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Specialities > Neurology > Flashcards

Neurology Flashcards

1
Q

At what nerves does the parasympathetic nervous system arise?

A

Cranial nerves 3, 7, 9 and 10

Sacral spinal nerves 2, 3, and 4

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2
Q

Does micturition have sympathetic or parasympathetic innervation?

A

Parasympathetic

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3
Q

What is the pathological cause of Alzheimer’s disease?

A

Cortical plaques due to deposition of type A-Beta-amyloid protein and intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein

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4
Q

Lesions in which lobe may cause anosmia?

A

Frontal lobe

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5
Q

What is anosmia?

A

The loss of the ability to discern smells

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6
Q

What are the symptoms of damage to the frontal lobe?

A
  • Expressive (Broca’s) aphasia
  • Disinhibition
  • Perseveration
  • Anosmia
  • Inability to generate a list
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7
Q

What is disinhibition?

A

The inability to withhold a prepotent response or suppress an inappropriate or unwanted behaviour. It can also refer to the production of socially inappropriate comments and/or actions.

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8
Q

What is perseveration?

A

The repetition of a particular response regardless of the absence or cessation of a stimulus

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9
Q

Damage to which lobe causes Broca’s aphasia?

A

Frontal lobe

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10
Q

Which structures pass through the jugular foramen?

A

Cranial nerves IX, X and XI

Internal jugular vein

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11
Q

What is Vernet syndrome?

A

Jugular foramen syndrome which is a group of cranial nerve palsies as a result of compression from a jugular foramen lesion.

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12
Q

What part of the hypothalamus controls satiety?

A

Ventromedial nucleus

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13
Q

What is hyperphagia?

A

Abnormal sensation of hunger/desire to eat leading to overeating

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14
Q

What function is carried by the corticospinal tract?

A

Motor

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15
Q

Where does the corticospinal tract cross the midline?

A

At the brainstem/medulla

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16
Q

Anatomically, where does the corticospinal tract run in the spinal cord?

A

Posterolaterally

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17
Q

What function(s) are carried by the spinothalamic tract?

A

Pain and temperature

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18
Q

Where does the spinothalamic tract cross the midline?

A

Immediately upon entering the spinal cord

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19
Q

Anatomically, where does the spinothalamic tract run in the spinal cord?

A

Anterolaterally

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20
Q

What function(s) are carried by the dorsal columns?

A

Vibration and proprioception

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21
Q

Where do the dorsal columns cross the midline?

A

At the brainstem/medulla

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22
Q

Anatomically, where do the dorsal columns run in the spinal cord?

A

Posteriorly

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23
Q

What spinal levels innervate the biceps?

A

C5/6

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24
Q

What spinal levels innervate the triceps?

A

C6, 7, 8

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25
Q

What spinal levels innervate the knees?

A

L3/4

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26
Q

What spinal levels innervate the ankles?

A

S1/2

27
Q

What are the six stages of the muscle power scale?

A 
5 = normal power
4 = movement possible against gravity and some resistance
3 = movement possible against gravity
2 = movement possible when gravity excluded
1 = flicker of contraction possible
0 = complete paralysis
28
Q

What is an AP view of the cervical spine?

A

Allows you to see the vertebrae

29
Q

What is a lateral XR of a cervical spine used for?

A

To check for misalignment

30
Q

What is an open mouth peg XR used for?

A

To check the odontoid process (it should be equidistant between the lateral masses of the atlas)

31
Q

What are the features of an essential tremor?

A
  • Postural tremor that gets worse if the arms are outstretched
  • Improved by alcohol and rest
  • Most common cause of titubation (head tremor)
  • Absence of other neurological signs or symptoms
  • Mainly symmetrical
32
Q

What is the management of essential tremor?

A

1st line = propranolol or primidone

33
Q

What is neuropraxia?

A

A transient (temporary) complete block of neuronal transmission that completely resolves spontaneously.

34
Q

What causes neuropraxia?

A
  • Blunt injuries
  • Compression
  • Stretching of nerves following dislocations and fractures
35
Q

What are the features of neuropraxia?

A
  • The nerve remains intact but electrical conductivity is affected
  • Myelin sheath integrity is preserved
  • No Wallerian degeneration
  • Autonomic function preserved
  • Recovers spontaneously
36
Q

What is Kluver-Bucy syndrome?

A

A syndrome resulting from bilateral lesions on the medial temporal lobe (including the amygdala)

37
Q

What are the features of Kluver-Bucy syndrome?

A
  • Hyperorality (putting inappropriate objects in your mouth)
  • Hypersexuality
  • Hyperphagia
  • Visual agnosia (inability to recognise objects and people)
  • Docility
38
Q

What do lesions/damage to the frontal lobe cause?

A
  • Expressive (Broca’s) aphasia
  • Disinhibition
  • Perseveration
  • Anosmia
  • Inability to generate a list
39
Q

Damage to what location causes expressive (Broca’s) aphasia?

A

Posterior aspect of the frontal lobe, specifically the inferior frontal gyrus

40
Q

What is a lacunar stroke?

A

The most common type of ischaemic stroke where small penetrating arteries that supply the deep brain structures are occluded. There is a strong association with hypertension.

41
Q

What is the presentation of a lacunar stroke?

A
  • Isolated hemiparesis
  • Hemisensory loss
  • Hemiparesis with limb ataxia
42
Q

What are the commonly affected areas of the brain in a lacunar stroke?

A
  • Basal ganglia
  • Thalamus
  • Internal capsule
43
Q

What is autonomic dysreflexia?

A

A condition triggered by faecal impaction or urinary retention resulting in sympathetic stimulations and hyperactivity seen as uncontrolled hypertension and bradycardia above the level of a spinal cord lesion

44
Q

What patients are at risk of autonomic dysreflexia?

A
  • Spinal cord injuries with lesions at or above T6

- Guillain-Barré syndrome

45
Q

What medication is used for long-term prophylaxis of cluster headaches?

A

Verapamil

46
Q

What is the most appropriate diagnostic investigation for bitemporal hemianopia?

A

MR of pituitary fossa

47
Q

What is acute dystonic reaction?

A

Involuntary contractions of muscles of the extremities, face, neck, abdomen, pelvis, or larynx in either sustained or intermittent patterns that lead to abnormal movements or postures

48
Q

What is the cause of acute dystonic reaction?

A

Dopaminergic-cholinergic imbalance in the basal ganglia caused by dopamine-receptor blocking agents

49
Q

What medications commonly cause acute dystonic reaction?

A

Antipsychotics (particularly typical/1st gen) and antiemetics (particularly metoclopramide and prochlorperazine)

50
Q

What is Holmes-Adie syndrome?

A

A rare condition that causes dilated pupils, slow pupil reaction to light as well as absent/reduced tendon reflexes

51
Q

When the eye is deviated ‘down and out’ what nerve palsy does this indicate?

A

Occulomotor

52
Q

What pathological process occurs in motor neuron disease?

A

Loss of large cholinergic neurones from the spinal cord

53
Q

What is essential tremor?

A

Progressive, symmetrical, involuntary tremor of the hands, forearms, voice and head that is usually absent at rent and present during posture and intentional movements

54
Q

What substances reduces essential tremor?

A
  • Alcohol
  • Benzos
  • Barbiturates
  • Gabapentin
55
Q

What are the characteristics of Parkinsonian tremor?

A
  • Resting

- Unilateral

56
Q

When do enhanced physiological tremors appear?

A

In situations of stress, anxiety or excessive caffeine use i.e. in the absence of neurological disease

57
Q

What is cervical radiculopathy?

A

When a nerve in the neck is compressed or irritated where it branches away from the spinal cord

58
Q

What are the signs and symptoms of cervical radiculopathy?

A
  • Burning/sharp pain in the neck travelling down the arm along the nerve path
  • Tingling/pins and needles in fingers and hand
  • Weakness in muscles of arm, shoulder or hand
  • Exacerbated by neck movements
59
Q

What are the key diagnostic factors for motor neuron disease?

A
  • Fasciculations
  • Mixture of upper and lower motor neuron symptoms
  • Wasting of small hand muscles
  • No sensory loss
60
Q

What is myasthenia gravis?

A

A chronic autoimmune disorder of the post-synaptic membrane at the neuromuscular junction in skeletal muscle

61
Q

What are the characteristic signs and symptoms of myasthenia gravis?

A
  • Muscle weakness that increases with exercise and improves on rest
  • Drooping eyelids
  • Double vision
  • Oropharyngeal/appendicular weakness
  • Dyspnoea
62
Q

What is a myasthenic crisis?

A

Exacerbation of symptoms leading mechanical ventilation being required

63
Q

What is the first-line treatment for myasthenia gravis?

A

Pyridostigmine (acetylcholinesterase inhibitor)

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