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NS > Survival Guide > Flashcards

Survival Guide Flashcards

1
Q

C5 myotome (motor, reflex, sensory)

A

Motor - Deltoid (shoulder abduction)

Reflex - Bicep tendon

Sensory - Lateral upper arm

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2
Q

C6 myotome (motor, reflex, sensory)

A

Motor - Bicep, extensor carpi ulnaris

Reflex - Brachioradialis

Sensory - Radial forearm, thumb and index finger

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3
Q

C7 myotome (motor, reflex, sensory)

A

Motor - Triceps, flexor carpi ulnaris/radialis

Reflex - Trcieps

Sensory - Middle finger

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4
Q

C8 myotome (motor, reflex, sensory)

A

Motor - Finger flexion (grip)

Reflex - None

Sensory - Ulnar forearm, ring and little finger

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5
Q

T1 myotome (motor, reflex, sensory)

A

Motor - Interossei (finger abduction)

Reflex - None

Sensory - Upper medial forearm and medial arm

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6
Q

L2 myotome (motor, reflex, sensory)

A

Motor - Psoas

Reflex - None

Sensory - Anterio-med thigh

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7
Q

L3 myotome (motor, reflex, sensory)

A

Motor - Quads

Reflex - None

Sensory - Medial thigh around knee

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8
Q

L4 myotome (motor, reflex, sensory)

A

Motor - Tibialis anterior (dorsiflex and foot inversion)

Reflex - Patellar

Sensory - Medial foot

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9
Q

L5 myotome (motor, reflex, sensory)

A

Motor - EHL

Reflex - None

Sensory - Dorsum foot

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10
Q

S1 myotome (motor, reflex, sensory)

A

Motor - Gastrocnemius, peroneus longus and brevis (foot eversion)

Reflex - Achilles

Sensory - Lateral foot

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11
Q

S2,3,4 myotome (motor, reflex, sensory)

A

Motor - External bladder sphincter

Reflex - Bulbocavernosus

Sensory - Perianal area

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12
Q

P1 ICP waveform

A

Percussion wave, arterial systolic pressure wave

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13
Q

P2 ICP waveform

A

Tidal wave, reflects brain compliance, vasomotor paralysis, brain swelling or edema

Normally about 80% of P1

Elevated with poor compliance

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14
Q

P3 ICP waveform

A

Dicrotic wave, aortic valve closure

Increased and becomes one with venous ‘A’ wave in increased ICP

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15
Q

Lundberg A waves

A

AKA plateau waves are mean waves > 50mmHg lasting 5-20 minutes which then returns to slightly elevated baseline

Reflects maximally dilated vessels d/t low CPP triggering brainstem response and increased MAP

Reflects ischemia

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16
Q

Lundberg B waves

A

AKA pressure wave

Lower peaks pressure 20-50 mmHg, lasting between 30 seconds to 3 minutes

Due to respiratory changes and changes in CBF

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17
Q

Lundberg C waves

A

Preterminal waves, mean wave

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18
Q

Normal PbO2 values

A

Normal is around 30 mmHg (when treating, keep above 20-30 mmHg)

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19
Q

PbO2 values indicating ischemia

A

Less than 15

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20
Q

Frazier’s point location

A

6 cm up from the inion, 3-4 cm off midline

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21
Q

Frazier’s point trajectory

A

Aim catheter toward contralateral medial canthus, hard pass to 5 cm, if getting CSF soft pass to 10 cm

22
Q

Keen’s point location

A

Measure 3 cm above and 3 cm behind the top of the pinna

23
Q

Keen’s point trajectory

A

Pass the catheter perpendicular to the cortex in a slightly cephalic trajectory

Will hit CSF around 5 cm

24
Q

Paine’s point location

A

2.5 cm above lateral orbital roof and 4.5 cm anterior to Sylvain fissure

25
Q

Paine’s point trajectory

A

Pass the catheter perpendicular to the brain, CSF should be reached at about 5 cm

26
Q

MR spec - NAA

A

Neuronal integrity marker

Decreases with tumor, stroke, epilepsy

27
Q

MR spec - creatine

A

Energy source, most stable peak

Increased in hypo-metabolic states

Decreased in hyper-metabolic states

28
Q

MR spec - choline

A

Precursor of Ach

Increased from increased cell proliferation or increased number of cells (tumors)

29
Q

MR spec - lactate

A

Metabolic - if present, think badness

Necrosis from infection or high grade tumor

30
Q

MR spec - characteristics seen with malignancy

A

Decreased NAA as it destroys neurons, and creatine as it depletes energy stores

Increased choline (cell turnover), lactate (necrosis from outgrowing blood supply), and lipid (d/t necrotic center in higher grade neoplasms)

31
Q

Normal Hunter’s angle

A

The direction of Hunter’s angle is upward to the right in the normal WM

32
Q

MR spec characteristics of lymphoma

A

++choline, - NAA, absent creatine

33
Q

MR spec characteristics of GBM/mets

A

+choline, - NAA, - creatine, +++lactate

34
Q

MR spec characteristics of abscesses

A

absent choline, absent NAA, absent creatine, +++lactate

35
Q

Typical location of intraventricular colloid cyst

A

Foramen of Monro/third ventricle

36
Q

Typical location of intraventricular meningioma

A

Trigone of lateral ventricle

37
Q

Typical location of intraventricular choroid

A

Fourth ventricle

38
Q

Typical location of intraventricular ependymoma

A

Lateral ventricle (more common in children) and 4th ventricle

39
Q

Typical location of intraventricular neurocytoma

A

Lateral ventricle (involving septum pellucidum)

40
Q

Typical location of intraventricular mets

A

Lateral ventricle, ependyma, and choroid plexus

41
Q

Typical imaging features of sellar/parasellar pituitary macroadenoma

A

Enlarged sella turcica, strong enhancement, sometimes hemorrhagic (apoplexy)

42
Q

Typical imaging features of sellar/parasellar meningioma

A

Broad dural base with tail, enhancement along planum sphenoidale, hyperostosis

43
Q

Typical imaging features of sellar/parasellar Schwannoma

A

T1-hypo and T2-hyperintense, strong enhancement (CN V most common)

44
Q

Typical imaging features of sellar/parasellar chordoma

A

Bone destruction on CT, heterogenous signal and enhancement on MRI, respects dura

45
Q

Typical imaging features of sellar/parasellar chondrosarcoma

A

Bone destruction and calcification on CT, T2-hyperintense on MRI

46
Q

Typical imaging features of sellar/parasellar Rathke’s cleft cyst

A

T1-hyperintense, smooth peripheral enhancement

47
Q

Typical imaging features of sellar/parasellar dermoid

A

Hypodense on CT and T1-hyperintense on MRI

48
Q

Typical imaging features of sellar/parasellar epidermoid

A

Isodense to CSF on CT and MRI T1 and T2 imaging, brighter than CSF on FLAIR and DWI

49
Q

Typical imaging features of sellar/parasellar optic glioma

A

Thickening of chiasm, spread along optic pathways

50
Q

Typical imaging features of sellar/parasellar germ cell tumor

A

Located in midline, intense enhancement, often with pineal germinomas

51
Q

Commonly calcified lesions

A

Oligodendrogliomas (90%), choroid plexus tumors (papillomas), ependymoma, central neurocytoma, meningioma, craniopharyngioma, teratoma, chordoma

52
Q

Commonly hemorrhagic lesions

A

GBM, oligodendrogliomas, mets (melanoma, lung, breast)

NS (25 decks)

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