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Neuro > pastest 2 > Flashcards

pastest 2 Flashcards

1
Q

where does the saphenous nerve supple

A

anetriomedial aspect of the knee, leg and medial malleolus

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2
Q

when can saphenous nerve be damaged

A

during femoral vein catheterisation

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3
Q

ankle reflex

A

L1/L2

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4
Q

knee reflex

A

L3/L4

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5
Q

biceps reflex

A

C5/C6

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6
Q

triceps reflex

A

C7/C8

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7
Q

femoral nerve give rise to what nerve

A

anterior cutaneous and saphenous

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8
Q

where does femoral nerve bifurcate

A

inch below inguinal ligament

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9
Q

lateral cuteness of thigh arises from

A

branch of lumbar plexus

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10
Q

posterior cutaneous nerve of thigh arises from

A

sacral plexus

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11
Q

what nerve supplies dorsum of foot

A

peroneal nerve

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12
Q

peroneal nerve splits into superficial and deep, which does each innervate

A

superficial innervates all of dorsum except web space between 1st and 2nd toe which is innervated by deep peroneal

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13
Q

sural nerve supplies where

A

posterolateral lower leg, lateral heel, lateral aspect of foot and pinky

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14
Q

what is the thenar eminence

A

muscles at base of thumb

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15
Q

wasting of thenar eminence indicates what pathology

A

carpal tunnel syndrome (usually chronic in wasting)

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16
Q

wrist drop: what nerve

A

radial nerve

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17
Q

radial nerve supplies sensory to where

A

dorsal aspect of hand

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18
Q

what pathology causes a non-communicating hydrocephalus

A

pineal gland tumour

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19
Q

why do you get hydrocephalus with a pineal gland tumour

A

blocked CSF from lateral and 3rd ventricle flowing into 4th ventricle and subarachnoid space

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20
Q

how do you treat non communicating hydrocephalus

A

shunt between 3rd and 4th ventricle

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21
Q

wrist drop =

A

radial nerve

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22
Q

radia lnerev is what part of brachial plexus

A

terminal branch of posterior cord

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23
Q

radial nerve carries fibres from which levels

A

C5-C8

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24
Q

radial nerve sensory is from which level

A

T1

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25
Q

what muscles do radial nerve innervate

A

muscles of dorsal arm: anconuos and triceps bracii

extrinsic extensors of the wrist and hand

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26
Q

where does radial provide sensory

A

back of hand

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27
Q

axillary nerve originates in ____ cord of the brachial plexus

A

posterior cord

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28
Q

axillary nerve carries fibre from which levels

A

C5 and C6

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29
Q

axillary nerve innervates what muscles (3)

A

deltoids
long head of triceps brace
teres minor

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30
Q

median nerve is formed from which brachial plexus cords

A

lateral and median cords

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31
Q

median cord originated from which roots

A

C8 and T1

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32
Q

lateral cord originate from what levels

A

C5, C6, C7

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33
Q

brachial plexus made up of

A

C5, C6, C7, C8 and T1

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34
Q

sensory loss to lateral side of forearm

A

musculocutaneous nerve

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35
Q

what nerve if weak supination and flexion at elbow

A

musculocutaneous nerve

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36
Q

ulnar nerve comes from which cord of brachial plexus

A

medial cord

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37
Q

ulnar nerve originates from which nerve roots

A

C8 and T1

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38
Q

nerve impingement in elbow called

A

cubital tunnel syndrom: ulnar nerve

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39
Q

ulnar nerve sensory to where

A

pinky and lateral half of 4th digit

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40
Q

the main descending motor pathway

A

cortical spinal pathway

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41
Q

corticospinal tract fine details

A

motor cortex to alpha motor neurones in ventral horn of spinal cord

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42
Q

signs of upper motor neurone lesions

A

weakness, wasting, hyperflexia and fasciculations

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43
Q

ash leaf, cafe olay

A

tuberous sclerosis

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44
Q

cluster headache: uni or bi lateral

A

unilateral

45
Q

migraine: uni or bilateral

A

unilateral

46
Q

tension: uni or bilateral

A

bilateral

47
Q

treatment for cluster head aches

A

high flow oxygen and sumatriptan

48
Q

cluster headache prophylaxis

A

verapamil (calcium channel blocker)

49
Q

what type of dementia has fluctuations

A

lewy body

50
Q

dementia that has hallucinations

A

lewy body

51
Q

eye looking in and down

A

4th nerve palsy

52
Q

nerve palsy where the person may tilt their head

A

4th

53
Q

how many CAG repeats result in fully penetrant huntingtons

A

41+

54
Q

huntingtons inheritance

A

autosomal dominant

55
Q

essential tremor inheritance

A

autosomal dominant

56
Q

how many CAG repeats result in partial penetrance in huntingtons

A

36-40

57
Q

what drug can help in huntingtons

A

tetrabenazine

58
Q

neurofibromatosis 1 will have:

A

peripheral involvement

  • cafe aule
  • axillary and inguinal freckles
  • skin neurifibromas
59
Q

neurofibromatosis 2 will get:

A

central:
- bilateral acoustic neuromas
- cranial nerve and CNS tumours

60
Q

what is ramsay hunt syndrome

A

herpes zoster of external acoustic meatus

61
Q

bells palsy symptoms + facial spasm =

A

MS

62
Q

parkinsons is

A

reduced dopamine production from the substantial nigra of the basal ganglia

63
Q

in parkinsons, why can’t we just replace dopamine

A

it doesn’t cross BBB

64
Q

treatment for parkinson

A

L-dopa (levodopa)

65
Q

what is levodopa

A

dopamine precursor (that can cross BBB)

66
Q

what other drug must be given along with levodopa

A

a dopa decarboxylase inhibitor (can’t cross BBB) such as carbidopa

67
Q

what does carbidopa do?

A

inhibits peripheral dopa decarboxylase which converts levodopa to dopamine (stops formation of peripheral dopamine which has bad side effects)

68
Q

side main effects of levodopa (peripheral dopamine)

A

low BP
nausea
vomiting

69
Q

what enzyme in brain breaks down dopamine

A

MAO-B (monoamine oxidase B)

70
Q

what drug can you give to inhibit monoamine oxidase B (MAO-B)

A

selegiline - increases dopamine and increase L-dopa activity

71
Q

when is MAO-B inhibitors most effective

A

early and late stages of parkinsons

72
Q

which enzyme eliminates L-dopa

A

COMT - acetechol-O-methyltransferase

73
Q

what drug do you give to inhibit L-dopa clearance by COMT (acetechol-O-methyltransferase)

A

entacapone

74
Q

good drug for resting tremor

A

muscarinic antagonists: benzatropine

75
Q

in 3rd nerve palsy you will see:

A

ptosis (drooping eye lid)

mydriasis (big pupil)

76
Q

horners syndrom you wil see:

A

ptosis (drooping eye)
mitosis (small pupil)
anhydrosis

77
Q

what causes horners

A

lesion of sympathetic truck (if smokes, apical lesion of lung)

78
Q

age when motor neurone disease occurs

A

middle age

79
Q

what is the mainly affected area in motor neurone disease

A

anterior horn of spinal cord (hence why only motor affected) and motor neurones in motor cortex

80
Q

UMN or LMN symptoms seen in motor neurone disease

A

Both

81
Q

fasciculations in motor neurone disease?

A

yes, prominent

82
Q

most common form of motor neurone disease

A

amyotrophic lateral sclerosis (ALS)

83
Q

glove and stocking weakness

A

guillen-barre syndrome

84
Q

ascending paralysis

A

guillen-barre syndrome

85
Q

high protein and lymphocytes in CSF indicates

A

viral meningits

** can also be TB but viral more common**

86
Q

anti epileptic drug that causes cerebellar symptoms

A

phenytoin

87
Q

phenytoin is a

A

anti epileptic

88
Q

risk of taking phenytoin and why

A

phenytoin toxicity - small therapeutic window

89
Q

rinies test will normally show what findings

A

conduction (air) louder than sensoneural (bone)

90
Q

normal webber test will show

A

sound central

91
Q

webber test: louder in left ear following normal rinses indicates what?

A

loss of neurosensory in right ear

92
Q

findings in conductive hearing loss

A

rinnies: bone will be louder than air
weber: sond localises to affected ear

93
Q

head injury with lucid period

A

extradural

94
Q

common complication of subdural haematoma

A

recurrent bleed

95
Q

alpha beta amyloid in brain =

A

familial alzheimers

96
Q

familial alzheimers is also called

A

early onset

97
Q

familial alzheimers is due to mutation in what

A

amyloid precursor protein (APP)

98
Q

what is normal processing of amyloid precursor protein (APP) and how does it go wrong in early onset alzheimers

A

normally cleaved by gamma and alpha secretase, instead cleaved by gamma and bets secretes forming alpha beta -amylase. this accumulates and causes early onset.

99
Q

young, neurological and psychiatric symptoms

A

wilsons

100
Q

how do you diagnose wilsons

A

24 hour urine collection - will show higher than normal copper content

101
Q

dementia + hallucinations

A

lewy body dementia

102
Q

lewy body dementia: histological findings

A

alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas

103
Q

what part of brain is more pale in parkinsons

A

substantia nigra

104
Q

part of brain affected in lewy body (3)

A

substantia nigra, paralimbic and neocortical

105
Q

which 2 dementias are strongly interlinked

A

lewy and alzheimers

106
Q

what drugs should be avoided in lewy body

A

neuroleptics (antipsychotics)

107
Q

what avoid antipsychotics in lewy body

A

cause irreversible parkinsonism

108
Q

lewy body diagnosis

A
  • clinical

- single-photon emission computed tomography (SPECT)

Neuro (20 decks)

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