15.6.2013(neurosurgery) 38 Flashcards
(137 cards)
0
Q
Normal serum folate levels
A
5-15ng/ml
1
Q
Normal vit B12 levels
A
200-900pg/ml
2
Q
Types of bartter
A
Type1(NKCC) Type2(ROMK) Type3(clck) Type4(barttin) sensory neural deafness Type5(CASR) autosomal dominant
Others are autosomal recessive
3
Q
Pial veins are pain____________
A
Insensitive
4
Q
Part of duramater that is pain sensitive
A
Base
5
Q
Layers of scalp
A
Skin Connective tissue dense(blood vessels are situated) Aponeurosis Loose areolar tissue Pericranium
6
Q
Scalp blood vessels are situated in
A
Dense connective tissue layer
7
Q
Potts puffy tumor
A
Osteomyelitis of skull
With overlying scalp Edema
8
Q
Anterior and middle cranial fossa are innervated by
A
V1 and V2
9
Q
Posterior cranial fossa is supplie by
A
9th
10th
Upper cervical nerves
10
Q
Neural plate formation
A
2weeks
11
Q
Neural plate invagination
A
18 days
12
Q
Closure of neural tube begins in
A
Cervical region
13
Q
Segments of internal carotid artery
A
Cervical C1 Petrous C2 Laceral C3 Cavernous C4 Clinoid C5 Ophthalmic C6 Communicating C7
14
Q
Branches of petrous segment
A
Caroticotympanic
Vidian artery
15
Q
Cavernous segment branches
A
Meningohypophyseal Inferior hypophyseal Marginal tentorial(artery of bernasconi cassinari) Dorsal meningeal Cavernous Inferolateral Capsular
16
Q
C6
Ophthalmic segment branches
A
Ophthalmic
Superior hypophyseal
17
Q
Communicating branch branches
A
Anterior choroidal artery
Posterior communicating artery
18
Q
Commonest cause of isolated 3rd nerve palsy
A
PCOM artery aneurysm
19
Q
Lhermitte sign is seen in
A
Posterior column lesion
20
Q
Lhermitte sign is also known as
A
Barber’s chair sign
21
Q
Abadies sign
A
Decreased sensation while squeezing the Achilles tendon
22
Q
Hitzig zones
A
Central area of face Nipple Ulnar borders of arm Peroneal branches of legs Perineal area
23
Q
Sink sign
A
Fall forward immediately following eye closure in posterior column lesion
24
Impaired light touch perception in hitzig zone is seen in
Posterior column lesion
25
Stomping sign
Double tapping sign
| Seen in posterior column lesion
26
Broca area is situated in
Pars opercularis
27
Supra marginal and angular gyri are part of
Parietal lobe
28
Parts of inferior frontal gyrus
Pars opercularis
Pars triangularis
Orbitofrontal part
29
Literal alexia is seen in
Angular gyrus lesion
30
Anterior and posterior lobe of cerebellum are separated by
Primary fissure
31
Posterior lobe is separated from flocculonodular lobe by
Posterolateral
Or
Postnodular fissure
32
Nuclei of cerebellum
```
From medial to lateral
Fastigial
Globose
Emboliform
Dentate
```
33
Lesion of fastigial nucleus results in
Abasia
34
True seizures
```
Pupils dilate
BP and HR increase
Extensor plantar
Face and nail beds cyanosis
Po2 and pH lowered
Creatinine phosphokinase increased
Prolactin level is raised
```
35
Hydantoin syndrome
Hypoplastic phalanges
Microcephaly
Cleft lip/cleft palate
36
Adverse effects of phenobarbitone
Cognitive dysfunction
Hyperactive child
Dupuytren contracture
37
Anti epileptics causing weight gain
Gabapentin
Carbamazepine
Valproate
38
Type of nystagmus in foramen magnum lesion
Downbeat nystagmus
39
Teratogenic effect of warfarin
Nasal bone dysplasia
40
Histamine cephalgia
Cluster headache
41
Primary brain injuries
Concussion
Contusion/laceration
Diffuse white matter disease
42
Diffuse white matter disease
Diffuse Axonal injury due to rotational forces
43
Diffuse Axonal injury types
Mild(6-24hrs)
Moderate(>24hrs without brainstem effect)
Severe(coma with decortication or decerebration)
44
Which is common?
| Extradural or subdural
Subdural(34%)
45
Glasgow blatchfold scale
To assess GIT bleeding
46
Earliest sign of tuberous sclerosis in infants
Hypopigmented patches
47
Only autosomal recessive phakomatosis
Louis Barr disease
48
Vogt triad
Epiloa
49
Sensitivity of maternal AFP for neural tube defects
100% for anencephaly
50
Most common site of CSF leak
Fovea ethmoidalis
51
Rx of traumatic CSF rhinorhea
Wait for 7 days for spontaneous closure
Leak persists for greater than 10 days,do surgery
52
Causes of spontaneous CSF leak
Tumors around sella
| Empty sella syndrome
53
Paradoxical CSF rhinorhea
CSF rhinorhea in transverse fracture of petrous temporal bone
54
Longest intradural course
Abducent nerve
55
Smallest cranial nerve(number of axons)
Trochlear
56
First sign of dorsal mesencephalon tumor
Isolated 4th nerve palsy
57
Albright syndrome
Galactorhea,amenorrhea syndrome
58
Normal prolactin level
5-20ng/ml
59
Number of spinal nerves
31 pairs
60
Average length of spinal cord
45cm(male)
| 42-43cm(female)
61
Length of vertebral column
70cm
62
Number of ligamentum denticulatum
21pairs
63
Lambert sign
Incremental test to nerve stimulation
64
Sites affected in diffuse Axonal injury
Corpus callosum
| Dorsolateral pons
65
Immunoglobulins absent in ataxia telangiectasia
IgE
| IgM
66
Capsular cells
Satellite cells or capsular gliocytes
| Surrounds neurons in peripheral ganglia
67
Character of headache due to raised ICT
Early morning headache
68
Number of foramen of Munro
2
69
Isodense or hypodense lesion in brain that is brilliantly enhance after contrast administration
Choroid plexus papilloma
70
A middle aged man admitted with recurrent fall following loss of consciousness. Diagnosis?
Drop attack due to colloid cyst of 3rd ventricle
71
Appearance of colloid cyst of third ventricle in CT or MRI
Hypodense lesion
72
Content of colloid cyst of 3rd ventricle
Cholesterol
73
Common site of choroid plexus papilloma
Adults(infratentorial)
| Children(supratentorial)
74
Hitzelberg sign is seen in
Vestibular schwannoma
75
Structure affected in Nothnagel syndrome
Superior cerebellar peduncle
76
Brachium conjunctivam
Superior cerebellar peduncle
77
Brachium pontis
Middle cerebellar peduncle
78
Inferior cerebellar peduncle is also known as
Restiform body
79
Acute cervical central cord syndrome
Man in barrel syndrome(distal muscles more affected than proximal)
Initially quadriplegic but lower limbs regain power immediately
80
Papilledema is _____________ oedema
Extracellular
81
papilledema,retinal arterial to venous pressure
<1.5 to 2
82
Cause of papilledema
Stasis of axoplasmic flow
| Venous congestion
83
Most common spinal cord tumor
Extramedullary intradural
84
Funicular pain is common in
Intramedullary tumor
85
Common site of oligodendroglioma
Frontal
86
Classical HPE feature of ependymoma
Blepharoplast
87
Metastatic abscess are common in
Corticomedullary junction
88
Klumpke paralysis
Paralysis of intrinsic muscles of hand
Sensory loss
Horner syndrome
89
Most common retroorbital mass in adult
Cavernous hemangioma
90
Optic nerve glioma arises from
Pilocytic astrocytes
91
X ray in optic nerve glioma
J shaped sella
92
Test done to detect Horner syndrome
Cocaine test
93
Test done to differentiate preganglionic from postganglionic
Hydroxy amphetamine test
94
B/L facial nerve palsy
```
PAN
SLE
sarcoidosis
Wegener
Sjogren
Meningitis
Leprosy
Syphilis
Lyme
Polio
HIV
pontine glioma
Leukemia
Lymphoma
NF2
Thalidomide
GBS
miller fisher
Melkerson Rosenthal
```
95
Melkerson
Recurring facial palsy,facial Edema
| Congenitally furrowed tongue
96
Sx not indicated in which type of depressed #
Closed depressed #
97
Moderate head injury
GCS 9-12
98
Upper roots of brachial plexus is commonly injured in
Caudally forced shoulder
99
Forced arm abduction affects which part of brachial plexus
Lower roots
100
Which injury has better prognosis?
| Supraclavicular or infraclavicular brachial plexus injuries
Infraclavicular
101
Which has better prognosis? Upper root or lower root injury of brachial plexus
Upper(hand function is preserved)
102
Worst prognosis in which type of brachial plexus injury?
Preganglionic(root avulsion)
| No repair possible
103
Features suggesting preganglionic lesions of brachial plexus
Horner syndrome
| Winged scapula
104
Lipoma in brain
Corpus callosum agenesis
105
Loss of innervation of cervical paraspinals is seen in
Preganglionic lesion
106
Only LMN degeneration is seen in which motor neuron disease
Progressive muscular atrophy
| Progressive bulbar palsy
107
Gold standard test for identifying level of nerve root injury in brachial plexus injuries
CT myelography
Pseudomeningocele is formed due to root avulsion
108
SNAP(sensory nerve action potentials) are preserved in which type of brachial plexus injury
Preganglionic(cell bodies are preserved)
109
Abnormal histamine test is seen in
Postganglionic lesions
| only redness and wheal present,absent flare
110
Which ventricle is more enlarged in NPH
Lateral ventricles
111
Signs of good prognosis in NPH
Gait disturbance is the first symptom to appear
Periventricular lucency
Presence of beta wave for more than 5% in 24hrs monitoring(ICP monitoring)
112
Apneustic breathing
Lesion of lateral tegmentum
113
Ataxic breathing
Dorsomedian medulla damage
114
Cluster breathing
Lesion in lower pons or upper medulla
115
Types of craniopharyngioma
Adamantinous
| Squamous papillary
116
Growing skull fracture occurs in
First 3 yrs of life
| Never occurs after 8 yrs
117
Growing skull fracture,synonyms
Craniocerebral erosion
| Post traumatic Leptomeningeal cyst
118
Rx of growing skull fracture
Cranioplasty
119
Vernet syndrome
Jugular foramen syndrome
| 9,10,11
120
Villaret syndrome
9,10,11,12
| Horner
121
9,10,11,12 cranial nerves affected in
Collet siccard syndrome
122
Foix Jefferson syndrome
Cavernous sinus syndrome
123
Superior orbital fissure syndrome
3,4,6,V1
124
Orbital apex syndrome
2,3,4,6,V1
125
Artery which causes tic doulereux
Superior cerebellar artery
126
Subdural empyema is commonly caused by
Streptococcus pneumoniae
127
Commonest cause of subdural effusion
H.influenzae
128
Commonest presentation of subdural empyema
Seizures
129
Nerve injury with best prognosis
Radial nerve
130
Commonly injured peripheral nerve
Radial nerve
131
Nerve abscesses are common in
Ulnar nerve
132
Order of reimplantation
```
Bone
Extensor tendon
Flexor tendon
Arteries
Nerve
Vein
Skin
```
133
Nerve compression effects
Tingling(15min)
Loss of pain(30 min)
Muscle weakness(45min)
134
Irreversible changes in nerves and muscles follow ischemia for
8 hours
135
Part of ICA that is intradural
Supraclinoid
136
Benediction hand is seen in
Syringomelia
| Ulnar nerve
