Brainscape's Knowledge GenomeTM

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


See full index

Anaesthesia VTS > Neurology > Flashcards

Neurology Flashcards

1
Q

What is the blood brain barrier?

A

A physical barrier separating the blood from the brain - unlike normal vessel walls, there are no gaps at the junctions of endothelial cells. Astrocytic end feet make up the BBB and surround the vessel and help regulate the tight junctions of the endothelial cells.

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

How is the nervous system (NS) subdivided?

A

The NS is split into the central NS (brain and spinal cord) and peripheral NS (spinal nerves). The PNS is subdivided into automatic and somatic (movement) NS. The ANS is subdivided into sympathetic, parasympathetic and enteric (second brain - GI tract control) NS.

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

What are the 12 cranial nerves?

A

Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducent
Facial
Vestibulocochlear
Glossopharangeal
Vagal
Accessory
Hypoglossal

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

All the cranial nerves innervate structures in the head, except one, which one?

A

Vagus nerve (the ‘wanderer’) innervates the back of the tongue, larynx and pharynx but also the viscera of the thorax and abdomen.

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

What is the function of the olfactory nerve?

A

Sensory function only - smell

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

What is the function of the optic nerve?

A

Sensory only - vision

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

What is the function of the oculomotor nerve?

A

Motor only - movement of eyelids and eyes

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

What is the function of the trochlear nerve?

A

Motor only - its controls the dorsal or superior oblique muscle, responsible for ventromedial eye movement

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

What is the function of the trigeminal nerve?

A

Motor and sensory function - sensory to eyes and face & motor to muscles for mastication

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

What is the function of the Abducens cranial nerve?

A

Motor only - lateral eye movements (lateral eye muscles) and outward eye movement - involved in nystagmus

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

What is the function of the facial nerve?

A

Motor and sensory - facial sensation and muscle movement (except chewing - trigeminal!) including facial expressions and closing eyelid movement.

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

What is the function of the vestibulocochlear (formerly acoustic) nerve?

A

Sensory only - hearing and balance

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

What is the function of the glossopharangeal nerve?

A

Sensory and motor - taste on the caudal third of the tongue and movement of pharynx

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

What does the prefix glosso mean?

A

Tongue!

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

What is the function of the vagus nerve?

A

Sensory and motor - motor - innervates back of tongue, pharynx and larynx (swallowing and coughing) and parasympathetic innervation of thoracic and abdominal viscera.

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

What is the function of the accessory nerve?

A

Motor only - muscles of shoulders and neck - shrugging, side to side head movement

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

What is the function of the hypoglossal nerve?

A

Motor only - tongue movement - glossal!

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

The palpebral reflex tests which cranial nerves?

A

The facial nerve (motor function of closing the eyelids) and trigeminal nerve (sensory function of touch)

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

What are the 3 cranial nerves involved in eye movement?

A

Oculomotor, abducens and trochlear

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

What is my synonym for the 12 cranial nerves?

A

OOOTTAF Vestibulocochlear Goes Vagal At Hypoglossal

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

Where do the motor efferent and sensory afferent nerves enter and exit?

A

Motor efferent nerves exit via the ventral spinal nerve root.
Sensory afferent nerves enter via the dorsal spinal nerve root.

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

Where do the SNS and PSNS stem from?

A

SNS stems from T1-L2 (thoracolumbar). Chain of sympathetic ganglia.
PSNS from the cranial nerves and sacrum

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

Where is the epidural space?

A

Often performed between L7-S1, it lies between the dura mater and the ligmentum flavum lining the spinal canal.

24
Q

Between which meninges is CSF found?

A

Between the arachnoid mater and the pia mater (subarachnoid space)

25
Q

Name the 3 meninges

A

Outermost is the dura mater, then arachnoid mater then pia mater = DAP

26
Q

What is the basic equation for cerebral perfusion pressure?

A

CPP = MAP-ICP
This is why if ICP increases, then MAP must increase to maintain CPP - hence Cushings reflex

27
Q

What is normal ICP?

A

5-15mmHg

28
Q

What is the Cushings response?

A

Increased ICP = decreased CPP. Cerebral vasodilation attempts to maintain cerebral blood flow but worsens ICP causes a ‘CNS ischaemic/hypoxic response’. This causes a huge increase in sympathetic tone, causing MAP to increase (systemic hypertension) with possible initial tachycardia before reflex bradycardia (which may also be due to compression of vagus nerve). With brain herniation, the respiratory centres are compressed leading to respiratory depression/altered breathing patterns.

29
Q

What is the Glasgow coma scale?

A

Each scores out of 6 - Motor activity, brainstem reflexes and level of consciousness.
Prognoses = 3-8 grave, 9-14 guarded & 15-18 good

30
Q

What cranial nerves are involved in the ocular-cardio reflex?

A

The sensory opthalmic branch of the trigeminal nerve and the motor response of the vagus nerve.
Caused by pressure or traction of the globe, causing bradycardia, bradyarrhythmias. Can be treated with anticholinergics.
These trigeminal afferents synapse with the visceral motor nucleus of the vagus nerve.

31
Q

Which of the cranial nerves are involved in parasympathetic activity?

A

III Oculomotor
VII Facial
IX Glossopharyngeal
X Vagus
…Only Fresh Gullables Vape

32
Q

What is the Monroe-Kellie doctrine?

A

The doctrine states that for ICP to remain normal a volume increase in any of the 3 components must be matched by a decrease in another.

The skull is a non-compliant box essentially, comprising of brain parenchyma (84%) blood (4%) and CSF(12%). Brain volume cannot change, blood and CSF can alter a little.

33
Q

What causes the symptoms of tetanus?

A

The neurotoxin binds to the interneurons in the spinal cord or brainstem (via a peripheral entry point) and inhibit their action - which is to prevent repeated firing of motor neurons and prevent contraction of extensor and flexor muscles at the same time.

34
Q

What causes myasthenia gravis?

A

An autoimmune disease causing destruction of nicotinic cholinergic receptors on the muscle motor end plate, although release of Ach is normal. Therefore unable to elicit an impulse for muscle contraction.

35
Q

What neurotransmitters are released at SNS and PSNS synapses?

A

SNS - a short preganglionic neuron, releasing Ach & a long post ganglionic neuron releasing noradrenaline to the effector organ.
PSNS - a long preganglionic neuron releasing Ach then a short postganglionic neuron (often within the effector organ) also releasing Ach.

36
Q

SNS postganglionic neurons generally release norarenaline to the effector organ. What is the main exception?

A

Post ganglionic SNS neurons innervating the sweat glands release Ach.

37
Q

How does sympathetic innervation get to the head?

A

After leaving the spinal cord, sympathetic nerves enter the paravertebral/chain ganglia and move along to the superior, middle and inferior cervical ganglia, where they synapse with these ganglia and the post ganglionic branches continue to the head and neck.
Cervical chain ganglia are the ‘highway to the head’.

38
Q

What are some anaesthesia considerations for myasthenia gravis?

A

Increased risk of aspiration, administer prokinetics, antiemetics, care on extubation, artificial ventilation. If administering NMBAs then use one fifth or sixth of usual dose as very sensitive.

39
Q

How do patients with myasthenia gravis respond differently to depolarising and non-depolarising NMBAs?

A

They are more resistant to dep. NMBAs because there is insufficient receptor stimulation for depolarisation.
They are more sensitive to non-dep. NMBAs and much lower doses should be used (a fifth of usual dose).

40
Q

Where does the phrenic nerve exit the spinal cord?

A

At C3, C4 and C5

41
Q

What nerves can be affected by retraction in ventral slot surgery?

A

Phrenic nerve, vagus nerve and laryngeal nerve injuries or compression may occur.
Care with extubation/recovery if suspected laryngeal nerve damage.

42
Q

Head trauma is often associated with hyperglycaemia - true or false?

A

True! Do not give glucose containing fluid therapy. For this reason corticosteroids are contraindicated in cases of head trauma.

43
Q

Why is aggressive fluid therapy required in head trauma patients?

A

To maintain CPP >70mmHg - significantly reduced morbidity and mortality.

44
Q

What is hydrocephalus?

A

An excess of CSF build up in the skull, putting pressure on the brain

45
Q

What is status epilepticus?

A

Status epilepticus means continuous state of seizures - when seizures last more than about 5 mins. They can be convulsive (tonic followed by clonic convulsions) or non convulsive (unconscious) which can be followed by convulsions.

46
Q

What are cluster seizures?

A

Multiple seizures within 24hrs

47
Q

What happens in the body during seizures?

A

Increase in cerebral metabolism (increased oxygen demand), lactic acid, cardiac output, BP, CBF, HR, catecholamine release. A lot of sympathetic activity.

If these factors are not controlled, it can lead to loss of autoregulation of CBF, cerebral hypoxia, cerebral oedema and intracranial hypertension.

48
Q

What are some neuroprotective drugs?

A

Propofol - reduces CBF and ICP, activates GABA receptors (which inhibit NS activity) and inhibits NMDA receptors.
Dexmedetomidine - neuroprotective
Benzos - anticonvulsants
Opioids may or may not be used, depending where you read.
ACP - but consider other effects and that it cannot be antagonised.

49
Q

What is chiari malformation?

A

Chiari malformation is when the lower part of the cerebellum (called tonsils) are forced into the upper part of the spinal canal due to a deformed base of the skull that surrounds the cerebellum. CM can lead (amongst other causes) to syringomyelia. The cerebellum controls balance and coordination.

50
Q

What is syringomyelia?

A

Syringomyelia is the formation of a fluid filled cyst in the spinal cord called a syrinx. Often associated with chiari malformation.

51
Q

What is an intrathecal injection?

A

An injection into the subarachnoid space i.e. where the CSF is found. Drugs injected into this space bypass the BBB.

52
Q

What is a myelogram?

A

Contrast injected intrathecally followed by xrays or CT for diagnosing spinal disease.

53
Q

What are the clinical signs of raised ICP?

A

Depression of cranial nerve responses, seizures, dull mentation, dyspnoea, dysphagia, deafness, blindness etc.

54
Q

What is Horners syndrome?

A

Damage to the sympathetic neurons innervating the head

55
Q

Which cranial nerves have parasympathetic function?

A

Oculomotor, Facial, Glossopharyngeal and Vagus - Only Fresh Gullables Vape.

Cranial nerves 3,7,9,10

56
Q

What are some examples of signs seen with Horners?

A

Partial ptosis (drooping of upper eyelid) - paralysis of muscle that opens eyelid, miosis and anhidrosis (decreased sweating).

Anaesthesia VTS (9 decks)

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