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Y6 Senior Med COPY > Neuro 2 > Flashcards

Neuro 2 Flashcards

(50 cards)

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1
Q

Biceps reflex dermatome

A

C5, C6 PICK UP STICK

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2
Q

Triceps reflex dermatome

A

C7, C8 Shut the gate

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3
Q

Dermatomal patch covering the regimental pat h

A

C5

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4
Q

dertmatome to thumb

A

C6

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5
Q

Dermatome to middle finger

A

C7

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6
Q

dermatome to little finger

A

C8

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7
Q

dermatome to medial elbow

A

T1

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8
Q

Where must you touch for UL dermatomal sensation

A 
axilla (c5) 
thumb (C6) 
middle (C7) 
little finger (C8) 
inside of elbow (T1)
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9
Q

what nerve roots make up the mussculocutaneous nerve

A

C5-C7

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10
Q

fuction of musculocutaenous

A

innervates biceps, brachialis, coracobrachialis > flexion of arm at elbow

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11
Q

nerve roots of median nerve

A

C7-T1

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12
Q

function of median N

A

SENSORY to lat 3.5 fingers

MOTOR to anterior forearm and LOAF muscles of hand (flexion of wrist, thenar eminence)

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13
Q

nerve roots of axillary

A

C5, C6

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14
Q

functions of Axillary N

A

Motor to teres minor and deltoid (abduction of arm beyond first 15 degrees)

Sensory to reegimental patch

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15
Q

Radial nerve roods

A

C5-T1

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16
Q

function of radial nerve

A

posterioor arm and forearm muscles

cutaneous to possterior arm / forearm and dorsal lat 3.5 fingers

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17
Q

How do you check radial, median and ulnar nerve sensation in the hand

A

Radiial: side of thumb

median: medial 3.5 fingers
ulnar: at 1.5 fingers

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18
Q

how od you commonly damage musculocutaenous nerve

A

breast surgery

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19
Q

cause of lateral medullary syndrome

A

OCCLUSION of POSTERIOR INFERIOR CEREBELLAR ARTERY

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20
Q

sx lateral medullary syndrome

A

cerebellum:
- ataxia
- nystagmus

brainstem:
- ipsilat: dysphagia, facial numbness, HOrners
- contralat: limb sensory loss

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21
Q

when should you refer for specialist review someone with TIA

Study These Flashcards
A

<24h if within 7 days since FIRST TIA

><7 days if more than 7 days from first TIA

22
Q

what should you do if pt presents with more than one TIA

Study These Flashcards
A

CRESCENDO TIA > you need to admit and invesitgatw

23
Q

when should you admit and investigate someone with TIA

Study These Flashcards
A
  • crescendo TIA (more than 1)
  • suspected cardioembolic source
  • severe carotid stenosis
  • patient on warfarin / doac or with bleeding disoorder
24
Q

what must you do if hhaemorrhagic transformation in TIA

Study These Flashcards
A

STOP all anticoagulants

lower BP

25
what does a contralateral homonymous hemianopia with macular sparing suggest?
that the lesion is in the occipital cortex
26
how can you tell the difference between prolactimona and craniopharyngioma causing a bitemporal hemianopia
prolactinoma: UQ> LQ craniophharyngioma: LQ>UQ
27
features of neuroleptic malignant syndrome
Confusion Autonomic lability (hypertension, tachycardia and tachypnoea) Rigidity Pyrexia
28
what investigations must you do for BELL's palsy
NONE - usually clinical dx serology - borrelia, VZV
29
what does WHITE on head CT mean
HYPERDENSE region = acute clotted blood, from haemorrhage
30
what does BLACK on head CT mean
HYPODENSE (dark) region = ishaemic infarct, chronic clotted blood
31
differentials for cerebellar disease
``` V- stroke (vertebrobasilar) i - encephalitis, abscess T - Trauma (raised ICP) A - MS, Paraneoplastic cerebellar dege M - ethanol, poisons, N- Posterior fossa tumour ```
32
ix for cerebellar disease
Bloods: ETOH, FBC, UE, LFT, CLotting, Ceruloplasmin (Wilson) ECG (arrythma) CSF (oligoclonal bands for MS) MRI (posterior cranial fossa)
33
what do you see on NC CT for ischaemic stroke
hyperdense artery loss of grey white matter interface hypodense area
34
how do you treat trigeminal neuralgia
carbamazepine
35
complex regional pain sydrome fts
``` PORTS: Pain Oedema Restriction of Movement Temperature/ colour change Stiffness ```
36
what is pituitary aapopexy
sudden enlargement of the pituitary gland | usually due to haemorrhage or infarction of tumour
37
fts of pituitary apopexy
sudden onset headache similar to that seen in subarachnoid haemorrhage vomiting neck stiffness visual field defects: classically bitemporal superior quadrantic defect extraocular nerve palsies features of pituitary insufficiency e.g. hypotension/hyponatraemia secondary to hypoadrenalism
38
how do you manage pituitary apopexy
steroids URGENTLY to replace lack of AACTH | fluid balance > surgery
39
cubital tunnel syndrome s/sx an def
o Compression of the ulnar nerve --> numbness/tingling of the 4th and 5th finger o Tinels sign positive o Weakness and muscle wasting o Pain worse on learnin on the affected elbow o Hx of osteoarthritis or prior trauma
40
what is meningitis
Inflammation of the leptomeningeal (pia and arachnoid mater) coverings of the brain, most commonly due to infection
41
causes of bacterial meningitis in > 6yo, teens and young adults
N meningitidis, S pneumoniae
42
causes of bacterial meningitis in older adults
N meningitidis, S pneumoniae, H influenzae (NHS) Listeria monocytogenes
43
wh is meningococcal disease
* Neisseria meningitidis disease --> multiplication of the bacteial in the blood stream -> Meningococcal septicaemia
44
kernig vs brudzinski sign
*Kernig's Sign* - with the **hips fully flexed, there is pain/resistance on passive knee extension** *Brudzinski's Sign* - **flexion of the hips and knees on bending head forward**
45
investigations for meningitis
Bedside: **basic obs, blood glucose, ABG (incl lactate), throat swab** Bloods: **FBC, Glucose, U&Es, Clotting, CRP, Blood cultures, LFTs** **Lumbar puncture** (CI if raised ICP, or meningoccal sepsis) Imaging: **CT** (if LP CI)
46
CSF appearance in meningitis: viral, bacteria, tb,
viral = no pus so no polymorphs (just lymphhocytes) bacteria = eat glucose, shit proteins TB = same as bacterial just lymphocytes instead of neutrophils
47
meningitis management in GP
* NOTIFY PUBLIC HEALTH AUTHORITIES * URGENT transfer to hospital * If suspected meningococcal sepsis: **IM/IV benzylpenicillin** (only if wont delay transfer) * If allergic: cefotaxime or ceftriaxone
48
meningitis management in secondary care
ABCDE insert 2 wide bore cannule **take blood cultures** LP within 1 hr if safe start antibiotics * **< 3 months: IV cefotaxime + amoxicillin ( Listeria)** * **> 3 months: IV ceftriaxone** * Adults **< 60: IV ceftriaxone** * Adults **> 60: IV ceftriaxone AND amoxicillin** high dose dexamethasone (reduces complications - deafness)
49
o Prophylactic treatment of contacts in meningitis
ciprofloxacin or rifampicin given to close contacts within 24 hours
50
when is lumbar puncture contraindicated
signs of **severe sepsis** or a **rapidly evolving rash** **severe respiratory/cardiac compromise** **significant bleeding risk** signs of **raised intracranial pressure** - *focal neurological signs* (changes to gait/balance, sensation or movement) - *papilloedema* - *continuous or uncontrolled seizures* - *GCS ≤ 12*

Y6 Senior Med COPY (29 decks)

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