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Year 4 Mind and Movement > Neurology pre-placement > Flashcards

Neurology pre-placement Flashcards

1
Q

what are the main PC in neurology

A
  • Headache
  • Loss of consciousness
  • Weakness of limbs
  • Sensory alteration
  • Impaired speech
  • Vertigo or dizziness
  • Confusion
  • Change in vision
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2
Q

how does increased ICP usually present

A

Headache triggered by changes in position or exertion. Changes in vision when leaning forwards

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3
Q

how does migraine usually present

A

Unilateral, pounding, multiple triggers, lasts for hours, aversion to bright light and loud noises, can be preceded by aura

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4
Q

how does acute glaucoma present

A

Pain around eye, blurred vision with halos around lights

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5
Q

how does subarachnoid haemorrhage present

A

Sudden onset, excruciating headache

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6
Q

how does trigeminal neuralgia present

A

Brief stabbing pain when brushing teeth or chewing

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7
Q

how does cluster headache present

A

20 minute unliteral, debilitating episodes of retro-orbital pain with red eye and eye watering

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8
Q

How does temporal arteritis present

A

scalp tenderness, unilateral, jaw claudication

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9
Q

how does meningitis present

A

Photophobia, neck stiffness and fever

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10
Q

how does tension headache present

A

Tight band like sensation, precipitated by stress

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11
Q

how does sinusitis present

A

facial tenderness and rhinorrhoea

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12
Q

name the red flags for for headache

A

Sudden onset high severity headache
Headache with fever
New onset neurological deficit
New onset cognitive dysfunction
Change in personality
Impaired level of consciousness
Recent head trauma (within past three months)
Headache triggered by cough, sneeze, exercise, or changes in posture.
Headache associated with halos around lights or headaches that get worse in the dark.
Headache associated with jaw claudication and scalp tenderness.

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13
Q

name some things to consider when taking a LOC history

A

what happened before LOC, was there any trigger
did you get any warning
what happened during
the characteristics
what happened after
any post ictal symptoms, tongue biting, incontinence, injury
any episodes in the past

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14
Q

during fundoscopy what would indicate raised ICP

A

papilloedema

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15
Q

what does rapid afferent pupillary defect suggest

A

sign of damage to the optic nerve of the affected side

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16
Q

tell me which cranial nerves are responsible for the different eye movement

A

SO4, LR6 all the rest are 3

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17
Q

what are saccades and how are they tested

A

rapid eye movements between the two targets are known as saccades ( may indicate movement disorder such as progressive supra nuclear palsy PSP)

hold palm one side and fist in the other

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18
Q

if the forehead is spared in facial weakness what does this suggest

A

stroke as this is an upper motor neurone pathology

19
Q

if there is a CNX palsy which way will the uvula deviate

A

away from the side with the lesion

20
Q

if there is a CNXII palsy which way will the tongue deviate

A

towards the side with the lesion

21
Q

if there is pronator drift what does this suggest

A

indicates a lesion in the pyramidal tracts, an UMN lesion

22
Q

tell me about the reflexes in LMN pathology

A

they are decreased or absent

23
Q

tel me about the reflexes in UMN pathology

A

exaggerated

24
Q 
which nerves are the following reflexes 
biceps
supinator 
tricep
knee 
ankle
A 
biceps C5/6
supinator C6/7
tricep C7/8
knee L3/4
ankle S1
25
Q

if the plantar reflex points upwards what does this suggest

A

UMN pathology

26
Q

what should you check in a patient with meningitis

A

neck stiffness and photophobia

27
Q

in Parkinson’s disease what kind of tremor do they have

A

resting pill tremor (most easily seen when the patient is distracted with another task ie get them to close their eyes and count backwards from 20)

28
Q

medical research council scale for reporting muscle strength from 1 to 5. what does each number mean §

A 
0 no power 
1 twitching but no movement 
2 movement but can't overcome gravity 
3 can overcome gravity
4 movement against gravity and resistance 
5 normal muscle strength
29
Q

name the structures that are considered CNS structures and therefore UMN

A

white matter tracts, motor cortex and the spinal cord

30
Q

name the structure that are considered PNS structures and therefore LMN

A

neuromuscular junction, nerve root, anterior horn cell and motor nerve

31
Q

both upper and lower motor neurone injuries will have non specific weakness however what is the main difference

A

UMN will have increased reflexes and tone

LMN will have decreased reflexes with normal/decreased tone and fasciculations

32
Q

what information does the dorsal columns carry

A

fine touch and proprioception

33
Q

what information does the spinothalamic tracts carry

A

pain and temperature

34
Q

where do motor pathways cross and why does this matter in terms of lesion location

A

cross at medulla so if lesion is above medulla will be contralateral signs
if below the medulla will be ipsilateral signs

35
Q

what signs will brainstem lesions show

A

contralateral signs in the limbs and ipsilateral cranial nerve signs

36
Q

if someone has a stab wound affecting a semi section of the spinal cord what is this referred to and

A

brown-sequard syndrome

37
Q

what signs would you expect to see in a right sided brown-sequard syndrome

A

affected spinal cord so will get UMN signs such as increased tone and brisk reflex
loss of sensation to right side below lesion
right side loss of vibration, proprioception and fine touch
left side loss of temperature and pinprick as the nerves decussation at the level of the spinal cord

38
Q

where does the dorsal column nerves decussate compared to spinothalamic

A

dorsal column decussate in brainstem whereas spinothlamic decussate at the level of the spinal cord

39
Q

in homonymous hemianopia which part of the visual pathway is damaged

A

the occipital cortex or optic radiation

40
Q

in bitemporal hemianopia which structure of the visual pathway is damaged

A

the optic chiasm

41
Q

in monocular blindness which part of the visual pathway is damaged

A

the optic nerve

42
Q

note that a sudden onset of excruciating headache with a background of polycystic kidney disease is suggestive of what

A

subarachnoid haemorrhage

43
Q

what scan would you order to distinguish between haemorrhage and ischaemic stroke

A

CT scan as it will show the intraparenchymal blood collections seen in a haemorrhagic stroke

44
Q

in MS what symptoms may spontaneously resolve and so need to ask about

A

incontinence, leg weakness and eye pain

Year 4 Mind and Movement (3 decks)

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