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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
Paine's point trajectory
Pass the catheter perpendicular to the brain, CSF should be reached at about 5 cm
26
MR spec - NAA
Neuronal integrity marker Decreases with tumor, stroke, epilepsy
27
MR spec - creatine
Energy source, most stable peak Increased in hypo-metabolic states Decreased in hyper-metabolic states
28
MR spec - choline
Precursor of Ach Increased from increased cell proliferation or increased number of cells (tumors)
29
MR spec - lactate
Metabolic - if present, think badness Necrosis from infection or high grade tumor
30
MR spec - characteristics seen with malignancy
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
Normal Hunter's angle
The direction of Hunter's angle is upward to the right in the normal WM
32
MR spec characteristics of lymphoma
++choline, - NAA, absent creatine
33
MR spec characteristics of GBM/mets
+choline, - NAA, - creatine, +++lactate
34
MR spec characteristics of abscesses
absent choline, absent NAA, absent creatine, +++lactate
35
Typical location of intraventricular colloid cyst
Foramen of Monro/third ventricle
36
Typical location of intraventricular meningioma
Trigone of lateral ventricle
37
Typical location of intraventricular choroid
Fourth ventricle
38
Typical location of intraventricular ependymoma
Lateral ventricle (more common in children) and 4th ventricle
39
Typical location of intraventricular neurocytoma
Lateral ventricle (involving septum pellucidum)
40
Typical location of intraventricular mets
Lateral ventricle, ependyma, and choroid plexus
41
Typical imaging features of sellar/parasellar pituitary macroadenoma
Enlarged sella turcica, strong enhancement, sometimes hemorrhagic (apoplexy)
42
Typical imaging features of sellar/parasellar meningioma
Broad dural base with tail, enhancement along planum sphenoidale, hyperostosis
43
Typical imaging features of sellar/parasellar Schwannoma
T1-hypo and T2-hyperintense, strong enhancement (CN V most common)
44
Typical imaging features of sellar/parasellar chordoma
Bone destruction on CT, heterogenous signal and enhancement on MRI, respects dura
45
Typical imaging features of sellar/parasellar chondrosarcoma
Bone destruction and calcification on CT, T2-hyperintense on MRI
46
Typical imaging features of sellar/parasellar Rathke's cleft cyst
T1-hyperintense, smooth peripheral enhancement
47
Typical imaging features of sellar/parasellar dermoid
Hypodense on CT and T1-hyperintense on MRI
48
Typical imaging features of sellar/parasellar epidermoid
Isodense to CSF on CT and MRI T1 and T2 imaging, brighter than CSF on FLAIR and DWI
49
Typical imaging features of sellar/parasellar optic glioma
Thickening of chiasm, spread along optic pathways
50
Typical imaging features of sellar/parasellar germ cell tumor
Located in midline, intense enhancement, often with pineal germinomas
51
Commonly calcified lesions
Oligodendrogliomas (90%), choroid plexus tumors (papillomas), ependymoma, central neurocytoma, meningioma, craniopharyngioma, teratoma, chordoma
52
Commonly hemorrhagic lesions
GBM, oligodendrogliomas, mets (melanoma, lung, breast)

NS (25 decks)

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