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CP3 Medicine > Neurology - Basic Neuroanatomy and Physiology > Flashcards

Neurology - Basic Neuroanatomy and Physiology Flashcards

1
Q

Blood supply to medial surface cerebral hemisphere

A

Anterior cerebral aa

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2
Q

Blood supply to lateral 2/3 brain

A

Middle cerebral aa

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3
Q

What do the central branches of the middle cerebral aa supply/

A

Corpus striatum
Thalamus
Internal capsule

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4
Q

What does the posterior cerebral aa supply

A

corpus callosum

occipital and temporal lobes

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5
Q

Which arteries supply the brainstem and cerebellum

A

Vertebral aa

Basillar aa

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6
Q

Location olfactory nn

A

Olfactory epithelium

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7
Q

Function CN I

A

Sensory - smell

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8
Q

Location optic nn

A

Retinal ganglion

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9
Q

Function CN II

A

Sensory - vision

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10
Q

Function CN III

A

Motor - 4/6 extraocc mm + LPS

Visceral - pupil constriction

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11
Q

Function CN IV

A

SO mm

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12
Q

Location CN III and IV

A

Midbrain

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13
Q

Function CN V1

A

Ophthlamic
SUperior 1/3rd sensation
+ cornea

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14
Q

Function CN V2

A

Maxillary

Middle 1/3rd sensation

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15
Q

Function CN V3

A

Mandibular
Bottom 1/3rd sensation
Mm mastication

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16
Q

Function CN VI

A

LR mm

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17
Q

Function CN VII

A

Motor - facial expression. Visceral glands (SM,SL and lacrimal)
Sensory - ant 2/3 tongue, around ear

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18
Q

Location CN V, VI and VII

A

Pons

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19
Q

Function - CN VIII

A

Balance

Hearing

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20
Q

Location CN VIII

A

Vestibular ganglion

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21
Q

Function - CN IX

A

Motor - swallow (stylopharyngeus) and parotid gland

Sensory - post 1/3rd tongue

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22
Q

Function CN X

A

Motor - soft palate, parasymp of trachea, bronchi, digestive tract
Sensory - taste, epiglottis, sensation viscera

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23
Q

Function CN XI

A

Motor - SCM and trapezius

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24
Q

Location CN XI

A

SC

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25
Q

FUnction CN XII

A

Tongue mm

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26
Q

Location CN IX, X + XII

A

Medulla

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27
Q

Where in the brain does a bulbar palsy occur

A

LMN of CN 9, 10 + 12

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28
Q

PS bulbar palsy (5)

A 
Tongue - wasting flaccid + fasciculations 
Dysphagia 
Poor elevation soft palate 
Quiet and nasal speech 
Jaw jerk + gag reflex absent
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29
Q

Causes bulbar palsy (5)

A 
MND
Stroke 
GBS
Infective 
Neoplastic
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30
Q

Where is the brain does a pseudobulbar palsy occur

A

Bilateral UMN of CN 9,10,12

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31
Q

PS pseudobulbar palsy (5)

A 
Tongue - stiff/spastic, slow movement 
Dysphagia 
Normal elevation SP 
Donald duck speech 
Incr jaw jerk and normal gag reflex
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32
Q

Cause pseudobulbar palsy (4)

A

MND
Stroke
MS
Head trauma

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33
Q

Sx frontal lobe lesion (5)

A 
Intellectual impairment 
Personality changes 
Incontinence 
Paralysis 
Brocas aphasia
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34
Q

Sx temporo-parietal lesion (left)

A 
Agraphia
Alexia
Acalculia
Wernicke's aphasia
Contralateral sensory neglect
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35
Q

Sx temporo-parietal lesion (right)

A

No face recognition

Contralateral sensory neglect

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36
Q

Sx occipital lobe lesion

A

VF defects

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37
Q

Fct vermis

A

Midline posture and balance

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38
Q

Fct flocculonodular lobe

A

eyes movements

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39
Q

Fct cerebellar hemisphere

A

Control limb movement

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40
Q

O/E Cerebellar lesion

A 
Dysdiadokinesis
Ataxia
Nystagmus 
Intention tremor 
Speech - slurred, staccato
Hypotonia/Heel-shin
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41
Q

Bilateral causes cerebellar dysfunction (4)

A

Alcohol
Dx - phenytoin, anti-epileptics
Paraneoplastic degeneration
Hypothyroid

42
Q

Unilateral causes cerebellar dysfunction (3)

A

MS
Stroke
Tumour - acoustic neuroma, meningioma

43
Q

Sections of the Basal Ganglia (4)

A

Corpus striatum
Subthalamic nucleus
Substantia nigra
Thalamus

44
Q

What 3 things make up the corpus striatum?

A

Caudate nucleus
Globus Pallidum
Putamen

45
Q

Function of basal ganglia

A

Modulates motor activity

46
Q

Signs Basal ganglia dysfunction

A

Bradykinesia
Rigidity
Involuntary tremor

47
Q

What is athetosis

A

Writhing movements of hands/face/tongue

48
Q

Causes of BG dysfunction (3)

A

Parkinsonism
Huntington’s
Hemiballismus

49
Q

Causes of central scotoma

A

Macular lesion

50
Q

Causes of bitemporal hemianopia

A

Optic chiasm lesion

51
Q

Causes of homonomous hemianopia

A

Contralateral optic tract lesion

52
Q

What area of the brain is Broca’s area

53
Q

Fct Broca’s area

A

Motor speech function

54
Q

Sx Broca’s aphasia

A

Expressive aphasia (non-fluent)

55
Q

What area of the brain is Wernicke’s area

A

Area 22 (temporal)

56
Q

Fct Wernicke’s area

A

Understanding of spoken word

57
Q

Sx Wernicke’s aphasia

A

Receptive aphasia

Cant understand speech/word salad

58
Q

What is global aphasia

A

Expressive AND receptive

59
Q

What is nominal aphasia

A

Difficulty word finding

60
Q

What is dysarthria

A

Disordered articulation

Slurred speech

61
Q

Bulbar palsy - dysarthria

A

LMN, high pitched nasal speech

62
Q

Pseudobulbar palsy dysarthria

A

UMN

Donald duck voice

63
Q

Cerebellar lesion dysarthria

A

Slow jerky speech

64
Q

Extrapyramidal lesion dysarthria

A

Soft monotonous speech

65
Q

Myasthenia gravis - dysarthria

A

Speech fatigues + dies away

66
Q

PS - Horners syndrome (PAMELA)

A 
Ptosis 
Anhydrosis 
Miosis 
Enophthalmos 
Loss of ciliary-spinal reflex
Anisocoria
67
Q

If Horners syndrome is congenital, what extra sign may the patient have?

A

Heterochromia (diff eye colour)

68
Q

1st order neuron - causes Horners syndome (4)

A

Tumour
Stroke
MS
Syphillis

69
Q

Anhidrosis - 1st order neurone Horners syndrome

A

Face/arm/trunk anhidrosis

70
Q

2nd order neuron causes of Horners syndrome (6)

A 
Pancoast trumour 
Cervical rib 
TB
Trauma (neck) 
Lymphadenopathy (neck) 
Thyroid surgery
71
Q

Anhidrosis - 2nd order neurone Horner’s syndrome

A

Facial anhidrosis only

72
Q

3rd order neurone causes of Horners (3)

A

ICA aneurysm
Migraine
Idiopathic

73
Q

Anhidrosis - 3rd order neurone Horner’s syndrome

A

NO anhidrosis

74
Q

Signs LMN lesion

A 
weakness 
wasting 
fasciculation 
hypotonia 
hyporeflexia
75
Q

Do LMN innervate contralateral or ipsilateral muscles?

A

Ipsilateral

76
Q

Causes - LMN lesion (5)

A 
ventral horn - MND
Ventral horn - polio 
Peripheral nn pathology 
MG (NMJ) 
Mm pathology
77
Q

Signs UMN lesion

A 
Extensor weakness upper limb 
Flexor weakness lower limb 
No wasting
Hypertonia 
Hyperreflexia 
Pronator drift 
Incr plantar response 
Clonus
78
Q

Do UMN innervate contralateral or ipsilateral muscles

A

Contralateral

79
Q

Causes UMN lesion (6)

A 
Stroke 
Meningitis 
MS, MND
Tumour 
Degen - Parksinsons
80
Q

How to differentiate LMN and UMN facial weakness

A

UMN - spares frontalis - brow/eye closing + blinking preserved
LMN - ipsilateral facial weakness all mm

81
Q

Function of spinothalamic tract

A

Pain
Temperature
Light touch

82
Q

Which level does the spinothalamic tract decussate at?

83
Q

Function of dorsal column

A

Sensory
Fasciculus, cuneatus + gracilis
Deep touch, proprioception + vibration

84
Q

Which level does the dorsal column decussate at?

85
Q

What level does the corticospinal tract decussate at

86
Q

PS C3 cord transection

A 
Neurogenic shock 
Resp insufficiency 
Quadriplegia 
Anaesthesia below level 
Loss bladder/bowel sphincter tine 
Sexual dysfunction 
Horners ?
87
Q

PS T10 cord transection

A

Paraplegia
Anaesthesia below
Loss rectal/bladder tone
Sexual dysfunction

88
Q

Presentation Brown Sequard syndrome

A

Ipsilateral decrease in power, vibration + proprioception

Contralateral decr pain/T + light touch

89
Q

Cause Brown Sequard syndrome

A

Penetrating injury

Facet dislocation RTA

90
Q

PS Posterior cord lesion

A

Tingling, numbness + electric shocks
Clumsy
Sensory ataxia, loss positional/vibrational + 2 point discrim

91
Q

Anatomical position lumbar puncture

A

L4 - top of iliac crest

92
Q

What position is patient in when having a lumbar puncture

A

Lie on side + knees to chest

Curl over pillow

93
Q

Indications lumbar puncture (7)

A 
Meningitis/encephalitis 
SAH
MS 
Neurosyphilis 
Bechet's 
Measure/remove CSF - idiopathic intracranial HTN 
Intrathecal drug admin
94
Q

Complications LP

A 
Post LP headache 
Dry tap 
Infection 
Damage to spinal nn 
Coning
95
Q

C/I Lumbar puncture (5)

A 
Suspicion of incr ICP 
Overlying/local infection 
Congenital lesions - meningomyelocele 
Problems w/ haemostasis 
Haemodynamically unstable
96
Q

What is Xanthochromia

A

Yellowish CSF

97
Q

Why does xanthochromia occur

A

B/c RBC breakdown –> bilirubin

98
Q

Cause xanthochromia

99
Q

Features of CSF in MS

A

Moderate increase in protein
50 lymphocytes/ml
Oligoclonal IgG bands (electrophoresis)

100
Q

C/I MRI (4)

A

Implanted devices
E.g. pacemaker, drug infusion pumps, cochlear implants
Implants w/ metal
Bullet/shrapnel

CP3 Medicine (29 decks)

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