Neurology Flashcards
Cranial nerves name and function
1- olfactory (smell) 2- optic (vision) 3- oculomotor (eye mvmt, light reflex) 4- trochlear (eye mvmt) 5- trigeminal (mastication, sensory face) 6- abducens (lat eye mvmt) 7- facial ( facial expression, taste) 8- vestibulocochlear (hearing, balance) 9- glossopharyngeal ( taste, swallow, speech) 10- vagus (taste, swallow, lift palate, speech) 11- accesory (turn head, lift shoulder) 12- hypoglossal (move tongue)
EXPLICIT PNEUMONIC: oh oh oh to touch and feel virgin girls’ vaginas arouses harry
Cranial nerves and if they control sensory, motor, or both
1- sensory 2- sensory 3-motor 4-motor 5- both 6- motor 7- both 8-sensory 9- both 10-both 11-motor 12-motor
EXPLICIT PEUMONIC: some say marry money but my brother says big boobs matter more
Parkinson’s disease
S/s: resting tremor bradykinesia rigidity posture/balance changes insidious onset unilateral constipation
Eval:
response to Parkinson meds
txt:
Levodopa
deep brain stim
dementia
Def: Acquired, sustained impairment in intellectual function in at least 3 areas
SS: Major memory changes Language deficits Perceptual deficits Praxis disturbances
Types: Alzheimer's dx (donepezil 5 mg po qd) diffuse lewy body disease vascular dementia frontotemporal dementias
MS
SS: blurred vision visual field defect paresthesia numbness weakness dysarthria loss balance urinary abnormalities lhermitte's sign - flick distal end of finger and it curls up
Eval:
MRI w and w/out contrast (T2)
Txt:
symptomatic
MS Types
Relapsing/Remitting MS - discrete attaches that evolve over days to weeksusually complete recovery back to baseline
Secondary Progressive MS - Begins as RRMS
steady deterioration where between acute attacks the pt does not return to baseline
Primary Progressive MS - no attacks but steady decline from disease onset
Progressive/Relapsing MS - occasional attacks steady deterioration from onset
Migraine
SS: lasts 4-72 hrs unilateral pulsating intensity moderate to severe aggravated by physical activity N/V photophobia phonophobia
Eval:
Have to have 5 attacks before dx
debilitating
Txt: - Prophyalixis BB CCB SSRI TCA anti-seizure meds - abortive OTC analgesics sumatriptan 25 mg po x 1 vasoconstrictors/ergots anti-emetics serotonin agonists IV/IM NSAID's Narcotics Steroids
Cluster HA
SS: unilateral excrutiating penetrating pain trigeminal nerve distribution lacrimation conjunctival injection nasal congestion/rhinorrhea ptosis miosis
Txt:
Oxygen
similar to migraine but no BB
Tension HA
SS: pressing/tightness/band-like mild-moderate intensity unaffected by physical activity possible photo/phonophobia
Txt:
Mild analgesics
stress reduction
relaxation techniques
Subdural Hematoma summary
Def: bleeding between dura and arachnoid/brain with significant brain injury
Cause: tears of bridging veins between cerebral cortex and dura
SS: sickle shape HA with confusion obtundation Elderly/alcoholics
Eval:
CT
Epidural Hematoma summary
Def: bleeding between inner skull table and dura with no brain injury
Cause: skull fx tear middle meningeal artery
SS: lenticular Brief LOC awake with HA deteriorating mental status rapidly progress to herniation of brain
Eval:
CT
Txt:
neurosurgery -> good prognosis
Grand mal seizure
SS:
Begin with abrupt LOC usually without warning
Pt falls to ground with trunk/extremities ext (tonic)
Then, rhythmic jerking of trunk and extremities (clonic)
often apnea, cyanosis, tongue-biting, urinary incontinence
lasts 60-90 seconds
Eval: Glucose Mg Ca Lumbar puncture
Txt: phenytoin carbamazepine valproic acid (500 mg bid) phenobarbital
Petit mal seizure
SS:
brief, abrupt LOC
blank stare with eyelids twitching
no response to voice
no falls, involuntary mvmt, post-ictal phase, attacks cease abruptly
Typically seen in little kids and then they grow out of it
Eval: Glucose Mg Ca Lumbar puncture
Txt:
valproic acid
Partial seizure
Simple partial seizure - no alt or loss consciousness
Complex partial - involves change in LOC or mentation
usually bizarre sx like visceral, hallucinations, memory disturbances, dream like states, automatisms, affective disorders
Concussion
Def: Transient LOC or alteration conciousness
SS: Duration secs to hours Post-concussive syndrome SS - HA - memory - anxiety - insomnia - dizziness
