Neurology Flashcards
One pupil is dilated and nonreactive to light or accommodation
Hutchinson pupil
UMN lesions affect what areas of the nervous system?
The brain or the spinal cord
What is the presentation of UMN lesion?
Increased muscle tone, increased reflexes, babinski is positive
What is the next step in diagnosis if you suspect a patient has an UMN lesion?
CT or MRI
Why does a patient with an UMN lesion have sparing of the Upper face?
Remember that the upper motor neurons synapse at both an upper and lower nucleus. The upper nuclei supplies the upper half of the face while the lower nuclei supplies the lower half. Keep in mind there is colateral innervation from the oppisite side of the cortex that suplies the neuron, meaning that the upper part of the face is innervated.
Lesion on the ____ motor neuron results in complete paralysis of one side of the face, resulting in an inability to close the eyes, smile, and decreased labial folds
LMN
A sensitive test for UMN lesion. Patients are asked to extend their hands with their palm up and close their eyes.
Pronator drift, if the patients palms rotate downward this is a positive sign.
What are the signs of LMN lesion?
Flaccidity, hyporeflexia, atrophy, fibrillation (small contractions detected on EMG) fasciculations (larger contractions)
What are etiologies for Bell’s palsy?
Herpes simplex, lyme, sarcoidosis
The inability to perform a series of rapidly alternating movements. Ask the patient to keep one hand over the other and rapidly move the upper hand in alternating supination/pronation.
Dysdiadokinesia
The patient overshoots when attempting to reach something
Dysmetria
Slurred speech
dysarthria
Signs that the cerebellum may be damaged?
DANISH Pendulum; dysdiadokinesia, dysarthria, ataxia, nystagmus, intention tremor, slurred speech, hypotonia, persistent back and forth swinging of the leg
What is the next step in managment if you suspect a patient has cerbellar comprimise?
CT or MRI
A 53 yo pt suddenly has painless loss of vision (like a “dark curtain” over one eye) followed by spontaneous recovery. What is the Dx?
Amaurosis fugax, which affects the retinal branch of the internal carotid artery
A 50 yo F patient woke up with symptoms of difficulty speaking and weakness in his right leg that lasted for 3 hours. Patient is currently asymptomatic. What is the next step in managment?
Aspirin, statin, Patient should also get a carotid duplex to see if intervention is required.
Where do the vertebral arteries originate from?
The subclavian artery
What branches does the basilar artery give off?
Pontine
The basilar artery eventually gives rise to what first portion to the circle of Willis?
The posterior cerebral artery
This artery of the brain gives off the lenticulostriate arteries
MCA
Where is the stroke happening in a patient where the upper extremities, and face are affected, homonymous hemianopia (it is contralateral)
MCA
Branches off of the MCA, supply what deeper structures of the brain?
The Internal capsule, thalamus, basal ganglia and temporal lobe.
A patient with MCA in the right lobe of the brain will have these additional signs associated with speech?
Broca and Wernicke’s