L17: approaches to patient with CNS disorder pt 2

Question 1

optic nerve tests (5)

Answer 1

• visual acuity (snellens chart)
• Visual fields
• visual accommodation
• Pupillary response to light and darkness
• Fundal examination

Question 2

complete oculomotor nerve lesion =

Answer 2

• eyes situated down and out
• pupil dilated
• ptosis

Question 3

apart from the extraocular muscles what other muscles does oculomotor nerve supply

Answer 3

• levator palpebrae superioris

- superior tarsal muscle

Question 4

Horner’s syndrome=

Answer 4

abnormal sympathetic supply

Question 5

ptosis=

Answer 5

falling of upper eyelid

Question 6

where do fibres elevating the eye run in the ocularmotor nerve

Answer 6

in the centre

Question 7

what do the sympathetic fibres run with

Answer 7

the blood vessels

Question 8

where do parasympathetic fibres in the ocular motor nerve run

Answer 8

outside the nerve

Question 9

cranial nerve motor/sensory mneumonic

Answer 9

some say marry money; but my brother says big boobs matter most

Question 10

trochlear nerve palsy–>

Answer 10

difficulty looking down and in

Question 11

abducens nerve palsy–>

Answer 11

can’t look right

Question 12

what can abducens nerve palsy indicate

Answer 12

pontine lesion

Question 13

UMN nerve lesion in face –>

Answer 13

lower face weakness

Question 14

LMW facial nerve lesion

Answer 14

whole one side of face palsy

Question 15

accessory nerve lesion–>

Answer 15

right trapezius does not contract when patient shrugs

Question 16

hypoglossal lesion –>

Answer 16

• wasting of tongue
• fasciculation’s
• weakness of tongue
• dysarthria
• tongue deviates to side of weakness (NOT lesion)

Question 17

UMNL has increased (2)

Answer 17

tone and reflexes

Question 18

UMNL has decreased (2)

Answer 18

muscle bulk and power

Question 19

LMNL has more

Answer 19

fasiculations

Question 20

LMNL has decreased (5)

Answer 20

• muscle bulk
• tone
• power
• reflexes

Question 21

decerebrate posture=

Answer 21

• arms adducted and extended, wrists pronated and fingers flexed
• legs extended

Question 22

decorticate posture=

Answer 22

• arms adducted and flexed, wrists and fingers flexed

- legs extended and internally rotated

Question 23

decerebrate posturing= lesion in the

Answer 23

upper brain stem

Question 24

decorticate posture= lesion in the

Answer 24

corticospinal tract

Question 25

grading of muscle power=

Answer 25

0-5 (5 normal)

Question 26

Babinsky response=

Answer 26

extensor or up going hallux

Question 27

babinsky’s suggests

Answer 27

an UMNL

Question 28

which are the only 2 places where lower limb is more medial to upper limb

Answer 28

DCML and motor homoculus in brain

Question 29

Brown-sequard syndrome=

Answer 29

hemispinal cord lesion

Question 30

central cord lesion–.

Answer 30

loss of motor and sensation in arms and hands

Question 31

anterior spinal artery syndrome –>

Answer 31

• complete motor loss below

- loss of spinothalamic function below

Question 32

Romberg’s test=

Answer 32

patient stands with feet together and closed eyes (wobble if vestibular dysfunction)

Question 33

4 types of stroke

Answer 33

• haemorrhagic
• Thromboembolic
• Embolic
• Lacunar

Question 34

causes of stroke (virchow’s triad)

Answer 34

• blood vessel wall
• blood flow
• blood constituents

Question 35

multiple sclerosis=

Answer 35

decreased nerve function due to inflammation of myelin sheath