neurology hard qs Flashcards

1
Q

what is cytoarchitecture classification based on? 5

A

STRUCUTRE, FUNCTION, SPACING PACKING DENSITY. BRODMANN AREAS

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2
Q

6 roles of frontal lobe

A
HIGHER FUNCTIONS,
 DECISION MAKING,
 PEERSONALITY, 
MOVEMENT 
LANGUAGE
 MEMORY 
ATTENTION
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3
Q

what is the role of the parietal lobe

A

SOMATOSENSORY, SPATIAL ORIENTATION AND PROPRIOCEPTION

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4
Q

3 roles of the temporal lobe?

A

hearing
memory
emotion

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5
Q

4 structures in the limbic lobe?

A

amygdala
mamillary body
gingulate gyrus
hippocampus

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6
Q

roles of limbic lobe

A

emotion
reward pathway
memory
learning

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7
Q

where is the insular cortex located

A

UNDER LATERAL FISSURE

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8
Q

what is the role of the insular cortex

A

visceral sensation, interoception, autonomics, auditary and vestibular processing

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9
Q

what lobes do the arcuate fasicululs gibre connect?

A

trontal to temporal

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10
Q

what lobes do the arcuate fasicululs gibre connect?

A

trontal to temporal

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11
Q

what doe sthe uncinate fasciculus connect?

A

temporal to frontal

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12
Q

how are primary cortices arranged

A

tophographically

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13
Q

what is seen in parietal lobe lesions

A

contralateral neglect

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14
Q

what things are seen in temporal lobe lesions

A

agnosia

antograde amnesia

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15
Q

how does fmri work

A

LOOKS AT APRT OF BRAIN EBIN USED IN SPECIFIC ACTIONS BY BLOOD OXYGEN IN REGION

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16
Q

what is the priinciple underlying tdcs

A

TRANSCRANIAL DC TIMULATION. USED DC OVER SCALP TO INCREASE/DECREASE NEURONAL FIRING RATES

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17
Q

how does dti work

A

imaging tracts using h2o diffusion

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18
Q

what is the first branch of the subclavian artery

A

vertebral artery

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19
Q

what is the FAST of stroke

A

face
arms
slurred speech
call ambulacne

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20
Q

features of anterior cerebral artery stroke?

A

LEG PROBLEMS, PERSONALITY CHANGESM LOSS OF INTELLECT, JUDGEMENT

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21
Q

FEATURES OF middle CEREBRAL ARTERY STROKE?

A

ARM PROBLEMS, HEMIANOPIA, APHASIA, HEMISENSORY DEFICITS

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22
Q

POSTERIOR CEREBRAL ARTERY STROKE SIGHNS?

A

VISION PROBLEMS AGNOSIA HOMONYMOUS HEMIANOPIA PROSOPAGNSIA

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23
Q

2 roles of tectospinal tract?

A

POSTURE

CHANGES MUSCLE TONE

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24
Q

when may the rubrospinal tract become more active

A

NNERVATE FLEXORS OF UPPER LIMBS IF CORTICOSPINAL INJURY

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25
Q

what is apraxia

when does it occur

A

APRAXIA - DISORDER OF FINESKILLED MOVEMENT.

OCCURS IN LESION OF SUPPLEMENTARY MOTOR AREA AND PREMOTOR CORTEX

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26
Q

when are fibrillations visable

A

emg

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27
Q

umn signs of ALS

A

DYSARGHIA, HYPERREFLEXIA, SPASTICITY BABINSKIS SIGN DYSPHAGIA

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28
Q

lmn symptoms of als

A

DYSPHAGIA, WEAKNESS, AYSARGHIA FASCICULATIONS AND WASTING, ATROPHY

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29
Q

what is the basal ganglia

A

SERIES OF STRUCTURES WICH HELP WITH MOTOR CONTROLL

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30
Q

role of the caudate nucleis

A

decision to move

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31
Q

role of lentiform nucleus

A

elaborating associated movements

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32
Q

role of substantia nigra

A

suppressing unwanted movemenrt

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33
Q

role of ventral pallidum

A

performing movements in order

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34
Q

what is damaged in ballism

A

subthalamic nucleus

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35
Q

5 symptoms of parkinsons

A
BRADYKINESIA, 
HYPOMIMIC FACE, 
AKINESIA, 
RIGIDITY, 
TRMOR AT REST
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36
Q

5 symptoms of huntingtons

A
CHOREIC MOVEMENTS,
 SPEECH IMPAREMENT, 
DYSPHAGIA, 
UNSTEADY GAIT, 
DEMENTIA
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37
Q

what is the role of the vestibulocerebellum?

what is seen in lesions?

A

BALANCE HEAD AND EYE MOVEMENTS AND BALANCE

BALANCE ISSUE, FALLS ATAXIA

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38
Q

what is the role of the spinocerebellum? what is seen in lesions?

A

COORDINATION OF SPEECH AND LIMB MOVEMENT

LESION DUE TO CHRONIC ALCHOHOLISM - ABNORMAL GAIT AND STANCE

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39
Q

role of cerebrocerebellum? what is seen in lesion?

A

EMOTION REGULATION, COGNITIVE FUNCTION AND LANGUAGE PROCESSING

LESIONS AFFECT ARMS, SKILLED MOVEMENT, SPEECH, TREMOR

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40
Q

5 broad symotoms of cerebellar dysfucntion?

A
ATAXIA
 DYSMETRIA 
INTENTION TREMOR 
DYSDIADOCHOKINESIA 
SCANNING SPEECH
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41
Q

where are alpha motor neurones found/

A

anterior horn of grey matter

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42
Q

what do alpha motor neurones innervate

A

extrafusal muscle fibres

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43
Q

what is a motor neuone pool

A

all alpha motor neurones that go to a single muscle

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44
Q

what do gamma motor neurones do

A

innervate intrafusal muscle fibres

detect and alter sensitivity to stretch

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45
Q

what is clonus

A

repeated rhythmic movements

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46
Q

2 ways dementia can be diagnosed?

A

plasma/csf markers

pet scanning

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47
Q

3 stages of dementia developemtn?

A

PRECLINICAL - LOSS OF CELL FUNCTION BUT NO PHENOTYPE
MILD COGNITIVE IMPAIRMENT
DEMENTIA

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48
Q

outline the clincial process for a dementai diagnosis

A

referral
clinical interview
neuro eam
investgations including mmse and inmaing

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49
Q

what is assessed in the nurological exam for dementia?

A

cns
gait
frontal lobe
psych

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50
Q

what is measured in neuropsychology?

A

mmse

aceIII

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51
Q

what is lewy bodies characterised by?

A

hallucinations within 1 year of parkinsonian symotms

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52
Q

what type of memory loss occurs in altzheimers and why?

A

short term

hippocampus loss

53
Q

what is seen in csf of altzheimers?

A

low amyloid

hihg tau

54
Q

what is seen on lewy body pet scan

A

reduced dopamine uptake

55
Q

what is seen on frontotemporal demeentia mri

A

atrophy of frontal lobe

assymetric and perisylbian fissure volume loss

56
Q

symtoms of meningism?

A

PHOTOPHOBIA NAUSEA VOMITNG STIFF NECK PHONOPHOBIA

57
Q

8 red flag headach neurological symptoms?

A
VISUAL LOSS, 
CONFUSION, 
SIEZURES, 
HEMIPARESIS, 
DOUBLE VISION, 
3RD NERVE PLASY
 HORNER SYNDROME
 PAPILLOEDEMA
58
Q

what is seen in horners syndrome

A

SYMPATHETIC DAMAGE - CONSTRICTED PUPIL, DROOPY EYE, ENOPTHALMOS dry eye

59
Q

how is a subarachnoid visualised

A

ct and angiogram

60
Q

what occurs naturally to stop subarachnoids

A

vasospasm

61
Q

3 ways of diagnosing carotid/vertebral dissection?

A

angiogram
doppler
mri

62
Q

what is seen on ct for subdural

A

flaxign herniation

63
Q

which group often gets temporal arteritis

A

women over 55

64
Q

presenting symptoms of temporal arteritis

A

PAIN BRUSHING HAIR
UNILATERAL HEADACHEM
JAW CLAUDICATION

65
Q

how is temporal arteritis treated?

A

steriods 3-4 years

asprin

66
Q

what condition is often seen with temproal arteritis

A

polymyalgia rheumatica

67
Q

serious complication of temporal arteritios

A

BLINDNESS DUE TO INVOLVEMENT OF POSTEIOR CILLARY MUSCLES

68
Q

what serology is seen in temporal arteritis?
what is seen on ultrasound
what is seen on biopsy

A

increased crp and esr
halos on uss
biopsy giant cells and inflammation

69
Q

4 causes of cerebral venous thrombosis

A

thrombophilia
pregnancy
dehydratino ]behcets

70
Q

what happens in herpes simplex encephalitis

A

haemorrhagic changes to temporal lobe

71
Q

symptoms of sinusitis

A

ANOSMIA
CATARRH
FOCAL TENDERNESS IF PRESS SINUS

72
Q

when is sinusitis worst?

A

morning

73
Q

symptoms of pseudotumour cerebri

A

VISUAL DISTURBANCES WHEN BENDING DOWN, HEADACHE, PAPILLOEDEMA
DIPLOPIA AND TINITTUS

74
Q

what is pseudotumour caused by?

A
HYPERTENSION AND OBESITY ,
 COP 
STERIODS
 ABS 
VIT E
75
Q

treatments of pseudotumour

A

WEIGHT LOSS
DIURETICS
OPTIC NERVE SHEATH SECOMPRESSION LUMBOPERITONEAL SHUNT,
STENTING VENOUS SINUSES

76
Q

4 treatments for trigeminal neuralgia

A

carbemazepine
lamotrigine
gabapentin
posterior fossa decoompression

77
Q

2 arms of migrane symptoms

A

focal symptoms and or headache

78
Q

2 arms of migrane symptoms

A

focal symptoms and or headache

79
Q

what is seen in prodrome

A

CHANGES IN MOOD, CRAVINGS, URINATION, FLUID RETENTION

80
Q

what happens in elemental visual disturbance

A

VISUAL DISTURBANCES MOVING FROM CENTRE TO EDGE OF VISION DUE TO SPREADING ELECTRICAL DEPRESSION

81
Q

drugs for migrane

A

paracetamol and metraclopride

triptans and nsaids

82
Q

what is tms

A

transcranial magnetic stimulation for migranes

83
Q

prophylactic drugs for migranes

A
over the counter preps 
trycyclic antidepressants 
beta blockers 
serononin agonist 
botox crown of thorn 
cop
84
Q

what doese erenumab target

A

cgrp antagonists - disables calcitonin gene receptor

85
Q

what type of pain does a cluster headache produce

A

severe unilateral

86
Q

acute treatment for cluster headaches

A

inhaled o2

triptans

87
Q

1st line prevention for cluster headaches

A

prevented with verapamil

88
Q

what are the afferent signals for crying

A

CORNEA, CN6, OPTHALMIC TRIGEMINAL

89
Q

what. are the whites of the eye made out of

A

sclera

90
Q

what is the choroid

A

vascular coat behind sclera

91
Q

5 layers of cornea

A
epithelium 
bowmans membrane 
stroma 
decemets membrane 
endothelium
92
Q

role of corneal endothelial cells?

A

PUMP FLUID OUT OF CORNEA AND PREVENT OEDEMA

93
Q

what is the uvea and what are the 3 parts

A

VASCULAR COAT OF THE EYE.
IRIS
CILARY BODY AND
CHOROID

94
Q

where is the lens

A

behind iris

its for accommodation

95
Q

where is the highest conc of cones

A

fovea of macula

96
Q

what are the first order/second/third order neurones in the transmission of light?

A

1ST - RODS/CONES
2ND - BIPOLAR CELLS
3RD - RETINAL GANGLION CELLS

97
Q

3 different types of cone?

A

S CONE - BLUE
M CON - GREEN
L CONE - RED

98
Q

what happens in myopia

A

excess refraction

globe too long

99
Q

what happens in axial hyperopira

A

globe too short

100
Q

what is ambylopia

A

uncorrected hyperopia >5d

101
Q

outlien the course of the optic nerve

A

PARTIAL DECUSSATION AT OPTICC CHIASM - OPTIC TRACT - LATERAL GENICULATE NUCLEIS - VISUAL CORTEX

102
Q

what would casue right homonymous hemianopia?

A

left cerebrovascular event

103
Q

why is the macula sometimes spared

A

AS A DUAL BLOOD SUPPLY FROM BOTH POSTERIOR CERBRAL ARTERIES

104
Q

3 things that happen when the eye is exposed to light

A

CONSTRICTION PSNS.
INCREASED SEPTH OF FIELD.
REDUCED BLEACHING OF PHOTOPIGMENTS

105
Q

how is the so tested?

A

look down and in

106
Q

how is the io tested?

A

look up and in

107
Q

what is the main role of the middle ear?

A

amplify sound and transmit to cochlea

108
Q

describe the uncoiled structure of the cochlea

A

SCALA VESTIBULI, SCALA MEDIA, SCALA TYPMANI

109
Q

what is contained in the basillar membrane

A

organ of corti

110
Q

how is neurotrasmitter produced by the hair cells

A

DEFLECTION OF STERIOCILIA TO LONGEST CILIUM - OPENS K+ CHANNELS - DEPOLARISATION - CA2+ INFLUX - LIBTERATION OF NT

111
Q

outline the auditory pathway

A

SPIRAL GANGLIA IN COCHLEA - CN8 - IPSILATERAL COCHLEAR NUCLEI - CONTRALATERAL SUPERIOR OLIve - INFERIOR COLLICULILS - MEDIAL GENICULATE BODY - AUDITORY CORTEX IN TEMPORAL LOBE

112
Q

what does tympanometry measure

A

MIDDLE EAR AND EAR DRUM MOTILITY BY CREATING VARIATIONS OF AIR PRESSURE IN THE EAR CANAL

113
Q

what is used for newborn hearing screening

A

OBOACOUSTIC EMISSIONS

noise of haircells contracting

114
Q

how does ABR work?

A

measure electrical activity from cn8

115
Q

2 types of hearing problems?

A

sensiorineural

conductive

116
Q

which part of the ear is the vestibular organ located

A

labrinth

117
Q

what is the vestibule formed of

A

utricle and saccule

118
Q

how are hair cells arranged in the utricle and saccule

A

horizontal in urtricle

verticle in saccule

119
Q

how do semicircular canals detect movement

A

HAIR CELLS IN AMPULLAE ARE SURROUNDED BY CUPULA - THIS HELPS HAIR CELL MOVEMENT AND DEFLECTION

CANAL HAS ENDOLYMPH WHICH PUSHES THE CUPULA TO ONE SIDE, CAUSING MOVEMENT OF HAIRS

120
Q

what movements d ootolith organs detect

A

linear accellaration and tilt

121
Q

what do semicircular canals detect

A

angular accellaration

122
Q

how do semicircular canels detect angular accelleration

A

HEAD MOVEMENT - ANGULAR ACCELLARATION - ENDOLYMPH FLOW - CUPULA DISPLACEMENT - HAIR CELL DISPLACEMENT - CN8 SIGNAL

123
Q

how are semicircular canals paired

A

opposite sides anterior and posteior

laterals together

124
Q

how do caloric tests wwork

A

STIMULATING INNER EAR WITH TEMPS - GENNERATE ASSYMETRY - EYE MOVEMENT

125
Q

how does vertibular evoked myogenic potential work

A

measures connection between neck and vestibular system. sees if theres a response in the neck muscles

126
Q

how does the rotational test wrok

A

detects if the organ is sensing and reflexing

127
Q

2 locations of vestivular disorders?

A

peripheral - labrinth or cn8

central - brainstem/cerebellum

128
Q

examples of peripheral disorders?

A
VESTIBULAR NEURITIS, BPPV (ITHOLODS IN CANALS)
MENIERS DISEASE (INCREASED LIQUID IN EAR)
129
Q
give an example of:
a acute 
b recurrent 
c intermittent 
d progressive 
vestibular disorders
A

A. acute VESTIBULAR NEURITIS
B. reccurent MENIERES DISEASE
C. intermittent BPPV
D. progressive MS