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Revision Week > Passmed Neuro > Flashcards

Passmed Neuro Flashcards

1
Q

Which nerve does the lingual nerve originate from?

A

Posterior trunk of the mandibular nerve

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2
Q

The damage of what nerve would cause floor of mouth to feel numb, tingling and painful tongue?

A

Lingual nerve

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3
Q

The damage of what nerve would cause tongue deviation towards the side fo the lesion?

A

Hypoglossal nerve

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4
Q

What is the function of the greater auricular nerve?

A

Provide sesnory nerve innervation to the parotid gland and external ear

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5
Q

What is the function of the occulomotor nerve?

A

Eye movement, accommodation, eyelid movement and pupil constriction

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6
Q

What is the function of the phrenic nerve?

A

Supply the diaphrgam, senstaion to the central diaphragm and pericardium

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7
Q

Where does the phrenic nerve originate?

A

C3,4,5

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8
Q

What is the function of the lingual nerve?

A

Sensory innervation to mucosa of the presulcal part of the tongue, floor of moth and mandibular lingual gingivae

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9
Q

How may a brain abscess present?

A

Headache, fever, focal neurology (oculomotor palsy), nausea, papilloedema, seizures

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10
Q

How would you investigate a brain abscess?

A

CT

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11
Q

How would you manage a brain abscess?

A

Surgery (craniotomy and debridement)
IV antibiotics
ICP management (dexamethasone)

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12
Q

What type of drug is ondansetron?

A

5-HT3 antagonist - antiemetic used for chemotherapy induced nausea. Acts on medulla oblongata

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13
Q

What is status epilepticus?

A

Single seizure >5 minutes

>2 seizures within 5 minutes without the patient returning to normal

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14
Q

1st line management for status epilepticus?

A

IV lorazepman

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15
Q

2nd line management for ongoing status epilepticus?

A

Phenytoin

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16
Q

What is a TIA?

A

Transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischaemia, without acute infarction

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17
Q

Lesions where will cause finger abduction weakness?

A

T1

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18
Q

What is an ataxic gate?

A

Wide-based gait with loss of heel toe walking

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19
Q

Causes of cerebellar injury?

A 
*PASTRIES*
Posterior fossa tumour
Alcohol
S(MS)
Trauma
Rare causes
Inherited (Friedreich's)
Epilepsy treatment
Stroke
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20
Q

How does Parkinson’s present?

A

Tremor, rigidity and bradykinesia

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21
Q

How does Lewy body dementia present?

A

Parkinsonism and visual hallucinations

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22
Q

Affects of a stroke in the anterior cerebral artery?

A

Contralateral hemiparesis and sensory loss, lower extremity

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23
Q

Affect of a stroke in the middle cerebral artery?

A

Contralateral hemiparesis and sensory loss, upper extremities.
Contralateral homonymous hemianopia
Aphasia

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24
Q

Affect of a stroke in the posterior cerebral artery?

A

Contralateral homonymous hemianopia with macular sparing

Visual agnosia

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25
Q

Management of an acute ischaemic stroke who present with 4.5 hours?

A

thrombolysis and thrombectomy

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26
Q

What nerves are frequently injured during axillary dissection?

A

Intercostobrachial

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27
Q

What nerve supplies sensation to the medial aspect of the thigh?

A

Obturator nerve

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28
Q

What if the function of the obturator nerve?

A

Supplies sensation to the medial aspect of the high.

Causes adduction and internal rotation of the thigh.

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29
Q

Where does the obturator nerve originate from?

A

L2,L3,L4

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30
Q

What are ependymal cells?

A

Provide the inner lining of the ventricles and are responsible for CSF production

31
Q

What are oligodendrocytes for?

A

The myelin sheath in the CNS

32
Q

What is the function of astrocytes?

A

Maintaining the blood brain barrier

33
Q

What is the function of Schwann cells?

A

Form the myelin sheath in the PNS

34
Q

What is the function of microglia?

A

CNS macrophage cells. First and main form of active immune defence in the CNS

35
Q

What is GBS?

A

Immune-mediated demyelination of the PNS, often triggered by an infection

36
Q

How does GBS present?

A

Ascending motor neuropathy, often rapidly advancing.
Proximal muscles
Back/leg pain
Absent reflexes

37
Q

What supplies Wernicke’s area?

A

Inferior division of the left MCA

38
Q

Symptoms of Wernicke’s aphasia?

A

Poor comprehension but normal fluency of speech

39
Q

What is Broca’s aphasia?

A

Lesion of inferior frontal gyrus causing non-fluent, laboured and halting speech. Repetition is impaired but comprehension is normal

40
Q

What supplies Broca’s area?

A

Superior division of the left MCA

41
Q

What is conduction aphasia?

A

Due to stroke affecting arcuate fasciculus (connection between Wernicke’s and Broca’s area).
Speech is fluent but repetition is poor. Aware of errors making

42
Q

What is global aphasia?

A

Large lesion affecting Broca’s, Wernicke’s and arcuate fasciculus. Causing severe expressive and receptive aphasia - may still be able to communicate during gestures

43
Q

What accompanies the radial nerve in the radial groove?

A

Profunda brachii artery

44
Q

What pattern of cell death explains the mixed upper and lower motor neurone lesion signs observed in ALS?

A

Motor cortex neuronal cells and anterior horn cells

45
Q

What does damage to anterior horn cells cause?

A

Lower motor lesion signs

46
Q

What does damage to the motor cortex neuronal cells cause?

A

Upper motor lesion signs

47
Q

What is a fasciculation?

A

Muscle twitch

48
Q

What signs suggest MND?

A

Fasciculations, absence of sensory symptoms, mixture of lower and upper motor neurone signs, wasting of small hand muscles

49
Q

What can cerebellar vermis lesions cause?

A

Upbeat nystagmus

50
Q

What can a lesion in the foramen magnum cause?

A

Downbeat nystagmus

51
Q

What can a lesion in the substantia nigra of the basal ganglia cause?

A

Parkinson’s disease

- bradykinesia, tremor and rigidity

52
Q

What can a lesion in the temporal lobe cause?

A

Superior homonymous quadrantopia

Changes to speech (word substitutions and neologisms)

53
Q

What can a lesion in the hypothalamus cause?

A

Wernicke and Korsakoff syndrome

- ataxia, nystagmus, ophthalmoplegia, confabulation, amnesia

54
Q

How does a third nerve palsy present?

A

Eye is deviated ‘down and out’
Ptosis
Pupil may be dialated

55
Q

Causes of a third nerve palsy?

A

Diabetes mellitus
Vasculitis
Posterior communicating artery aneurysm
Cavernous sinus thrombosis

56
Q

What is carpal tunnel syndrome?

A

Median nerve compression as it travels through the carpal tunnel

57
Q

Which branch of which nerve innervates the lateral aspect of the palm of the hand, and is therefore spared in carpal tunnel?

A

Palmar cutaneous nerve of the median nerve

58
Q

What is the function of the palmar cutaneous nerve of the median nerve?

A

Innervate the lateral aspect of the palm of the hand

59
Q

What is the function of anterior interosseous nerve branches of the median nerve?

A

Supply deep muscles of the anterior forearm

60
Q

What is the function of the palmar digital branch of the median nerve?

A

Innervates palmar aspect of the thumb, index finger and lateral aspect of ring finger.

61
Q

How do you differentiate between LEMS or MG?

A

In LEMS, weakness improves after exercise.

In MG, weakness worsens after exercise.

62
Q

Which antibodies are important in the diagnosis of LEMS?

A

Voltage-gated calcium channel antibodies

63
Q

Which antibodies are important in the diagnosis of MG?

A

ACh receptor antibodies

64
Q

What is trigeminal neuralgia?

A

Sever unilateral pain

Electric shock like, evoked by light touch such as shaving

65
Q

What does 4th nerve palsy cause?

A

Defective downward gaze -> vertical diplopia

66
Q

What can lesions on the 5th nerve cause?

A 
Trigeminal neuralgia
Loss of corneal reflex
Loss of facial sensation 
Paralysis of mastication muscles
Deviation of jaw to weak side
67
Q

What can a 6th nerve palsy cause?

A

Defective abduction -> horizontal diplopia

68
Q

What can lesions on the 7th nerve cause?

A

Flaccid paralysis of upper and lower face
Loss of corneal reflex
Loss of taste
Hyperacusis

69
Q

What can lesions on the 9th nerve cause?

A

Hypersensitive carotid sinus reflex

Loss of gag reflex

70
Q

What can lesions on the 10th nerve cause?

A

Uvula deviates away from site of lesion

Loss of gag reflex

71
Q

How to tell the difference between LMN lesion and UMN lesion of the facial nerve?

A

UMN spares upper face

LMN affects all facial muscles

72
Q

What is Bell’s Palsy?

A

Acute, unilateral, idiopathic, facial nerve palsy

73
Q

Features of Bell’s Palsy?

A

Lower motor neurone facial nerve palsy (forehead affected)

Altered taste, dry eyes, hyperacusis

74
Q

1st line treatment for neuropathic pain?

A

Amitryptyline, duloxetine, gabapentin

Revision Week (13 decks)

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