Neurosurgery Flashcards
what does the sensory spinocerebellar pathway do?
sends information about unconscious proprioception to the cerebellum for posture and movement of upper and lower limbs
what does the vestibulospinal tract do?
exerts posture via extensors for legs and flexors for arms
which spinal tract increases tone?
reticulospinal tract via the pontine reflex response
which spinal tract decreases tone?
reticulospinal tract via the medullary tract
knee reflex nerves
L3/4 femoral
biceps reflex nerves
C5/6 musculocutaneous
triceps reflex nerves
C7/8 radial
ankle reflex nerves
S1/2 tibial
what type of cartilage is the annulus fibrosus made of?
fibrocartilage
three directions of prolapse for the nucleus pulposis
- paramedian (posterolateral)
- extraforaminal (far lateral)
- central/ medial herniation
paramedian prolapse
compresses tranversing nerve
herniation at L4/5 causes damage to L5 as nerve root exits below level
extraforminal (far lateral) proalpse
compresses exiting nerve
herniation at L4/5 causes L4 damage
central/ medial prolapse
lumbar stenosis or if large enough can cause cauda equina
what is a radiculopathy?
dysfunction of a nerve root causing a dermatomal sensory deficit with weakness of the muscle groups supplied by that nerve
LMN
what is a myelopathy?
UMN signs more predominant in lower limbs before progressing to upper limbs
presentation of neurogenic claudication
leg weakness
tingling
numbness
normal pulses
cause of anterior cord syndrome
cord infarction by anterior spinal artery
presentation of spinal shock
flaccid areflexic paralysis
three components of the cerebellum
- vestibulocerebellum
- spinocerebellum
- cerebrocerebellum
role of the vestibulocerebellum
balance and coordination of vestibulo-ocular reflexes
role of the spinocerebellum
maintains muscle tone and participates in posture and gait
role of the cerebrocerebellum
voluntary motor movement
presentation of thalamic infarction
hemiparesis
spontaneous pain
hemichorea
severe impairment of consciousness
appearance of glioblastoma multiforme
butterfly
appearance of oligodendroglioma
toothpaste
where do meningiomas originate from?
arachnoidal cap cells within arachnoid membrane
what are associations with meningiomas
NF2
childhood radiation
what are haemangioblastomas?
benign cystic vascular tumours in posterior fossa leading to cerebellar dysfunction and raised ICP
which are haemangioblastomas associated with?
VHL
diagnosis of AVM
catheter angiography
CTA
management of AVM
excision
radiosurgery
what is a cavernous malformation?
benign vascular lesion in sinusiodal spaces
types of aneurysms
berry/saccular
fusiform (hypertension associated)
mycotic
diagnosis of SAH
CT > LP > CTA or angiogram