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head neck and neuro > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Where do the posterior column and corticospinal tracts cross over?

A

the medulla oblongata

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2
Q

Where does the spinothalamic tract cross over?

A

the spinal cord

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3
Q

give examples of incomplete spinal injuries

A 
central cord syndrome
anterior cord syndorme 
posterior cord syndrome
Brown-Sequard syndrome
cauda equina syndrome
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4
Q

Describe central cord syndrome

A

typically older patients
hyperextension injury
compression of cord anteriorly by osteophytes and posteriorly by ligametum flavum

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5
Q

Describe Brown-Sequard syndrome

A

hemi-section of spinal cord
stab / gun shot wounds
paralysis of affected side
pain and temperature loss on opposite side below the lesion

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6
Q

Describe cauda equina syndrome

A 
bony compression or disc protrusion in lumbar or sacral region
back pain
bowel and bladder dysfunction
leg numbness and weakness
saddle parasthesia
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7
Q

What is spinal shock?

A

temporary suppression of all reflex activity below the level of injury
immediate
babinski’s sign is first to reappear

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8
Q

Describe spinal shock

A 
flaccid paralyis
areflexia
loss of sensation 
bladder
bowel
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9
Q

What are the stages of spinal shock?

A

arefelxia
initial reflex return
hyperreflexia - spasticity

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10
Q

What is the clinical triad in neurogenic shock?

A

hypotension
bradycardia
hypothermia

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11
Q

What are the signs of an upper motor lesion?

A

muscle weakness
increased tone
increased refelxes

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12
Q

What are the signs of a lower motor neuron lesion?

A

muscle weakness and wasting
reduced tone
reduced reflexes
fasiculations

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13
Q

Describe tendon jerk reflexes

A

involuntary stereotyped response to a stimulus
reflex muscle contractions produced by muscle stretch
Tendon jerks are useful as a neurological test

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14
Q

Describe a monosynaptic circuit

A 
stimulus - tendon tap
activates muscle spindle receptors
conduction along afferent fibres
transmission at synapses between afferent and motor neurons
conduction along efferent motor fibre
excitiation contraction coupling
Twitch contaction of skeletal muscle
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15
Q

Describe Jendrassik’s manoeuvre

A

massive motor common, some excitation overflows to lumbar sacral segments, means neurons can get excited more easily

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16
Q

WHat is the purpose of the stretch reflex?

A

it acts to maintain constant muscle length and control of muscle tone.
Sensitivity of this reflex is controlled by the brain

17
Q

What are the clinical effects of spinal shock?

A

flaccid paralysis
areflexia
loss of sensation
loss of bladder and bowel reflexes

18
Q

What are the stages of spinal shock?

A

arefelxia
initial refelx return
initial hyperreflexia
hyperreflexia and spasticity

19
Q

Describe upper motor neuron lesions

A 
no muscle wasting
no fasiculations
spastic
weakness
hyperreflexia
positive babinksi response
20
Q

Describe lower motor neurone lesions

A 
muscle wasting
fasciculations
flaccid
muscle loss in bulk
reduced or absent reflexes 
negative babinski response
21
Q

What is tinnitus?

A

perception of sounds in the absence of external auditory stimulus

22
Q

What is vertigo?

A

illusion of motion
objective -person is moving and environment is stationary
Subjective - person is stationary and environment is moving

23
Q

What is the triad caused by meniere’s disease?

A

vertigo
tinnitus
hearing loss

24
Q

WHat are some of the suggested mechanisms of menniere’s disease?

A

increased production of endolymph
decreased production of perilymph accompanied by compensatory over production of endolymph
Decreased absorption of endolymph

25
Q

Give examples of focal injury

A

scalp, skull, intracranial haemorrhage, brain (laceration/contusion)

26
Q

Give examples of diffuse injuries

A

traumatic axonal injury, ischaemia, swelling

27
Q

Describe extradural haematomas

A

most with skull fracture
middle meningeal vessels
young adults
lucid interval then deterioration

28
Q

Describe subdural haematomas

A

bridging veins
acute / chronic
gradual deterioration
increased ICP

29
Q

What protein accumulates near the site of injury?

A

amyloid precursor protein

30
Q

What is brain ischaemia a consequence of?

A

raised ICP
hypoxaemia
reduced cerebral perfusion pressure

31
Q

What are the common symptoms of concussion?

A

headache
dizziness
memory disturbance
balance problems

32
Q

What are the signs of concussion?

A

loss of consciousness
seizure
incoordination
irritable

head neck and neuro (6 decks)

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