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Finals > Neurology > Flashcards

Neurology Flashcards

1
Q

What movement tests C5 nerve root? Which muscle is involved?

A

Shoulder abduction

Deltoid. Also tests axillary nerve.

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2
Q

What movement tests C6 nerve root? Which muscle is involved?

A

Elbow flexion

Brachioradialis

Not biceps, which has mixed root innervation.

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3
Q

What movement tests C7 nerve root? Which muscle is involved?

A

Wrist extension

Wrist extensors. Also tests radial nerve.

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4
Q

What movement tests C8 nerve root? Which muscle is involved?

A

Finger extension

Long extensors.

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5
Q

What movement tests T1 nerve root? Which muscle is involved?

A

Finger abduction

Interossei muscles. Also tests ulnar nerve.

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6
Q

How do you specifically test the median nerve.

A

Thumb abduction.

Abductor pollicis brevis. Part of LOAF in the thenar eminence

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7
Q

What do you get claw hand in an ulnar nerve palsy?

A

Loss of lumbricals that normally flex the MCPs and extend the fingers.

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8
Q

Explain these findings:

Positive Rinne’s with equal Weber’s

A

Normal.

Positive Rinne’s = AC > BC

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9
Q

Explain these findings:

Negative Rinne’s on L side
Weber’s louder on L side

A

L sided conductive hearing loss

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10
Q

Explain these findings:

Positive Rinne’s
Weber’s louder on R side

A

L sided SNHL

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11
Q

What is the ABCD2 score for TIAs

A 
Age >60
BP >140/90
Clinical features: unilateral weakness (2) or speech impairment (1)
Duration (0-59 = 1, >60 = 2)
Diabetes

0-3 - discharge with review

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12
Q

Holmes-Adie pupil

A

Myotonic dilated pupil that is unresponsive to light and sluggish response to accommodation.

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13
Q

Argyll-Robertson pupil

A

Syphilitic Prostitute’s pupil

Accommodates but doesn’t react.
Small, irregular pupil with atrophied iris.

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14
Q

Marcus Gunn pupil

A

RAPD - pupil dilates on direct aspect of swing test.

Optic nerve atrophy and retinal disease

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15
Q

What happens to evoked potentials in MS?

A

They are delayed in all modalities including auditory, visual and sensory.

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16
Q

Causes of optic atrophy

A

Commonest: MS and glaucoma

VISION CAC
Vascular - DM, GCA, CVA
Inflammatory - MS
Sarcoid
Infectious - VZV, TB, syphilis
Oedema - papilloedema
Neoplasia - hymphoma/leukaemia infiltration

Compression - Glaucoma, neoplasm, Paget’s
Alcohol and other toxins
Congenital - Leber’s, HMSN, Friedrich’s

17
Q

Causes of RAPD

A

Optic atrophy

Retinal disease

  • retinal detachment
  • retinal vein or artery occlusion
  • severe diabetic retinopathy
  • age-related macular degeneration
18
Q

Signs of Lateral Medullary Syndrome

A

The key finding is loss of sensation to pain and temperature contralaterally in body and ipsilaterally in face. Due to disruption of spinothalamic tract and spinal trigeminal nucleus.

DANVAH

  • Dysphagia: disrupt CN IX + X
  • Ataxia: inferior cerebellar peduncle
  • Nystagmus: inferior cerebellar peduncle
  • Vertigo: vestibular nuclear
  • Anaesthesia - dissociated
  • Horner’s
19
Q

Definition of strabismus

A

Abnormal alignment of eyes

20
Q

Features of an oculomotor CN III palsy

A

Ptosis + divergent strabismus (down and out) + opthalmoplegia

Medical = normal pupil
Surgical = mydriasis
21
Q

How does the direction of nystagmus differ between cerebellar and vestibular cause?

A

Cerebellar: fast phase towards side of lesion, maximal towards side of lesion.

Vestibular: fast phase away from lesion, maximal away from side of lesion.

22
Q

What are the 4 types of Motor Neurone Disease?

A

Amyotrophic Lateral Sclerosis (50%)
Primary Lateral sclerosis (30%)
Progressive muscular atrophy (10%)
Progressive bulbar palsy (10%)

23
Q

Which type of MND has the best prognosis?

A

Progressive muscular atrophy

24
Q

Which type of MND has the worst prognosis?

A

Progressive bulbar palsy

25
Q

Which type of MND has only LMN signs?

A

Progressive motor atrophy

Anterior Horn cell lesion
Affects from distal to proximal

26
Q

Which type of MND has predominantly motor signs?

A

Progressive Lateral Sclerosis

Loss of Betz cells in motor cortex

27
Q

Which type of MND affects the CN 9-12?

A

Progressive Bulbar Palsy

28
Q

Which type of MND produces UMN and LMN signs?

A

Amyotrophic Lateral Sclerosis

29
Q

Cause of mixed UMN and LMN signs

A

MAST

MND
Ataxia,Friedrich’s
SCDC - B12
Taboparesis

Finals (17 decks)

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