Pastest Flashcards

1
Q

cranial nerve that passes through rotundum

A

maxillary division of trigeminal

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2
Q

innervates parotid

A

glossopharyngeal

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3
Q

innervates lateral gaze

A

abducens

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4
Q

superior oblique is innervated by

A

trochlear

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5
Q

laryngeal muscles are innervated by

A

branches of the vagus

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6
Q

only part of laryngeal muscles not innervated by recurrent laryngeal branch of vagus

A

cricothyroid - by external laryngeal nerve

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7
Q

innervates the anterior 2/3rd of tongue

A

facial

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8
Q

innervates posterior 1/3 of tongue

A

glossopharyngeal

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9
Q

unilateral headache > 50 yrs

A

temporal arteritis

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10
Q

first line investigation for temporal arteritis

A

ESR

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11
Q

age when migraines first present

A

young woman/man

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12
Q

why no COCP in migraine

A

oestrogen precipitates migrane

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13
Q

raised ICP will have what symptoms

A

morning headaches and postural (leaning forward)

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14
Q

triad of parkinson

A
  • resting tremor
  • rigidity
  • bradykinesia
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15
Q

pathophysiology of parkinsons

A

neurodegeneration and deposition of inclusion bodies in v pars compact of the substantianigra (midbrain) causing disruption/loss of dopaminergic transmission in basal ganglia

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16
Q

parkinson signs distribution: symmetric or asymmetric

A

asymmetrical

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17
Q

therapy given in parkinson

A

levodopa (L-dopa)

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18
Q

non ‘triad’ symptoms of parkinson

A

stooped posture
shuffling gate
reduced arm swing
monotone voice –> slurring dysarthria

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19
Q

what is normal pressure hydrocephalus

A

increases ventricle space and CSF without an increase in CSF pressure, usually due to inability of CSF to drain out of brain. Can be a late consequence of subarachnoid haemorrhage

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20
Q

who gets normal pressure hydrocephalus

A

old people

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21
Q

symptoms of normal pressure hydrocephalus

A

dementia, urinary incontinenece, gait abnormalities (shuffling)

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22
Q

molloscum contagiosa indicates what

A

HIV

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23
Q

HIV+ get what type of meningitis

A

cryptococcal neoformans

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24
Q

sudden onset severe headache

A

subarachnoid haemorrhage

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25
Q

most common area of subarachnoid haemorrhage pain

A

occipital

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26
Q

treatment for cryptococcal meningitis

A

anti fungal: amphotericin +/- fluctosine

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27
Q

what type of organism is cryptococcal neoformans

A

fungus

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28
Q

risk factors for subarachnoid haemorrhage

A

berry aneurism or atriovenous malformations

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29
Q

diagnosis of sub arachnid haemorrhage

A

CT if neg, then CSF

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30
Q

3 classical signs of BACTERIAL meningitis

A

fever, headache, neck stiffness

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31
Q

name for meningococcal (neisseria meningitidis) rash

A

petechial rash

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32
Q

treatment for suspected meningococcal meningitis

A

IM cefotaxime/ceftriaxone

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33
Q

who gets benign intracranial hypertension

A

fat woman

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34
Q

what is benign intracranial hypertension

A

increase in CSF production WITHOUT increase in ventricle size

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35
Q

how may benign intracranial hypertension present

A

headaches and visual disturbance (papilloedema)

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36
Q

what drugs can cause benign intracranial hypertension

A

steroids and tetracycline therapy

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37
Q

treatment for benign intracranial hypertension

A

diaretics: thiazides & acetazolamide + weight loss

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38
Q

what will you look for in CSF if suspect sub arachnid haemorrhage but CT doesn’t show anything

A

xanthochromia (bilirubin from broken RBCs in CSF)

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39
Q

tie scale for xanthocromia

A

12 hours after onset of symptoms

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40
Q

when will you do angiography in suspected subarachnoid haemorrhage

A

if want to try fix it

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41
Q

morning headache + vomiting =

A

raised ICP usually due to space occupying lesion

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42
Q

SOL/bleeds in temporal lobe of brain will cause what visual defects

A

homonymous superior quadrantanopia (on opposite side of lesion) PITS: parietal = inferior, temporal = superior

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43
Q

SOL/bleeds in parietal lobe of brain will cause what visual defects

A

homonymous inferior quadrantanopia (on opposite side of lesion) PITS: parietal = inferior, temporal = superior

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44
Q

SOL/bleeds in chiasm of brain will cause what visual defects

A

bi-temporal heminopia

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45
Q

loss of vision on just one side L/R heminopia

A

optic tract on opposite side

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46
Q

unilateral vision loss

A

eye/optic nerve on SAME side

47
Q

what test is usually abnormal in delirium of any cause

A

electroencephalogram

48
Q

what part of brain affected in huntingtons

A

caudate nucleus degeneration

49
Q

condition where you get ticks and choreosthesis

A

huntingtons

50
Q

dementia in stepwise fashion

A

vascular

51
Q

what will be common in someone with vascular dementia

A

hypertension, heart problems, arrhythmia and diabetes

52
Q

‘butterfly pattern’ on CT

A

huntingtons

53
Q

what part of brain will show ‘butterfly pattern’ on CT

A

caudate nucleus

54
Q

best imaging for vascular dementia lesions

A

MRI (not seen on CT)

55
Q

accessory nerve innervates what

A

traps and sternocleidomastoid

56
Q

accessory nerve arrives from

A

C1 - 5

57
Q

accessory passes out skull via

A

jugular

58
Q

when does the accessory nerve cross into posterior triangle of neck (where it is prone to injury)

A

3rd of the way down sternocleidomastoid

59
Q

a sub dural haematoma lies between what layers

A

dura and arachnoid

60
Q

meninigi layer closest to brain

A

pia

61
Q

outermost layer of meningis

A

dura

62
Q

dura mater has how many layers

A

2

63
Q

what is in-between 2 layers of dura mater

A

venus sinuses

64
Q

names of 2 layers of dura mater

A

outer: endosteal layer
inner: meningeal layer

65
Q

the inner meningeal layer of dura mater forms what 4 structures

A

4 fibrous septa:

  • diaphragma sellae
  • falx cerebri
  • falx cerebelli
  • tentorium cerebelli
66
Q

function of 4 fibrous flanges/septa of dura mater

A

stop rotatory displacement of brain

67
Q

dura mater well innervated?

A

yes (causes headache)

68
Q

archnoid mater is attached to what other layer and by what?

A

pia via filamentous processes

69
Q

where is CSF located

A

in sub arachnoid space (between arachnid and pia mater)

70
Q

extradural heamatoma is located where

A

between skull and endosteal layer of dura

71
Q

most common blood vessel implicated in extradural haematoma

A

middle meningeal artery

72
Q

middle meningeal artsy located where

A

beneath pterion

73
Q

location of subdural haematoma

A

venous bleeding into gap between dura and arachniod

74
Q

who gets subdural haematoma and why

A

elderly and alcoholics due to brain shrinkage, this damages overlying veins, because veins it is usually a slow bleed

75
Q

blood vessel involved (artery/vein):
subdural haematoma -
extradural heamatoma -
subarachnoid haematoma -

A

subdural haematoma - vein
extradural heamatoma - artery (middle meningeal)
subarachnoid haematoma -artery (from circle of willis)

76
Q

facial nerve supplies what glands

A

lacrimal (eye), submandibular, sublingual

77
Q

oculomotor innervates what eye muscle

A

levator palpebrae superioris (lift eye lid)

78
Q

blinking/screwin eye shut is what cranial nerve

A

facial

79
Q

what nerve innervates muscles of mastication

A

mandibular division of trigeminal

80
Q

bells palsy, upper or lower motor neurone

A

lower (facial)

81
Q

which has forehead sparing: stroke or bells palsy

A

stroke

82
Q

why can you get hypersensitivity to sound in bells palsy

A

because facial nerve innervates stapedius muscles (which dampens down sound)

83
Q

what is myasthenia gravis

A

auto Ab to ACh receptors on post synaptic membrane

84
Q

how may myasthenia gravis present

A

double vision, weakness and fatigueabiltiy, worse in evening

85
Q

diagnostic test for myasthenia gravis

A

nerve conduction study with repetitive nerve stimulation

86
Q

myasthenia gravis associated with what other condition

A

thymic hyperplasia or thymus tumour

87
Q

after diagnosis of myasthenia gravis what other test will you do and why

A

chest CT because of associating with thymic hyperplasia or thymus tumour

88
Q

‘panda eyes’

A

fracture of floor of anterior cranial fossa

89
Q

crescent shape haematoma on CT

A

sub-dural haematoma

90
Q

skull x-ray won’t show base of anterior fossa fracture, but what might you see

A

fluid leven in spenoidal sinus lateral view

91
Q

treatment for sub dural haematoma

A

urgent surgery

92
Q

wil x-ray show sub dural haematoma

A

No

93
Q

first line investigation for extra and sub-dural maenatoma

A

CT

94
Q

which head injury do you get lucid interval

A

extradural haematoma

95
Q

fasciculations and atrophy indicate what a lesion location

A

lower motor neurone

96
Q

tongue will deviate to what side in a lower motor lesion

A

same (ipsilateral)

97
Q

what nerve affects tongue

A

hypoglossal

98
Q

tongue will deviate to what side in a upper motor lesion

A

opposite side (contralateral)

99
Q

nerve for motor supply to tongue

A

hypoglossal

100
Q

what nerve for sensory and somatic innervation to posterior 1/3rd of tongue

A

glossopharyngeal

101
Q

nerve responsible for sensory role in gag reflex

A

glossopharyngeal

102
Q

nerve responsable for efferent limb in gag reflex

A

vagus

103
Q

things facial nerve supplies: (many)

A

motor:
- muscles of facial expression
- buccinator
- stapiduim muscle

parasympathetic:
- lacrimal gland
- sublingual and submandibular salivary glands
- blinking

sensory: taste to anterior 2/3rds

104
Q

anterior cerebral arteries supply what area of brain

A

medial aspect of frontal and parietal lobes

105
Q

stroke in anterior cerebral artery regions will affect what part of body

A

opposite side, lower limb

106
Q

middle cerebral arteries supply where

A

lateral frontal, parietal and superior temporal lobes

107
Q

occlusion of middle cerebral artery will have what features

A

upper limb weakness
speech problems
facial weakness
auditory comprehension problems

108
Q

posterior cerebral artery supplies where

A

occipital lobe
inferior temporal
thalamus
posterior limb of internal capsule

109
Q

how will a posterior artery stroke present

A

weakness in both upper and lower limbs
vision field defects
loss of sensation

110
Q

3rd nerve palsy present with:

A

ptosis (eyelid droop)
mydriasis (dilated pupil)
down and out
horizontal and vertical binocular diplopia (double vision)

111
Q

3rd nerve innervates what eye muscles

A

superior, inferior, medial rectus muscles, inferior oblique, levator palpera superioris

112
Q

shine light into left eye, no changes in left eye but consentual in right, what does this tell me?

A

optic never intact: recognises light

occulomotor not: light is being sensed but not pupillary response

113
Q

trochlear innervates what eye muscles

A

superior obligue

114
Q

abducens innervates what eye muscle

A

lateral rectus