Neurology (Week 12) Flashcards
Give 3 signs of a lower motor neurone lesion
Wasting
Loss of tone
Fasciculations
Give 2 signs of an upper motor neurone lesion
Increased tone
Weakness
What is the radial nerve responsible for in the arm?
Almost all extensor functions and snuff box sensation
What is the median nerve responsible for in the arm?
Forearm flexors and LOAF muscles of the hand
What is the ulnar nerve responsible for in the arm?
Fine motor movement and some wrist flexion
What is the femoral nerve responsible for?
Hip flexion and knee extension
What is the definition of a seizure?
Sustained and synchronised electrical discharge in brain causing signs and symptoms
In a tonic clonic seizure, what do the tonic and clonic phases consist of?
Tonic: generalised increased tone
Clonic: jerking
What is a partial seizure?
Activity restricted to one part off the brain with focal signs/symptoms
What is epilepsy?
Tendency to have recurrent unprovoked seizures
What is status epilepticus?
Prolonged medical emergency seizure
Give an example of a positive motor neurone sign
Jerk
Give an example of a negative motor neurone sign
Weakness
Name the three types of ischaemic stroke
Large vessel
Small vessel
Posterior circulation
What is neglect?
Loss of sense of one side (fail to attend to any stimuli on particular side)
Name three risk factors for stroke
High BP
AF
Smoking
Name three causes of intracranial haemorrhage
Hypertension
Aneurysm
AV malformation
Briefly describe tPA treatment
Tissue plasminogen activator, a clot buster with a 4.5hr window after symptom onset
What is an aneurysm?
Swelling in wall of an artery, forming branch points at areas of maximum haemodynamic stress
Name three risk factors for subarachnoid haemorrhage
Female
Smoking
Connective tissue disorders
In subarachnoid haemorrhage, what can seizures often indicate?
Aneurysm re-rupture
Which type of signals do large myelinated nerve fibres transmit?
Motor information
Which type of signals do thin myelinated nerve fibres transmit?
Pain and temperature
Which type of signals do small unmyelinated nerve fibres transmit?
Light touch, pain and temperature
What are polyneuropathies?
Diffuse nerve involvement, usually motor and sensory
What pattern of onset do peripheral neuropathies tend to follow?
Start distally because those are longest nerves in body, pathology in axon as opposed to myelin sheath
What is Guillain-Barre syndrome?
Post-infectious inflammatory demyelinating neuropathy which ascends over days
What is myasthenia gravis?
AI condition where antibodies block ACh receptor at post-synaptic NMJ
What does bulbar mean?
Nerves emerging from the medulla
In Parkinson’s, which type of neutrons are lost from which area of the brain?
Dopaminergic neutrons from substantia nigra
Which two proteins mainly make up Lewy bodies?
Alpha synuclein and ubiquitin proteins
What are the three cardinal features of Parkinson’s?
Resting tremor
Rigidity
Bradykinesia
What is MS?
Idiopathic inflammatory demyelinating disease of the CNS
What are the 4 categories of MS?
Relapse remitting MS
Primary progressive MS
Secondary progressive MS
Benign MS
What is the diagnostic definition of MS?
2 or more episodes of demyelination disseminated in time and space
What feature can be seen on lumbar puncture in MS?
Oligoclonal bands - immune proteins seen in spinal fluid but not blood (so compare two samples)
What is a common trigger for pseudo-relapse in MS?
Body temperature rising above 37.5/38 degrees
What cognitive function is the frontal lobe responsible for?
Executive function and language
What cognitive function is the parietal lobe responsible for?
Visuospatial function
What cognitive function is the temporal lobe responsible for?
Memory and language
What cognitive function is the occipital lobe responsible for?
Visual processing
In dementia, in which area of the brain does pathology usually start?
Temporal lobe, spreading to parietal and frontal
What defines chronic migraine?
More than 15 days per month
Which drug group should NEVER be prescribed for migraine?
Opiates
