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Neurology > Pattern Recognition (revision) > Flashcards

Pattern Recognition (revision) Flashcards

1
Q

Describe hyperkinetic movement disorders

A 
Dystonia
Tics
Myoclonus
Chorea
Tremor
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2
Q

Describe hypokinetic movement disorders

A

Parkinsons; rigidity and bradykinesia

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3
Q

What is the pattern of weakness in MND?

A

UMN and LMN signs
Absence of sensory symptoms
+/- frontotemporal dementia

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4
Q

Inflammatory muscle disorders

A 
Poly/deramatomyositis
Inclusion body myositis
Vasculitis
RA
Sjogren's
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5
Q

Endocrine muscle disorders

A 
Hypothyroidism
Cushing's 
Electrolyte disturbances
Hypophosphatemia
Hypocalcemia
Hypernatraemia/ hyponatraemia
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6
Q

Drugs/toxins causing muscle disorders

A 
Illicit drugs; cocaine, heroin
Alcohol
Corticosteroids
Colchicine
Antimalarial drugs
Stains
Penicillamine
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7
Q

Infections causing muscle disorders

A

Viral; influenza, parainfluenza, coxsackie, HIB, CMG, echovirus, adenovirus, EBV
Bacteria
Fungal
Parasitis

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8
Q

Rhabdomyolysis causing muscle disorders

A 
Crush trauma
Seizures
Alcohol absuse; hyperkinetic state with delirium tremens
Exertion 
Vascular surgery 
Malignant hyperthermia
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9
Q

Which muscle, nerve and nerve root are responsible for shoulder abduction?

A

M: deltoid
N: axillary
NR: C5

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10
Q

Which muscle, nerve and nerve root are responsible for elbow extension?

A

M: triceps
N: radial
NR: C7

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11
Q

Which muscle, nerve and nerve root are responsible for finger extension?

A

M: extensor digitorum
N: radial
NR: C7

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12
Q

Which muscle, nerve and nerve root are responsible for index finger abduction?

A

M: 1st dorsal interosseous
N: Ulnar
NR: T1

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13
Q

Which muscle, nerve and nerve root are responsible for hip flexion?

A

M: iliopsoas
N: femoral
NR: L1,2

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14
Q

Which muscle, nerve and nerve root are responsible for knee flexion?

A

M: hamstrings
N: sciatic
NR: S1

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15
Q

Which muscle, nerve and nerve root are responsible for ankle dorsiflexion?

A

M: tibialis anterior
N: common fibular and sciatic
NR: L4,5

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16
Q

Which muscle, nerve and nerve root are responsible for great toe dorsiflexion?

A

M: EHL
N: common fibular
NR: L5

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17
Q

Main deep tendon reflexes and oot innervation

A

Biceps/ supinator: C5,6
Triceps: C7,8
Knee: L3,4
Ankle: S1,2

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18
Q

What does a glove and stocking sensory loss indicate?

A

Length dependent neuropathy

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19
Q

What does a sensory level sensory loss indicate?

A

Spinal cord lesion

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20
Q

What does a hemianesthesia sensory loss indicate?

A

Contralateral cerebral lesion

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21
Q

What is a dissociated sensory loss indicate?

A

Loss of spinothalamic but preserved DCML; anterior spinal artery syndrome, brown sequard or syringomyelia

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22
Q

Extrapyramidal symptoms

A 
Bradykinesia
Rigidity
Resting tremor
Shuffling gait
Stooped posture
Hypomimia
Hypophonia
Reduced arm swing 
Impaired postural reflexes
Asymmetry in PD, symmetry in DI
23
Q

Main function of frontal lobe

A

Executive function

Prefrontal cortex connects to the basal ganglia, limbic system, thalamus and hippocampus

24
Q

Frontal lobe dysfunction

A 
Personality disorder
Disinhibition 
Paraparesis
Paratonia
Frontal gait dysfunction 
Cortical hand
Seizures
Incontinence
Visual field defects - homonymous hemianopia
Expressive dysphagia  - broca's area
Anosmia
25
Q

Temporal lobe dysfunction

A 
Episodic memory dysfunction 
Agnosia 
Receptive aphasia; wernicke's area
Superior quadrantanopia 
Auditory dysfunction; as hearing is bilateral deafness is NOT a cerebral feature
Limbic dysfunction
Temporal lobe epilepsy
26
Q

Parietal lobe dysfunction

A 
Inferior homonymous quadrantanopia 
Visuospatial dysfunction 
Gerstmann's syndrome
Dyspraxia
Inattention 
Denial
27
Q

What is gerstmann’s syndrome?

A

Dominant lobe; dysgraphia, left-right disorientation, finger agnosia, acalculia

28
Q

Treatment protocol for PD

A

Symptomatic; levodopa or dopamine agonist
MDT including speech and language, OT, PT, exercise
Deep brain stimulation

29
Q

Drugs used in PD

A 
Levodopa; crosses BBB
Dopamine agonists; acts on D2 receptors
MAO-B inhibitors; improve symptoms in those with mild disease
Anticholinergics for tremor 
Amantadine; blocks NMDA receptors
30
Q

Imaging in stroke

A

MRI T1/T2 and FLAIR for old lesions and lesions of non-vascular origin
T2 to identify bleeds and microbleeds
CT: hyperintense; bleed. Ischaemic; loss of lentiform nucleus, poor grey white matter differentiation, loss of insular ribbon

31
Q

Corticospinal tract origin and parts

A

Origin: primary motor cortex of precentral gyrus
Lateral (primary decussation) = voluntary motor control of limbs and digits
Anterior corticospinal (segmental decussation) = voluntary motor control of trunk and maintains posture

32
Q

Corticobulbar tracts origin and function

A

Origin: primary motor cortex in precentral gyrus
Function: muscles of face, head and neck

33
Q

Which CN do NOT have a bilateral innervation to their nuclei?

A

CN 12

Lower part of 7; if there is forehead sparing this is an UMN lesion of facial nerve

34
Q

Rubrospinal tract origin and function

A

Origin: red nucleus of midbrain
Function: excites flexors and inhibits extensors of upper body

35
Q

Reticulospinal tract origin and function

A

Origin: pons/medulla
Function: excites extensors

36
Q

Which motor tract is in charge in decorticate rigidity?

A

Lesion above midbrain

Rubrospinal tract; flexion of upper limbs

37
Q

Which motor tract is in charge in decerebrate rigidity?

A

Lesion below midbrain

Reticulospinal tract; extension

38
Q

DCML function and route

A

Function; fine touch, pressure and vibration
Decussates in medulla to contralateral medial lemniscus to reach the primary somatosensory cortex in the postcentral gyrus of the parietal lobe

39
Q

Difference between gracile fasciculus and cuneate fasiculus

A

Gracile; legs, below T6
Cuneatus; arms; above T6
Gracile medial to cuneate in spinal cord

40
Q

Spinothalamic tract function and pathway

A

Function: pain and temp

Decussates segmentally in spinal cord to reach opposite primary somatosensory cortex

41
Q 
Extradural haemorrhage: 
Location
Origin
Presentation
Symptoms
Ix
Imaging findings
A

L: skull and dura
O: middle meningeal artery
Px: injury to pterion
Sy: unconscious then lucid interval then unconscious
Ix: CT
Findings: hyperdense biconvex lens appearance

42
Q 
Chronic subdural haemorrhage 
Location
Origin
Presentation
Symptoms
Ix
Imaging findings
A

L: dura and arachnoid
Origin: cerebral bridging veins
Px: older patients due to low impact trauma
Sy: progressive headache and confusion
Ix; CT
Findings: hypodense crescent shaped appearance

43
Q 
SAH
Location
Origin
Presentation
Symptoms
Ix
Imaging findings
A

L: arachnoid and pia
Origin: arterial; commonly berry aneurysm
Px: severe head injuries or ruptured berry
Sy: thunderclap headache, meningeal irritation (neck stiffness, photophobia), loss of consciousness
Ix: CT initially. Definitive diagnosis is CTA
Findings; hyperdense in SA space. Commonly star shaped

44
Q

Symptoms of cerebral herniation

A

Extensor response
Cushing’s triad; hypertx, brady, agonal breathing
Uncal herniation = blown pupil

45
Q

Where can you find the dual venous sinuses?

A

Outer and inner dura

46
Q

Expressive dysphasia

A

Brocas area

47
Q

Receptive dysphasia

A

Wernicke’s area

48
Q

Nystagmus, intention tremor and dysarthria

A

Cerebellum

49
Q

Temperature control

A

Hypothalamus

50
Q

Oculomotor nucleus

A

Midbrain

51
Q

Most common cause of hydrocephalus in children

A

Aqueduct stenosis - non-communicating hydrocephlus

52
Q

Sy of aqueduct stenosis?

A

Growth in head circumference
Eyelids retracted; sunsetting eyes
Upward gaze impaired
Failure to thrive

53
Q

What GCS indicates comatomse?

A

8 or less

Neurology (48 decks)

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