What conditions would you see nystagmus in

A

diseases affecting the inner ear balance mechanisms or the brainstem or cerebellum

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22
Q

what is myoclonus

A

sudden, brief involuntary twitching or jerking of a muscle or group of muscles(think of sleep starts)

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23
Q

what diseases might you see myoclonus in

A

DystoniaMultiple sclerosisParkinson’s diseaseHuntington diseaseAlzheimer’s disease

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24
Q

what is spasticity

A

abnormal muscle tightness due to prolonged muscle contraction.Velocity dependant- exaggeration of stretch reflexWill feel it catch

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25
Q

what conditions would you see spastcity in?

A

cerebral palsybrain injurystrokeMS

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26
Q

What is rigidity

A

when muscles become stiff or inflexibleindependent of velocity

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27
Q

what causes spasticity

A

damage to the pyramidal tracts

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28
Q

what conditions cause rigidity

A

parkinsons

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29
Q

what are the signs of an upper motor lesion

A

minimal atropy or contracturesincreased tone (spasticity/ rigidity) pyramidal pattern of weakness in power (extensors weaker than flexors in arm, and vise versa in legs)hyperreflexiaupgoing plantars

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30
Q

what are the signs of an lower motor lesion

A

marked atrophyfasiculationsreduced tonereduced or absent reflexpower is reduced in distribution of affected nerve (flexors weaker in arms than extensors, and vise versa in legs)

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31
Q

where does an upper motor neuron lesion occur

A

CNS (brain + spinal cord)

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32
Q

where does a lower motor neuron lesion occur

A

anywhere from anterior horn cell to the muscle

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33
Q

what conditions present as an upper motor neuron lesion

A

strokeALS (Motor neuron disease)MS

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34
Q

what conditions present as lower motor neuron lesions

A

peripheral nerve trauma/ compressionspinal muscular atrophyALS (motor neurone disease)guillaine-barre syndrome

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35
Q

Exampls of dopaminergic drugs

A

LevadopaDopamine agonistsMonoamine oxydase type B inhibitors

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36
Q

What is the main indication for dopaminergic drug use eg. levadopa

A

Treatment of parkinsons

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37
Q

Why do dopaminergic drugs help parkinsons

A

alleviates motor symptoms

38
Q

MOA of dopaminergic drugs

A

Increase the concentration of dopamine in the brain

39
Q

Contraindications of dopaminergic drugs

A

History of addiction, OCD, impulsive personality

40
Q

Side effects of dopaminergic drugs

A

Nauseadaytime somnolencepostural hypotensionhallucinationsmotor symptom complications (dyskinesia)

41
Q

Examples of anti-convulsants

A

IamotriginePhenytoinCarbamazepine

42
Q

What is the main indication of anti-convulsants

A

Prevent epileptic seizures

43
Q

Side effects of anti-convulsants

A

Induce hepatic enzymes- can alter efficacy of combined oral contraceptiveDon’t use progesterone only pill

44
Q

Examples of cholinesterase inhibitors

A

Rivastigmine, donepezil

45
Q

What is the main indication for cholinesterase inhibitors

A

Slow the cognitive decline in some forms of dementia

46
Q

MOA of cholinesterase inhibitors

A

Inhibit cholinesterase receptors

47
Q

Side effects of cholinesterase inhibitors

A

GI- nausea and diarrhoeaHeadacheMuscle crampsBradykinesia

48
Q

Examples of opioid analgesics

A

Morphinediamorphinefentanylbuprenorphinetramadol

49
Q

MOA of opioid analgesics

A

Act on G-protein-coupled opioid receptors

50
Q

Side effects of opioids

A

Dependence/ addictionapnoeanausea, vomittingconstipationorthostatic hypotension

51
Q

Examples of opioid receptor antagonists

A

Naloxone

52
Q

What is the main indication for ORA

A

Reverse opioid toxicity

53
Q

What is the main indication for opioid use

A

pain relief

54
Q

What are the main indications for gabapentin and pregabalin

A

anti-epileptics (also chronic pain treatment)

55
Q

What can carbamazepine also be used for apart from anti-convulsants

A

treatment for trigeminal neuralgia pain

56
Q

what are fasiculi

A

tracts (bundles of nerve fibres)

57
Q

where does information that is conscious get processes

A

the cerebral cortex

58
Q

where does information that is subconscious get processed

A

cerebellum

59
Q

what is another name for the 1st order neuron

A

primary afferent neuron

60
Q

do 1st order neurons decussate or stay ipsilateral

A

ipsilateral

61
Q

do 2nd order neurons decussate or stay ipsilateral

A

ducussate

62
Q

where does ducussation occur

A

thalamus or medulla oblongata

63
Q

where are the 3rd order neurons located

A

cell body is in the thalamus, and it’s axons pass to the somatosensory cortex

64
Q

what information does the fasciculus gracilis contain

A

information from lower limb

65
Q

what information does the fasciculus cutaneous contain

A

information from the upper limb

66
Q

what are the 3 ascending tracts

A

dorsal columns (fasciculus cutaneous and gracilis)spinothalamicspinocerebellarwhat are the

67
Q

what are the 2 divisions of the descending tracts

A

pyramidal and extra-pyramidal

68
Q

what are the 4 extra-pyramidal tracts

A

rubrospinaltectospinalvestibulospinalreticulospinal

69
Q

what is the pyramidal tract

A

corticospinal

70
Q

what information does the dorsal columns carry

A

fine touch, proprioception and vibration

71
Q

what information does the anterior portion of the spinothalamic tract carry

A

pain and temperature

72
Q

what information does the lateral portion of the spinothalamic tract carry

A

crude touch

73
Q

What information does the spinocerebellar tract carry

A

proprioception

74
Q

What information does the rubrospinal tract carry

A

responsible for limb flexor

75
Q

What information does the tectospinal tract carry

A

movement in response to visual sensory information

76
Q

What information does the vestibulospinal tract carry

A

maintains posture

77
Q

What information does the reticulospinal tract carry

A

reflexes and muscle tone

78
Q

what information does the lateral portion of the corticospinal tract carry

A

skilled voluntary movement

79
Q

what information does the anterior portion of the corticospinal tract carry

A

axial motor information

80
Q

What are the 2 main arteries supplying the brain

A

internal carotid and vertebral arteries

81
Q

what is the course of the vertebral arteries

A

vertebral => basilar arteries => posterior cerebral arteries

82
Q

what is the course of the internal carotid arteries

A

internal carotid => anterior and middle cerebral arteries

83
Q

what is the venous system of the brain

A

dural venous sinuses => internal jugular vein

84
Q

what areas of the brain does the anterior cerebral artery supply

A

frontal and parietal cortex

85
Q

Are ACA stroke common or rare

A

rare

86
Q

What is the clinical presentation of an ACA stroke

A

motor deficits of the contralateral lower limbcontralateral face and arm paresissensory deficits/ memory impairments

87
Q

what areas of the brain does the middle cerebral artery supply

A

temporal lobesprecentral/ postcentral gyrus

88
Q

What is the clinical presentation of an MCA stroke

A

If precentral gyrus:Contralateral loss of motor innervation for the head, upper limbs or trunkIf postcentral gyrus:loss of sensation from head, upper limb and trunkCan involve broca’s/ wernicke’s area => asphasia (affects speech)

89
Q

What is the most common artery involved in stroke

A

MCA

90
Q

what areas of the brain does the posterior cerebral artery supply

A

occipital lobe

91
Q

What is the clinical presentation of an PCA stroke

A

headachedizzinessvisual changes (loss, diplopia, “curtain coming down”)

3rd year self made (6 decks)

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