Week 7: Neurological

Question 1

Cranial nerve 1

Answer 1

olfactory; sensory, smell

Question 2

Cranial nerve 2

Answer 2

optic; sight/vision

Question 3

Cranial nerve 3

Answer 3

oculomotor; muscles of eye

Question 4

Cranial nerve 4

Answer 4

trochlear; motor, oblique muscle

Question 5

Cranial nerve 5

Answer 5

trigerminal; motor: muscle for mastication, sensory: head, neck, sinus and meninges

Question 6

Cranial nerve 6

Answer 6

abducens; motor, lateral rectus muscle

Question 7

Cranial nerve 7

Answer 7

facial; motor: facial expression, sensory: ear membrane

Question 8

Cranial nerve 8

Answer 8

vestibulocochlear; sensory, hearing and balance

Question 9

Cranial nerve 9

Answer 9

glossopharyngeal; sensory: tongue, motor: parotid gland

Question 10

Cranial nerve 10

Answer 10

vagus; sensory & motor, pharynx, larynx, neck, thorax and abdomen

Question 11

Cranial nerve 11

Answer 11

accessory; motor, trapezius and sternocleidomastoid

Question 12

Cranial nerve 12

Answer 12

hypoglossal; motor, tongue muscles

Question 13

Effects of intracranial pressure (ICP)

Answer 13

obstruct cerebral blood flow, destroy brain cells, displace brain tissue, brain ischeamia

Question 14

Pathophysiology of alterations in cerebral circulation

Answer 14

supplied by 2 internal carotid arteries > BP v 60mmHg > blood flow compromised > 3 regulatory factors > (C02 = vasodialation, ^ H+ = vasodilation, v 02 = vasodialation)

Question 15

Define a stroke

Answer 15

an acute focal neurological defect caused by a vascular disorder that injures brain tissue

Question 16

Pathophysiology of a stoke

Answer 16

central core of dying cells > receive marginal blood flow > cells continue to die unless adequate circulation returns

Question 17

Ischaemic stroke

Answer 17

caused by an interruption to blood flow in a cerebral vessel

Question 18

Thrombic ischaemic stroke

Answer 18

atherosclerotic plaque ruptured > formation of a clot

Question 19

Embolic ischaemic stroke

Answer 19

embolus lodges and occludes a cerebral artery

Question 20

Haemorrhagic stroke

Answer 20

bleeding into the brain tissue

Question 21

Pathophysiology of bacterial meningitis

Answer 21

invading organism > endotoxins released from bacteria > inflammatory mediators released > increased production of CSF > endothelial lining becomes leaky protein and fluid leaks out > raised ICP cerebral oedema

Question 22

Causative agents of bacterial meningitis in adults

Answer 22

streptococcus pneumonia

Question 23

Causative agents of bacterial meningitis in children

Answer 23

escherichia coli

Question 24

Causative agents of bacterial meningitis virus

Answer 24

enterovirus, mumos, adrenovirus

Question 25

Compilations of bacterial meningitis

Answer 25

increased ICP, residual neurological effect (eye movement, unequal pupils, sensory loses, facial paralysis), dysphasia, seizures

Question 26

Define seizure

Answer 26

abnormal, uncontrolled electrical discharge from a group of neurons in the cerebral cortex

Question 27

Partial seizure

Answer 27

seizure begins in a specific of focal area of one cerebral hemisphere

Question 28

Simple partial seizure

Answer 28

consciousness not impaired

Question 29

Complex partial seizure

Answer 29

consciousness impaired

Question 30

Signs and symptoms of partial seizures

Answer 30

movement, tingling & crawling sensation, visual, auditory,

gustatory or olfactory phenomena, flushing, tachycardia, hypo/hypertension

Question 31

Generalized seizure

Answer 31

begin simultaneously in both cerebral hemispheres

Question 32

Generalized absence seizure

Answer 32

non convulsive, disturbance of consciousness

Question 33

Generalized atonic seizure

Answer 33

sudden, split second loss of muscle tone, leading to slackening of the jaw, drooping of limbs or falling to the ground

Question 34

Generalized myoclonic seizure

Answer 34

brief involuntary contractions, bilateral jerking of the limbs, generalized or confined to the face, truck or one or more extremities

Question 35

Generalized major-motor seizure (tonic-clonic

Answer 35

vague warning, shark tonic contraction of muscles with extension of extremities and immediate loss of consciousness

Question 36

Define status epilepticus

Answer 36

seizures that do not stop spontaneously or occur in succession without recovery

Question 37

Stroke risk factors

Answer 37

age, gender, family history, heart disease, hypertension, smoking,

Question 38

Management of stroke

Answer 38

anticoagulants, modify risk factors, serum cholesterol

Question 39

Stroke investigations

Answer 39

CT, ultrasound doppler, MRI, lumbar puncture

Question 40

Migraine causes

Answer 40

illness, cranial neuralgias, musculoskeletal tension

Question 41

Clinical manifestations of migraine

Answer 41

irritability, cold, visual disturbances, drowsiness, headache, nausea, exhaustion, mood changes

Question 42

Management of migraine

Answer 42

medication, sleep, quiet dark environment

Question 43

Meningitis clinical manifestations

Answer 43

severe headache, photophobia, disorientation, neck stiffness

Question 44

Meningitis investigations

Answer 44

lumbar puncture, blood culture, test meningeal irritation

Question 45

Meningitis management

Answer 45

antibiotics (bacterial only), antieumetics, IV hydration, treat symptoms, frequent neurological assessment, airway management, 02 therapy

Question 46

aetiology of stoke

Answer 46

cerebral hypoxia, fever, head injury, hypoglycaemia, CNS infections, drug withdrawal