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3rd year > Neurology > Flashcards

Neurology Flashcards

1
Q

Which nerve is compressed in carpal tunnel syndrome?

A

Median

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2
Q

Which type of neurons have their cell body in the CNS?

A

Multipolar

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3
Q

How many pairs of spinal nerves are there?

A

31

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4
Q

How many pairs of sacral nerves are there?

A

5

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5
Q

How many pairs of cervical nerves are there?

A

8

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6
Q

How many pairs of coccygela nerves are there?

A

1

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7
Q

What is the surface landmark for the T4 dermatome?

A

Nipple

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8
Q

What is the surface landmark for the T10 dermatome?

A

Umbilicus

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9
Q

Which spinal levels supply the skin of the posterior scalp, neck, and shoulder?

A

C2-4

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10
Q

Which spinal levels supply the upper limb?

A

C5-T1

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11
Q

Which spinal levels supply the lower limb, gluteal region, and perineum?

A

L2-Co1

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12
Q

Which spinal levels contribute to the sacral plexus?

A

L5-S4

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13
Q

Where are the cell bodies of sympathetic nerves found?

A

Lateral horns of T1 to L2

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14
Q

Where do presynaptic sympathetic axons to the heart synapse?

A

T1 or cervical paravertebral ganglia

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15
Q

Which nerves carry postsynaptic sympathetic axons to the heart?

A

Cardiopulmonary splanchnic

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16
Q

Where do presynaptic sympathetic axons to the lung synapse?

A

Thoracic paravertebral ganglia

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17
Q

Which nerves carry postsynaptic sympathetic axons to the lung?

A

Cardiopulmonary splanchnic nerves

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18
Q

Where do presynaptic axons to the foregut synapse?

A

Coeliac prevertebral ganglia

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19
Q

Where do presynaptic sympathetic axons to the kidneys synapse?

A

Aorticorenal prevertebral ganglia

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20
Q

Where do presynaptic sympathetic axons to the midgut synapse?

A

Superior mesenteric prevertebral ganglia

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21
Q

Where do presynaptic sympathetic axons to the hindgut and pelvic organs synapse?

A

Inferior mesenteric prevertebral ganglia

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22
Q

Which organ refers pain to the neck?

A

Liver

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23
Q

Which cranial nerves carry parasympathetic fibres?

A

III, VII, IX, X

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24
Q

Which ganglion do parasympathetic fibres to the eye travel in?

A

Ciliary ganglion

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25
Q

From rostral to caudal, what are the three primary vesicles of the neural tube?

A

Prosencephalon, mesencephalon, rhomencephalon

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26
Q

Which secondary vesicle(s) are formed from the prosencephalon?

A

Telencephalon and diencephalon

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27
Q

Which secondary vesicle(s) are formed from rhombencephalon?

A

Metencephalon and myelencephalon

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28
Q

Which structure is derived from telencephalon?

A

Cerebral hemisphere

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29
Q

Which structures does diencephalon form in the mature brain?

A

Thalamus and hypothalamus

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30
Q

Which structure does mesencephalon form in the mature brain?

A

Midbrain

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31
Q

Which secondary vesicle do the pons and cerebellum form from?

A

Metencephalon

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32
Q

Which secondary vesicle forms the medulla?

A

Myelencephalon

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33
Q

At which stage of development do the prosencephalon and rhombencephalon divide into their secondary vesicles?

A

6-8 weeks

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34
Q

Brainstem structures rostral to caudal

A

Midbrain, pons, medulla

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35
Q

Which glial cells contribute to maintenance of the blood-brain barrier?

A

Astrocytes

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36
Q

Which glial cells have a rounded nucleus with numerous branches?

A

Oligodendrocytes

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37
Q

Which cells produce myelin in the CNS?

A

Oligodendrocytes

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38
Q

Which cells produce myelin in the PNS?

A

Schwann cells

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39
Q

Which glial cells have a haematopoeitic origin?

A

Microglia

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40
Q

What is the function of microglia?

A

Immune monitoring and antigen presentation

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41
Q

What are ependymal cells?

A

Ciliated cuboidal/columnar cells which line the ventricles

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42
Q

Which type of glial cells does this image show?

A

Astrocyte

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43
Q

Which type of glial cell does this image show?

A

Oligodendrocyte

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44
Q

Which type of glial cell does this image show?

A

Ependymal cell

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45
Q

What is structure A?

A

Substantia nigra

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46
Q

What is structure B?

A

Red nucleus

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47
Q

What is structure C?

A

External capsule

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48
Q

What is structure D?

A

(Posterior limb of) internal capsule

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49
Q

What is structure E?

A

Body of fornix

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50
Q

What is structure F?

A

Corpus callosum

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51
Q

What is structure G?

A

Caudate nucleus

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52
Q

What is structure H?

A

Putamen

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53
Q

What is structure I?

A

Thalamus

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54
Q

What is structure L?

A

Pons

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55
Q

What is structure N?

A

Hippocampus

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56
Q

What is structure O?

A

Inferior horn of lateral ventricle

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57
Q

What is structure A?

A

Putamen

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58
Q

What is structure B?

A

(Anterior limb of) internal capsule

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59
Q

What is structure C?

A

Caudate nucleus

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60
Q

What is structure D?

A

Corpus callosum

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61
Q

What is structure E?

A

External capsule

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62
Q

What is structure H?

A

Optic chiasm

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63
Q

What is structure I?

A

Optic nerve

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64
Q

What is structure A?

A

Insula

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65
Q

What is structure B?

A

Putamen

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66
Q

What is structure C?

A

Globus pallidus

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67
Q

What is structure D?

A

(Anterior limb of) internal capsule

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68
Q

What is structure E?

A

Caudate nucleus

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69
Q

What is structure F?

A

Corpus callosum

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70
Q

What is structure H?

A

Anterior commissure

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71
Q

What is structure I?

A

Optic tract

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72
Q

What is structure J?

A

Third ventricle

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73
Q

What is structure K?

A

Uncus

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74
Q

What is structure L?

A

Amygdala

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75
Q

What is structure M?

A

Hypothalamus

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76
Q

What is structure A?

A

Corpus callosum

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77
Q

What is structure B?

A

(Posterior horn of) lateral ventricle

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78
Q

What is structure C?

A

Pineal gland

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79
Q

What is structure D?

A

Hippocampus

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80
Q

What is structure E?

A

Fourth ventricle

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81
Q

What is structure F?

A

Middle cerebellar peduncle

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82
Q

What is structure G?

A

Superior cerebellar peduncle

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83
Q

What is structure H?

A

Inferior colliculus

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84
Q

What is structure I?

A

Superior colliculus

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85
Q

What is structure J?

A

Thalamus

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86
Q

What is structure K?

A

Fornix

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87
Q

Which ligament of the back contains elastin?

A

Ligamentum flavum

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88
Q

What is tract A?

A

Lateral corticospinal

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89
Q

What is tract B?

A

Anterior corticospinal

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90
Q

What is tract C?

A

Rubrospinal

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91
Q

What is tract D?

A

Reticulospinal

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92
Q

What is tract E?

A

Olivospinal

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93
Q

What is tract F?

A

Vestibulospinal

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94
Q

What is tract G?

A

Gracile fasciculus

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95
Q

What is tract H?

A

Cuneate fasciculus

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96
Q

What is tract I?

A

Posterior spinocerebellar

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97
Q

What is tract J?

A

Anterior spinocerebellar

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98
Q

What is tract K?

A

Lateral spinothalamic

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99
Q

What is tract L?

A

Anterior spinothalamic

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100
Q

What does the orange arrow indicate?

A

Cauda equina

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101
Q

What does the red line indicate?

A

Supraspinatous ligament

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102
Q

What does the green line indicate?

A

Ligamentum flavum

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103
Q

What does the yellow line indicate?

A

Posterior longitudinal ligament

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104
Q

What does the blue line indicate?

A

Anterior longitudinal ligament

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105
Q

Which line indicates ligamentum flavum?

A

Green

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106
Q

Which line indicates the supraspinous ligament?

A

Red

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107
Q

Which line indicates the anterior longitudinal ligament?

A

Blue

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108
Q

Where is the myenteric plexus located?

A

Outer layers of gut smooth muscle

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109
Q

What is A?

A

Internal carotid artery

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110
Q

What is B?

A

Anterio cerebral artery

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111
Q

What is C?

A

Anterior communivating artery

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112
Q

What is D?

A

Middle cerebral artery

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113
Q

What is E?

A

Basilar artery

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114
Q

What is F?

A

Posterior cerebral artery

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115
Q

What is H?

A

Vertebral artery

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116
Q

What is I?

A

Posterior inferior cerebellar artery

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117
Q

Which vein do the venous sinuses drain to?

A

Internal jugular

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118
Q

At what vertebral level does the dural sac end?

A

S2

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119
Q

What is the denticulate ligament composed of?

A

Pia and arachnoid tissue

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120
Q

Which ventricle is the central canal of the spinal cord continuous with?

A

4th

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121
Q

What is the artery of Adamkiewicz?

A

A particularly large segemntal artery around the T2 level

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122
Q

Where do the anterior and posterior venous plexuses of the spine lie?

A

Epidural space

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123
Q

At what section does the spinal cord have a rugby ball shape?

A

Cervical

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124
Q

At which section of the spinal cord are lateral horns present?

A

Thoracic

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125
Q

Which spinal levels does fasciculus gracilis carry informatiom from?

A

T6 and below

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126
Q

Which spinal levels does fasciculus cuneatus carry information from?

A

Above T6

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127
Q

Where do the 1st order neurons of the DCML system synapse?

A

The gracile and cuneate nuclei in the medulla

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128
Q

Where do 2nd order neurons of the DCML project?

A

Ventral posterolateral lobe of thalamus

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129
Q

Where does the DCML decussate?

A

In the medulla

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130
Q

Where do 2nd order neurons of the spinothalamic tract synapse?

A

Thalamus

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131
Q

What is the function of the corticospinal tract?

A

Fine movement, particulary of the distal limb muscles

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132
Q

What proportion of corticospinal tract fibres decussate?

A

85%

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133
Q

Where do corticospinal tract fibres decussate?

A

The decussation of the pyramids

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134
Q

Where do fibres of the ventral/anterior corticospinal tract cross over?

A

Segmentally at the level they supply

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135
Q

What are the consequences of CVA of the internal capsule?

A

Loss of descending control of the corticospinal tract resulting in spastic paralysis with upper limb hyperflexion (decorticate posturing).

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136
Q

What is the function of the tectospinal tract?

A

Mediation of head and neck movement in response to visual stimuli

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137
Q

Where do fibres of the tectospinal tract originate?

A

Superior colliculus of midbrain

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138
Q

Where do tectospinal fibres cross over?

A

Immediately, at superior colliculus

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139
Q

Where do fibres of the reticulospinal tract originate?

A

The reticular formation in the pons and medulla

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140
Q

What is the function of reticulospinal tract fibres from the pons?

A

Faciliate extensor movements, inhibit flexor movements

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141
Q

What is the function of the reticulospinal tract fibres from the medulla?

A

Facilitate flexor movements, inhibit extensor movements(medulla has an L)

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142
Q

What is the function of the vestibulospinal tract?

A

Excitatory input to antigravity extensor muscles

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143
Q

Where do fibres of the vestibulospinal tract originate?

A

Vestibular nuclei of the pons and medulla

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144
Q

Lesions of which area can cause loss of control of the vestibulospinal tract?

A

Midbrain

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145
Q

What symptoms are seen in Brown-Sequard syndrome?

A

Ipsilateral spastic paralysisIpsilateral hyperreflexia and extensor plantar reflexIpsilateral loss of vibration sense and proprioceptionContralateral loss of pain and temperature

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146
Q

Loss of control of which tract causes extensor plantar reflex and hyperreflexia in Brown-Sequard syndrome?

A

Lateral corticospinal tract

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147
Q

Which structures does the tentorium cerebelli separate?

A

Separates cerebellum and brainstem from occipital lobes

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148
Q

Which structures does the falx cerebri separate?

A

The hemispheres of the brain

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149
Q

What structures does the falx cerebelli separate?

A

Cerebellar hemispheres

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150
Q

Which structures attach the cerebellum to the brainstem?

A

The superior, middle, and inferior peduncles

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151
Q

What are the three layers of the cerebellar cortex?

A

Molecular outermost

Purkinje cell layer

Granule cell layer

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152
Q

What is the result of unilateral cerebellar hemisphere lesion?

A

Ipsilateral limb coordination disturbance, intention tremor, unsteady gait

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153
Q

What is the result of midline cerebellar lesion?

A

Disturbance of postural control but spares limb coordination

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154
Q

Describe the direct pathway

A

Cerebral cortex excites neostriatum with glutamate

Neostriatum inhibits medial lobe of globus pallidus with GABA

Medial lobe is unable to inhibit thalamus with GABA

Thalamic activity increases, increasing cerebral stimulation and therefore movement

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155
Q

Describe the indirect pathway

A

Cerebral cortex excites neostriatum with glutamateNeostriatum inhibits lateral lobe of globus pallidus with GABALateral lobe cannot inhibit subthalamic nucleus with GABASubthalamic nucleus excites medial lobe of globus pallidusIncrease inhibition of thalamus, decreased movement(Lateral lobe means less movement, medial means more)

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156
Q

What are the two groups of intrinsic back muscles?

A

Erector spinae (superficial)Transversospinalis (deep)

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157
Q

What are the attachments of erector spinae?

A

Superiorly: Fibres attach via tendon to a rib, transverse process, or spinous processInferiorly: Common tendon attaches to sacrum and iliac crest

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158
Q

Where does transversospinalis run?

A

Between the transverse and spinous processes

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159
Q

Which muscles facilitate flexion of the spine?

A

Psoas major and rectus abdominis

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160
Q

Which muscles extend the spine?

A

Erector spinae, transversospinalis

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161
Q

What is the normal lordosis in the adult spine?

A

2 degrees cervical2 degrees lumbar

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162
Q

What is the normal kyphosis in the adult spine?

A

1 degree thoracic1 degree sacral

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163
Q

What is the outer ring of the intervertebral disc called?

A

Annulus fibrosus

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164
Q

What is the name of the inner soft pulp of the intervertebral disc?

A

Nucleus pulposus

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165
Q

Which areas have no intervertebral disc?

A

Between C1 and C2, sacrum, and coccyx

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166
Q

Which structures does ligamentum flavum connect?

A

Laminae of adjacent vertebrae

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167
Q

Which structures does the interspinous ligament connect?

A

The superior and inferior surfaces of adjacent spinous processes

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168
Q

Which ligament prevents overflexion of the spine?

A

Posterior longitudinal

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169
Q

Which ligament prevents overextension of the spine?

A

Anterior longitudinal

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170
Q

Which ligament is indicated in red?

A

Anterior longitudinal ligament

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171
Q

Which ligament is indicated in purple?

A

Posterior longitudinal ligament

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172
Q

Which ligament is indicated in blue?

A

Ligamentum flavum

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173
Q

Which ligament is indicated in green?

A

Interspinous ligament

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174
Q

Which ligament is indicated in yellow?

A

Supraspinous ligament

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175
Q

Which colour indicates the interspinous ligament?

A

Green

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176
Q

Which colour indicates the posterior longitudinal ligament?

A

Purple

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177
Q

What are the characteristic features of cervical vertebrae?

A

Transverse foramen, bifid spinous processes, triangular vertebral foramen

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178
Q

What are the atypial features of C1?

A

Anterior and posterior arch in place of body and spinous process

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179
Q

What type of joint are the atlanto-occipital joints?

A

Synovial

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180
Q

What % of translation occurs in stage 2 vertebral dislocation?

A

25%

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181
Q

What % of translation occurs in stage 3 vertebral dislocation?

A

50%

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182
Q

How many atlanto-axial joints are there, and where do they lie?

A

Two between the inerior articular facets of atlas and the super articular facets of axisOne between the anterior arch of atlas and odontoid process of axis

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183
Q

At what vertebral level does the spinal cord end?

A

L1/2

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184
Q

Which layers are passed through in laminectomy?

A

Skin, superficial fascia, aponeurosis of trapezius/thoracolumbar fascia, ligaments (supraspinous, interspinous, flavum), lamina, spinous process, epidural fat, dura mater, arachnoid mater

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185
Q

Whqt area of skin is supplied by C2?

A

Back of scalp, Adam’s apple

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186
Q

What area of skin is supplied by C3?

A

Back of neck, jugular notch

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187
Q

What area of skin is supplied by C4?

A

Clavicle and shoulder tip

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188
Q

What area of skin is supplied by C5?

A

Badge patch, lateral arm

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189
Q

What area of skin is supplied by C6?

A

Lateral forearm, lateral hand, thumb

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190
Q

What area of skin is supplied by C7?

A

Middle aspect of hand

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191
Q

What area of skin is supplied by C8?

A

Medial hand

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192
Q

What area of skin is supplied by T1?

A

Medial forearm

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193
Q

What area of skin is supplied by T2?

A

Medial arm and sternal angle

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194
Q

What area of skin is supplied by L1?

A

Groin - “hands in pockets”

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195
Q

What area of skin is supplied by L2?

A

Anterior thigh

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196
Q

What area of skin is supplied by L3?

A

Anterior knee

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197
Q

What area of skin is supplied by L4?

A

Medial leg and ankle

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198
Q

What area of skin is supplied by L5?

A

Lateral leg, dorsum of foot

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199
Q

What area of skin is supplied by S1?

A

Lateral foot, heel

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200
Q

What area of skin is supplied by S2?

A

Posterior knee and thigh

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201
Q

What area of skin is supplied by S3?

A

Buttock (outermost part of ‘bullseye’)

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202
Q

What area of skin is supplied by S4?

A

Perineum

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203
Q

What area of skin is supplied by S5?

A

Perianal skin (middle of bullseye)

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204
Q

Which cranial nerve exits the brainstem posteriorly?

A

Trochlear

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205
Q

Which cranial nerve exits the brainstem laterally?

A

Vestibulocochlear

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206
Q

Which cranial nerve is purely sensory?

A

Olfactory

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207
Q

Which cranial nerves are purely motor?

A

III, IV, VI, XII

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208
Q

Which nucleus gives sympathetic fibres to the oculomotor nerve?

A

E

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209
Q

What is nucleus A?

A

Mesencephalic nucleus of trigeminal

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210
Q

What is nucleus B?

A

Sensory nucleus of trigeminal

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211
Q

What is nucleus C?

A

Spinal nucleus of trigeminal

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212
Q

What is nucleus D?

A

Solitary nucleus

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213
Q

What is nucleus E?

A

Edinger-Westphal nucleus

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214
Q

What is nucleus F?

A

Oculomotor nucleus

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215
Q

What is nucleus G?

A

Trochlear nucleus

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216
Q

What is nucleus H?

A

Motor nucleus of trigeminal

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217
Q

What is nucleus I?

A

Abducens nucleus

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218
Q

What is nucleus J?

A

Superior salivatory nucleus

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219
Q

What is nucleus K?

A

Facial nucleus

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220
Q

What is nucleus L?

A

Inferior salivatory nucleus

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221
Q

What is nucleus M?

A

Hypoglossal nucleus

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222
Q

What is nucleus N?

A

Dorsal motor nucleus of vagus

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223
Q

What is nucleus O?

A

Nucleus ambiguus

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224
Q

What is nucleus P?

A

Spinal accessory nucleus

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225
Q

Which muscle of the tongue is not supplied by the hypoglossal nerve?

A

Palatoglossus

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226
Q

Which cranial nerve passes through the interpeduncular fossa in the midbrain?

A

Oculomotor

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227
Q

Which cranial nerves does nucleus O give fibres to?

A

IX, X and accessory XI

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228
Q

What are the functions of the trigeminal nerve?

A

Somatosensation of faceProprioception e.g. in chewingMotor control of muscles of mastication, tensor tympani, mylohyoid, digastric, tensor veli palatini

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229
Q

Which nucleus receives proprioceptive information from the muscles of mastication?

A

Mesencephalic trigeminal (A)

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230
Q

Which nucleus receives discriminative touch and vibration information from the face?

A

Main sensory/pontine/principal trigeminal nucleus (B)

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231
Q

Which nucleus receives pain and temperature information from the face?

A

C (spinal trigeminal)

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232
Q

What are the functions of the facial nerve?

A

Motor supply to muscles of facial expressionParasympathetic innervation to pterygopalatine and submandibular gangliaTaste to anterior 2/3 of tongue

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233
Q

Which muscle receives motor supply from the glossopharyngeal nerve?

A

Stylopharyngeus

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234
Q

Which cranial nerves give fibres to the solitary nucleus?

A

VII, IX, X

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235
Q

Which cranial nerves receive fibres from the superior and inferior salivatory nuclei?

A

VII and IX

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236
Q

Which cranial nerves does nucleus J give fibres to?

A

VII, IX (sup. salivatory)

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237
Q

Which nerves exit the brainstem in the pontomedullary junction?

A

VI, VII, VIII

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238
Q

Where does CN IV exit the brainstem?

A

Posterior midbrain

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239
Q

How is auditory information transmitted from the cochlea to the cortex?

A

Spiral ganglion -> dorsal ventral cochlear nuclei in medulla ->superior olivary nucleus in pons -> inferior colliculus in midbrain ->medial geniculate body in thalamus -> primary auditory cortex in superior temporal gyrus

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240
Q

Which aspect of the auditory cortex maps to low frequency sound?

A

Anterolateral

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241
Q

Where does Broca’s area lie?

A

Inferior frontal gyrus (usually left hemisphere)

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242
Q

What is Broca’s aphasia?

A

Expressive aphasia - difficulty producing language, but no issues comprehending it

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243
Q

Where does Wernicke’s area lie?

A

Superior temporal gyrus (usually left)

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244
Q

What is Wernicke’s aphasia?

A

Receptive aphasia - difficulty comprehending language

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245
Q

What is structure A?

A

Ciliary body

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246
Q

What is structure B?

A

Sclera

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247
Q

What is structure C?

A

Choroid

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248
Q

What is structure D?

A

Retina

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249
Q

What is structure E?

A

Optic nerve

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250
Q

What is structure F?

A

Macula

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251
Q

What is structure G?

A

Fovea

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252
Q

What is structure H?

A

Lens

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253
Q

What is structure I?

A

Anterior chamber

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254
Q

What is structure J?

A

Pupil

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255
Q

What is structure K?

A

Cornea

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256
Q

What is structure L?

A

Iris

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257
Q

What are the layers of the retina, from deep to superficial?

A

Inner limiting membrane

Layer of optic nerve fibers

Ganglion cell layer

Inner plexiform layer

Inner nuclear layer

Outer plexiform layer

Outer nuclear layer

Outer limiting membrane

Rods and cones

Retinal pigment epithelium

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258
Q

Where do the lower visual fields project to?

A

Gyrus superior to calcarine sulcus

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259
Q

Where does the macula project to?

A

Posterior pole of visual cortex

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260
Q

Which brainstem nucleus is involved in the consensual light reflex?

A

Edinger-Westphal

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261
Q

What are the features of the accomodation reflex?

A

Convergence of gaze, contraction of ciliary muscles, pupil constriction

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262
Q

5 layers of the scalp

A

Skin Connective tissue Aponeurosis Loose connective tissue Pericranium

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263
Q

Branches of which artery supply the scalp?

A

External carotid

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264
Q

Which layer of the scalp contains a rich anastomotic network?

A

Connective tissue

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265
Q

Which bones meet at the pterion?

A

Frontal, parietal, temporal, sphenoid

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266
Q

What is foramen A?

A

Cribriform plate of ethmoid

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267
Q

What is foramen B?

A

Optic canal

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268
Q

What is foramen C?

A

Superior orbital fissure

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269
Q

What is foramen D?

A

Foramen rotundum

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270
Q

What is foramen E?

A

Foramen ovale

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271
Q

What is foramen F?

A

Foramen lacerum

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272
Q

What is foramen G?

A

Foramen spinosum

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273
Q

What is foramen H?

A

Carotid canal

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274
Q

What is foramen I?

A

Internal acoustic meatus

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275
Q

What is foramen J?

A

Jugular foramen

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276
Q

What is foramen K?

A

Hypoglossal canal

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277
Q

What is foramen L?

A

Foramen magnum

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278
Q

Which cranial nerves pass through the internal acoustic meatus?

A

VII and VIII

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279
Q

Which cranial nerves pass through the superior orbital fissure?

A

III, IV, V1, VI

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280
Q

Which cranial nerve passes through foramen rotundum?

A

V2

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281
Q

Which cranial nerve passes through foramen ovale?

A

V3

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282
Q

Which cranial nerves pass through the jugular foramen?

A

IX, X, XI

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283
Q

Which cranial nerve gives sensory supply to the dura?

A

V

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284
Q

Which bone does the tentorium cerebelli attach to?

A

Petrous temporal bone

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285
Q

What are the attachments of the falx cerebri?

A

Crista galli of ethmoid anteriorly, internal occipital protuberance posteriorly

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286
Q

Where does the confluence of the sinuses lie?

A

At the internal occipital protuberance

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287
Q

What foramen allows passage of CSF from the lateral ventricles to third ventricle?

A

Foramen of Munro

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288
Q

How does CSF pass from the 3rd to 4th ventricle?

A

Through the cerebral aqueduct

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289
Q

Which type of haemorrhage is caused by rupture of the middle meningeal artery?

A

Extradural

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290
Q

Which type of haemorrhage is seen in the elderly and those with alcohol problems?

A

Subdural

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291
Q

Which type of haemorrhage can occur due to rupture of aneurysm in the circle of Willis?

A

Subarachnoid

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292
Q

Which type of haematoma is lemon shaped?

A

Extradural

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293
Q

Which type of haematoma is crescent-shaped?

A

Subdural

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294
Q

Which type of haemorrhage presents with a ‘worst ever’ thunderclap headache?

A

Subarachnoid

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295
Q

Which cranial nerves travel in the wall of the cavernous sinus?

A

III and IV

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296
Q

Which cranial nerve travels within the cavernous sinus?

A

VI

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297
Q

Which cranial nerve runs with the carotid sheath?

A

XII

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298
Q

Where will the tongue deviate in CN XII pathology?

A

Towards the affected side

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299
Q

Which foramina do the divisions of CN V pass through?

A

V1 - SOFV2 - rotundumV3 - ovale

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300
Q

Which nerve gives sensory supply to the angle of the mandible?

A

Great auricular nerve (C2, 3)

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301
Q

Which muscle of mastication closes the jaw?

A

Lateral pterygoid

302
Q

What nerve forms the afferent limb of the corneal reflex?

A

Long ciliary nerve (from nasociliary branch of V1)

303
Q

Where does the facial nerve exit the skull?

A

Stylomastoid foramen

304
Q

What are the five divisions of the facial nerve?

A

TemporalZygomaticBuccalMarginal mandibularCervical

305
Q

Which ganglion receives parasympathetic fibres from CN VII?

A

Pterygopalatine

306
Q

What is the position of the vagus nerve within the carotid sheath?

A

Posterior to and between the common carotid and internal jugular

307
Q

At what level does the oesophagus pass through the diaphragm?

A

T10

308
Q

In pathology of the vagus nerve, what abnormality of the uvula is seen?

A

Deviation away from the affected side

309
Q

Which cell organelle is seen as Nissl substance?

A

Rough endoplasmic reticulum

310
Q

What is the most common excitatory transmitter of the CNS?

A

Glutamate

311
Q

What are the most common inhibitory neurotransmitters of the CNS?

A

GABA, glycine

312
Q

Name 3 amino acid neurotransmitters

A

Glycine, GABA, glutamate

313
Q

Name 3 amine neurotransmitters

A

Dopamine, histamine, serotonin, noradrenaline

314
Q

Name 3 peptide neurotransmitters

A

CCK, somatostatin, substance P, TRH, VIP

315
Q

Which fibres and receptors are found in Merkel cells?

A

AB fibres, SA1 receptors

316
Q

How would a mechanoreceptor with fast adaptation and a small receptive field be classified?

A

FA1

317
Q

Where are Merkel cell complexes found?

A

Basal epithelium of fingers, palms, dorsum of hand, sole of foot

318
Q

What do Merkel cell complexes detect?

A

Sustained pressure and texture

319
Q

Which type of fibres and receptors do Meissner corpuscles have?

A

AB, FA1

320
Q

Where are Meissner corpuscles found?

A

Basal epithelium in skin areas of high acuity

321
Q

What do Meissner corpuscle detect?

A

Stroking, flutter, low frequency vibration

322
Q

What type of fibres and receptors do Ruffini endings have?

A

AB, SA2

323
Q

Which type of mechanoreceptor has a collagen core?

A

Ruffini ending

324
Q

Where are Ruffini endings found?

A

The dermis of glabrous and hairy skin, and joint capsules

325
Q

What are Ruffini endings sensitive to?

A

Drag

326
Q

What type of fibres and receptors do Pacinian corpuscles have?

A

AB, FA2

327
Q

Which mechanoreceptors resemble onions?

A

Pacinian corpuscles

328
Q

Where are Pacinian corpuscles found?

A

Close to the periosteum

329
Q

What are Pacinian corpuscles sensitive to?

A

Vibration 200-300 Hz

330
Q

Which type of fibres do free nerve endings have?

A

Adelta or C

331
Q

Which laminae of the spinal cord contain nociceptors?

A

I and II

332
Q

Which laminae of the spinal cord contain proprioceptors?

A

VII to IX

333
Q

Which type of receptor has direct gating?

A

Ionotropic

334
Q

What is stereognosis?

A

The ability to recognise an object by touch

335
Q

What is detected by the DCML?

A

Vibration, stereognosis, fine touch, proprioception

336
Q

How does somatic information from the face reach the cortex?

A

Trigeminal nerve -> chief sensory/spinal nucleus, then decussation and projection via trigeminal lemniscus to VPN of thalamus. 3rd order from thalamus to cortex.

337
Q

Which Broadmann areas around found in the central sulcus?

A

1, 2, 3a, 3b

338
Q

Layers of somatosensory cortex

A

MolecularExternal granularExternal pyramidalInternal granularInternal pyramidalMultiform

339
Q

Which layer of somatosensory cortex do thalamic inputs terminate in?

A

4 (internal granular)

340
Q

Which area is damaged in hemispatial neglect syndrome?

A

Right parietal cortex - esp. posterior

341
Q

Which vitamin deficiency causes Wernicke’s encephalopathy?

A

B1 (thiamine)

342
Q

What are the three deficits seen in Wernicke’s encephalopathy

A

Gait ataxia, oculomotor dysfunction, encephalopathy

343
Q

How are LMNs arranged in the ventral horn?

A

Axial muscles medial to distalFlexors dorsal to extensors

344
Q

Which type of muscle fibres derive ATP from glycolysis?

A

Type IIb (fast fatiguing)

345
Q

Which channel do tip links gate?

A

TMC1

346
Q

Types of visual migraine aura

A

Central scotomata, central fortification, hemainopic loss

347
Q

Abortive treatment of migraines

A

NSAIDs - aspirin 900, naproxen 250, ibuprofen 400 +/- anti-emetic

348
Q

What is the action of triptans?

A

5-HT agonist

349
Q

Triptans used in migraine

A

Rizatriptan, eletriptan

350
Q

Drugs used for migraine prophylaxis

A

Propranolol

Topiramate

Amitriptyline

Gabapentin

Pizotifen

Sodium valproate

351
Q

Drugs used in tension headache

A

Amitriptyline Dothiepin

352
Q

Treatment of cluster headaches

A

High flow o2 for 20 mins6mg sc sumatriptan 2 week course steroidsprophylaxis - verapimil

353
Q

Cluster headache presentation

A

Occur in 30-40s, predominantly menCircadian and seasonal variationSevere unilateral pain lasting 45-90 minutes, occurring multiple times per day during bouts

354
Q

What are SUNCT headaches?

A

Short-lived (15-120s)UnilateralNeuralgiformConjunctival injectionsTearing

355
Q

Treatment of SUNCT headache

A

Lamotrigine Gabapentin

356
Q

Management of idiopathic intracranial hypertension

A

Weight lossAcetazolamideVentricular atrial/lumbar peritoneal shift

357
Q

Trigeminal neuralgia presentation

A

Occurs in elderly, mostly womenStabbing pain in v2/3 lasting 1-90s 10-100 times per day during bout

358
Q

Treatment of trigeminal neuralgia

A

Carbamazepine, gabapentin, phenytoin, baclofen, surgery

359
Q

What is Kernig sign?

A

Neck stiffness in meningitis

360
Q

Which types of meningitis have low CSF glucose?

A

Bacterial and fungal/TB

361
Q

Which type of meningitis will have PMNs/granulocytes in CSF?

A

Bacterial

362
Q

Which type of white cells are found in CSF in viral meningitis?

A

Lymphocytes

363
Q

What is the motor function of the obturator nerve?

A

Adduction of the thigh

364
Q

What is the motor function of the sciatic nerve?

A

Leg flexion at knee

365
Q

What is the motor function of the tibial nerve?

A

Foot plantarflexion, inversion

366
Q

What is the motor function of the superficial peroneal nerve?

A

Foot eversion

367
Q

What is the motor function of the deep peroneal nerve?

A

Foot dorsiflexion, toe extension

368
Q

Which area does the deep peroneal nerve give sensory supply to?

A

Space between 1st and 2nd toes

369
Q

What area does the tibial nerve give sensory supply to?

A

Sole

370
Q

What are the motor functions of the radial nerve?

A

Extension at arm, wrist, and proximal finger jointsForearm supinationThumb abduction

371
Q

What are the motor functions of the median nerve?

A

Thumb flexion and oppositionFlexion of digits 2 and 3Wrist flexion and abductionForearm pronation

372
Q

What are the motor functions of the ulnar nerve?

A

Finger adduction and abduction

Thumb adduction

Flexion of digits 4 and 5

Wrist flexion and adduction

373
Q

What are the motor functions of the axillary nerve?

A

Abduction of arm beyond first 15 degrees

374
Q

What are the motor functions of the musculocutaneous nerve?

A

Flexion of arm at elbowSupination of forearm

375
Q

Which area does the median nerve give sensory supply to?

A

Palm, thumb, digits 2 and 3

376
Q

Which area does the ulnar nerve give sensory supply to?

A

Medial palm, digits 4 and 5

377
Q

Which area does the axillary nerve give sensory supply to?

A

Badge patch

378
Q

Which area does the musculocutaneous nerve give sensory supply to?

A

Lateral forearm

379
Q

Which nerve palsy gives a claw-like appearance of the hand?

A

Ulnar

380
Q

Which nerve palsy causes preacher’s hand?

A

Median

381
Q

Which nerve palsy causes simian hand?

A

Median and ulnar

382
Q

Common drugs which precipitate epileptic seizure

A

Aminophylline

Tramadol

Antibiotics

Anti-emetics

Opioids

383
Q

When is acute CT indicated after a fall/LOC?

A

Clinical or radiological skull fracture

Deteriorating GCS

Focal signs

Head injury with seizure

GCS <15 after 4 hours

384
Q

How long should patients stop driving after a first seizure?

A

6 months

385
Q

What is the difference between simple and complex partial seizures?

A

Complex have impaired consciousness

386
Q

Treatment of choice for primary generalised epilepsy

A

Sodium valproate

387
Q

First line treatment for focal onset epilepsy

A

Carbamazepine or lamotrigine

388
Q

How does carbamazepine work?

A

Inhibits voltage-gated Na channels

389
Q

How does lamotrigine work?

A

Inhibits voltage-gated Na channels

390
Q

How does sodium valproate work?

A

Enhances GABA synthesis

391
Q

First line for partial seizures

A

Carbamazepine or lamotrigine

392
Q

First line for absence seizures

A

Sodium valproate, ethosuxamide

393
Q

First line for myoclonic seizures

A

Sodium valproate, levetiracetam, clonazepam

394
Q

First line for tonic and tonic clonic seizures

A

Sodium valproate, levetiracetam, topiramate, lamotrigine

395
Q

Sodium valproate side effects

A

Weight gain, teratogenicity, hair loss, fatigue

396
Q

Carbamazepine contraindications

A

Worsens primary generalised epilepsies

397
Q

Topiramate side effects

A

Sedation, dysphasia, weight loss

398
Q

Complications of status epilepticus

A

Respiratory insuffiency, hypotension, hyperthermia, rhabdomyolysis

399
Q

What is Lambert Eaton Myasthenic Syndrome?

A

Autoimmune condition with antibodies against presynaptic calcium channels

400
Q

How low is ACh receptor function when symptoms of myasthenia gravis occur?

A

~30%

401
Q

Incidence peaks for myasthenia gravis

A

20s for women50s and 60s for men

402
Q

Treatment of myasthenia gravis

A

AChesterase inhibitor - pyridostigmine

IVIG

Thymectomy

Steroids

403
Q

Drugs to avoid in myasthenia gravis

A

Antibiotics esp. gentamicin

Antimalarials

Beta blockers

Many psych/neuro drugs

404
Q

Which channels are often affected in myotonic disorders?

A

Chloride

405
Q

Blood test for polymyositis

A

Creatine kinase

406
Q

Main symptom distinguishing dermatomyositis from polymyositis

A

Heliotrope rash on face

407
Q

Which immune-mediated muscle disorder is often associated with underlying malignancy?

A

Dermatomyositis

408
Q

Which form of myositis characteristically spares the thumbs?

A

Inclusion body myositis

409
Q

What is the genetic defect in myotonic dystrophy?

A

Trinucleotide repeat disorder inherited in autosomal dominant manner

410
Q

Triad of signs/symptoms in rhabdomyolysis

A

MyalgiaMuscle weaknessMyoglobinuria

411
Q

What muscle power rating would movement against gravity but not resistance be?

A

3

412
Q

How is a muscle power rating of 1 described?

A

A flicker of movement

413
Q

Summarise muscle power rating

A

0 - no movement at all

1 - flicker of movement when attempting to contract muscle

2 - some muscle movement if gravity removed but none against gravity

3 - movement against gravity but not against resistance

4 - movement against resistance but not full strength

5 - normal strength

414
Q

Where are the cell bodies of the rubrospinal tract?

A

Red nucleus

415
Q

What is the function of the rubrospinal tract?

A

Control of limb flexors

416
Q

Where are the cell bodies of the tectospinal tract?

A

Superior colliculus

417
Q

Which type of nociceptive fibre is unmyelinated?

A

C fibre

418
Q

Which type of nociceptive fibre mediates ‘first’, or fast, pain?

A

Aδ

419
Q

Which family of receptors is triggered by thermal stimuli?

A

TRP

420
Q

What is the action of horizontal cells in the retina?

A

Receive input from photoreceptors and project to other photoreceptors and bipolar cells

421
Q

What is the function of amacrine cells in the retina?

A

Receive input from bipolar cells and project to ganglion cells, bipolar cells, and other amacrine cells

422
Q

How does light result in the closure of Na channels in the retina?

A

Light stimulates rhodopsin, activating G protein transducin, which in turn activates cGMP phosphodiesterase, reducing cGMP and leading to closure of Na channels

423
Q

Properties of rod cells

A

Found in peripheryLow densityHigh convergence-> low acuity but increased sensitivity

424
Q

Properties of cone cells

A

Found in highest concentration in foveaHigh densityLow convergence (only a couple per ganglion cell)

425
Q

How do off bipolar cells respond to light?

A

By releasing less glutamate

426
Q

What do M type retinal ganglion cells detect?

A

Movement

427
Q

What do P type retinal ganglion cells detect?

A

Form and colour

428
Q

What do non-M-non-P type retinal ganglion cells detect?

A

Colour

429
Q

Which cancer should NF patients be screened for?

A

Thyroid

430
Q

What are the different categories of GCS scored out of?

A

Eyes out of 4, verbal out of 5, motor out of 6

431
Q

GCS E2 V4 M5

A
432
Q

GCS E4 V1 M2

A
433
Q

GCS E3 V3 M4

A
434
Q

GCS E1 V5 M2

A
435
Q

GCS E4 V5 M5

A
436
Q

GCS E2 V4 M1

A
437
Q

GCS E2 V3 M5

A
438
Q

GCS E2 V1 M4

A
439
Q

Which nerve supplies the skin posterior to the external ear?

A

Lesser occipital (C2)

440
Q

Which nerve supplies the skin over the angle of the mandible?

A

Great auricular nerve (C2,3)

441
Q

Which nerve supplies the skin over the anterior neck?

A

Transverse cervical (C2,3)

442
Q

Which nerve roots are found in the musculocutaneous nerve?

A

C5/6/7

443
Q

Which nerve roots around found in the axillary nerve?

A

C5/6

444
Q

Which nerve roots around found in the radial nerve?

A

C5-T1

445
Q

Which nerve roots around found in the median nerve?

A

C5-T1

446
Q

Which nerve roots around found in the ulnar nerve?

A

C8, T1

447
Q

Which nerve roots are found in the ilioinguinal nerve?

A

L1

448
Q

Which nerve roots around found in the obturator nerve?

A

L2,3,4

449
Q

Which nerve roots around found in the femoral nerve?

A

L2,3,4

450
Q

Which nerve roots are found in the superficial fibular nerve?

A

L4,L5,S1

451
Q

Which nerve roots are found in the deep fibular nerve?

A

L5

452
Q

Which nerve roots are found in the sural nerve?

A

S1,2

453
Q

Which area of skin is supplied by the femoral nerve?

A

Anterior thigh

454
Q

Which area of skin is supplied by the saphenous nerve?

A

Anteromedial leg

455
Q

Which area of skin is supplied by the deep fibular nerve?

A

First web space

456
Q

Which muscle compartment is supplied by the musculocutaneous nerve?

A

Anterior arm

457
Q

Which muscle compartment is supplied by the median nerve?

A

Anterior forearm

458
Q

Which muscle compartment is supplied by the radial nerve?

A

Posterior arm and forearm

459
Q

Which muscle compartment is supplied by the sciatic nerve?

A

Posterior leg

460
Q

Which muscle compartment is supplied by the deep fibular branch of sciatic nerve?

A

Anterior leg

461
Q

Which muscle compartment is supplied by the superficial fibular branch of sciatic nerve?

A

Lateral compartment

462
Q

Most common extra-axial intracranial neoplasm

A

Meningioma

463
Q

Which cells do meningioma arise from?

A

Residual mesenchymal cells of the meninges

464
Q

Most common presentations of brain tumour

A

Progressive neurological deficitMotor weaknessHeadacheSeizure

465
Q

Perseveration is a sign seen in tumours of which lobe?

A

Frontal

466
Q

Tumours of which lobe can present with dyspraxia and neglect?

A

Parietal

467
Q

What is glioblastoma multiforme?

A

An astrocytic tumour with necrosis

468
Q

Grades of astrocytomas

A

I - Pilocytic. Truly benign, slow growing.II - Low grade fibrillary, gemistocytic, or protoplasmic. Often present with seizures, can become high grade. Treated surgicallyIII - Anaplastic astrocytoma. No contrast enhancement. Median survival 2 years.IV - GBM. Survival under a year. Treatment focused on symptom management, includes surgery, chemo.

469
Q

Features distinguish oligodendroglial tumours from astrocytomas

A

Calcification, cysts, peritumoural haemorrhage.Subarachnoid accumulations can look like toothpaste

470
Q

Risk factors for meningioma

A

NF2, breast cancer

471
Q

Aggressive forms of meningioma

A

Clear cell, chorioid, rhabdoid, papillary

472
Q

Which cranial nerves are affected by acoustic neuroma?

A

V VII VIII

473
Q

Symptoms of acoustic neuroma

A

Hearing loss, tinnitus, disequilibrium

474
Q

Epidemiology of germ cell tumours

A

More men than women, almost exclusively under 20s

475
Q

Most common CNS germ cell tumour

A

Germinoma

476
Q

Markers for germ cell tumours

A

Alpha fetoprotein (yolk sac, teratoma)HCG (choriocarcinoma, germinoma)Placental alkaline phosphate (PLAP) (germinoma, choriocarcinoma, yolk sac)

477
Q

Symptoms of pituitary tumours

A

Bitemporal hemianopiaHeadacheEndocrine abnormalities

478
Q

Treatment of prolactinoma

A

Cabergoline

479
Q

Treatment of GH and IGF-1 tumours

A

Surgery, somatostatin analogues

480
Q

Main complication of cortisol-secreting tumours

A

Cushings

481
Q

Signs of panhypopituitarism

A

Pale/yellow skin, skin wrinkling, absent axillary hair, puffy and expressionless face, diabetes insipidus

482
Q

Treatment of bacterial meningitis (pre-culture result)

A

Ceftriaxone IV 2g BD (chloramphenicol if pen allergic)+ dexamethasone IV 10mg qdsIf listeria cover required add amoxicillin IV 2g 4 hourly (co-trimox if pen allergic)

483
Q

When should listeria be considered in bacterial meningitis?

A

Age >60

Immunocompromise (inc. alcohol dependency and DM)

484
Q

Causitive organisms of bacterial meningitis in neonates

A

Listeria, group B strep, E coli

485
Q

Causitive organisms of bacterial meningitis in young children

A

H influenzae

486
Q

Causitive organisms of bacterial meningitis in 10-21 year olds

A

Neisseria meningitidis

487
Q

Causitive organisms of bacterial meningitis in adults over 21

A

Strep pneumoiae, followed by Neisseria

488
Q

Causitive organisms of bacterial meningitis in over 65s

A

Streptococcus pneumoniae, listeria

489
Q

Which type of meningitis does cribriform plate fracture predispose to?

A

Strep pneumoniae meningitis

490
Q

Which cranial nerves are mostly vulnerable to exudate collection in bacterial meningitis?

A

III, VI

491
Q

What type of organism is Neisseria meningitidis?

A

Gram-negative coccus

492
Q

Which type of H influenzae is the most common cause of meningitis in under 4s?

A

B

493
Q

What type of bacteria is H influenzae?

A

Gram-negative coccobaccilus

494
Q

Which groups are most susceptible to Strep pneumo meningitis?

A

Hospitalised patientsPatients with skull fracturesDiabeticsAlcoholics Young children

495
Q

What type of bacteria is listeria monocytogenes?

A

Gram-positive bacilli

496
Q

Management of tuberculous meningitis

A

Isoniazid, rifampicin, pyrazinamide, ethambutol

497
Q

Treatment of cryptococcal meningits

A

IV amphotericin C

498
Q

Symptoms of encephalitis

A

Meningismus, stupor, coma, seizures, paralysis, confusion, psychosis, speech and memory problems.

499
Q

Which form of meningitis may have normal CSF protein?

A

Viral

500
Q

When should CT be performed before LP in suspected bacterial meningitis

A

Immunocompromise, history of CNS disease, new onset seizure, papilloedema, altered consciousness, focal neurologic deficit

501
Q

Contact prophylaxis for bacterial meningitis

A

600mg rifampicin 12-hourly for 4 dosesLR500mg ciprofloxacin single dose

502
Q

Stroke mimics

A

Seizure, sepsis, toxic/metabolic causes, SOL, syncope, delirium, vestibular dysfunction, functional disorders, dementia

503
Q

Total anterior circulation stroke presentation

A

Hemplegia of at least 2 of face, arm, leg.Homonymous hemianopiaCortical signs such as dysphasia and neglect

504
Q

Total anterior circulation stroke survival

A

40% alive at 1 year, only 5% independent

505
Q

Partial anterior circulation syndrome presentation

A

Two of the three features of TACS or isolated cortical dysfunction or pure/motor sensory signs less severe than lacunar syndrome

506
Q

Partial anterior circulation stroke survival

A

84% alive at 1 year, 55% independent

507
Q

Lacunar stroke presentation

A

Pure motor or sensory deficits affecting two of face, arm, leg, or dysarthria, or acute onset movement disorders

508
Q

Posterior stroke presentation

A

Cranial nerve palsies, bilateral motor and/or sensory deficits, eye movement disorders, isolated homonymous hemianopia, cortical blindness, cerebellar deficits.

509
Q

Stroke in which hemisphere is more likely to affect language?

A

Dominant (usually left)

510
Q

Stroke in which hemisphere is more likely to affect spatial awareness?

A

Non-dominant (usually right)

511
Q

Drugs used in prevention of stroke recurrent

A

Perindopril plus indapamide

512
Q

Most successful method of preventing stroke recurrence

A

Carotid endartectomy

513
Q

How much CSF does a normal adult have?

A

~140ml

514
Q

Mean CSF pressure

A

10mmHg/14cm

515
Q

Where is CSF produced?

A

Chorioid plexus

516
Q

Which drug can reduce CSF production?

A

Acetazolamide

517
Q

How are streptococci arranged?

A

Chains

518
Q

Chemical functions of CSF

A

Ionic homeostasis

Transport of micronutrients such as vitamin C and thyroxine

Clearing neuron waste products such as 5HIAA

519
Q

Causes of spinal arachnoid webs

A

Idiopathic

Infection

Intracranial haemorrhage

520
Q

Signs of congenital hydrocephalus

A

Large head, thin shiny scalp with visible veins, bulging or tense fontanelles, downward-looking eyes, poor feeding, irritability, vomiting, sleepiness

521
Q

Congenital causes of paediatric hydrocephalus

A

Chiari malformation, spina bifida, X-linked aqueductal stenosis, Dandy-Walker complex, congenital arachnoid cysts, atresia of the foramen of Munro

522
Q

Complications of shunts

A

Overdrainage (acute subdural, slit ventricles)Underdrainage (blockage, displacement)InfectionIntracerebral haemorrhageSeizuresCraniosynostosisUmbilical fistula

523
Q

Signs of blocked shunt

A

Headache and vomitingSunsetting (children)Lack of upgaze (adults)

524
Q

Alternative to shunt in hydrocephalus

A

Endoscopic 3rd ventriculostomy (high failure rate though)

525
Q

What type of haemorrhage can cause xanthochromic CSF?

A

Subarachnoid

526
Q

IQ range of moderate learning disability

A

35-49

527
Q

Which neurotransmitter is involved in appetite and approach systems?

A

Dopamine

528
Q

What type of visual field defect is associated with a lateral optic nerve lesion anterior to the chiasm?

A

Junctional scotoma

529
Q

What type of visual field defect occurs in a lesion of the optic chiasm?

A

Bitemporal hemianopia

530
Q

What type of visual field defect occurs in damage to the right optic tract?

A

Left homonymous hemianopia

531
Q

Nominal aphasia is due to disorder of which area of the brain?

A

Angular gyrus

532
Q

Inheritance pattern of Becker’s muscular dystrophy

A

X-linked recessive

533
Q

Inheritance pattern of myoclonic epilepsy with ragged red fibers

A

Mitochondrial

534
Q

Which area of the brain is affected first in Alzheimer’s?

A

Nucleus basalis of Meynert

535
Q

Which neurotransmitter is reduced in withdrawal from sedative drugs?

A

GABA

536
Q

Nerve root(s) for knee jerk reflex

A

L3/4

537
Q

Nerve root(s) for ankle jerk reflex

A

S1 (and S2?)

538
Q

Triad of symptoms in normal pressure hydrocephalus

A

Ataxia, memory decline, incontinence

539
Q

Causes of normal pressure hydrocephalus

A

SAH, meningitis, trauma, craniotomy (but often idiopathic)

540
Q

Gait in normal pressure hydrocephalus

A

Broad-based and shuffling

541
Q

Treatment of normal pressure hydrocephalus

A

Lumboperitoneal shunts, ventriculoperitoneal shunts, or endoscopic ventriculostomy

542
Q

Risk factors for IIH

A

Female sex, obesity, sleep apnoea, hypothyroidism, Addison’s disease, uraemia, SLE, lithium, antibiotics

543
Q

Management of IIH

A

Weight loss, diuretics, LP, shunts

544
Q

Symptoms of spontaneous intracranial hypotension

A

Orthostatic headache, neck/interscapular/arm pain, diplopia, dizziness, muffled hearing, impaired sphincter control, subdural haematoma

545
Q

Causes of kinetic tremor

A

Cerebellar diseaseWilson’s disease

546
Q

Treatment of essential tremor

A

Propranolol, anticonvulsants (primidone)

547
Q

Core diagnostic criteria for essential tremor

A

Bilateral action tremor of hands and forearmsAbsence of other neurological signs

548
Q

Which type of tremor is improved by alcohol?

A

Essential tremor

549
Q

Which area is stimulated in DBS for essential tremor?

A

Ventralis intermedius nucleus

550
Q

What is palilalia?

A

Repetition of the same phrase, word, or syllable

551
Q

Diagnostic criteria for Tourette’s syndrome

A

Present of multiple motor tics AND one or more vocal ticsTics many times a day, nearly every day, or intermittently for over a yearOnset under 18Exclusion of secondary causes

552
Q

Treatment of Tourette’s

A

Clonidine, tetrabenazine, CBT

553
Q

Drugs that can cause secondary tic disorders

A

Cocaine, amphetamines, anticonvulsants

554
Q

Drugs that can cause chorea

A

Dopamine receptor blockers, levodopa, stimulants, OCP, anticonvulsants

555
Q

Gene defect in Huntington’s

A

Autosomal dominant CAG triplet repeat in huntingtin gene on chromosome 4 (>40 repeats pathological)

556
Q

When does benign infantile myoclonus tend to occur?

A

During feeding or sleep

557
Q

Common triggers in juvenile myoclonic epilepsy

A

Alcohol, sleep deprivation

558
Q

Treatment of juvenile myoclonic epilepsy

A

Sodium valproate, levetiracetam

559
Q

EEG pattern in juvenile myoclonic epilepsy

A

3-5Hz polyspike and wave pattern

560
Q

What is classified as early dystonia?

A

Onset under 26 years

561
Q

Mutation frequently found in young onset primary dystonia

A

GAG deletion in DYT1 gene on chromosome 9q

562
Q

Which drug should be trialled in young onset dystonia?

A

Levadopa

563
Q

Clinical features of cervical dystonia

A

Abnormal head posture, head tremor, head pain

564
Q

Clinical features of oromandibular dystonia

A

Jaw clenching, jaw in opening position, lateral jaw shift

565
Q

Clinical features of axial dystonia

A

Movements of shoulders, back, or abdomen

566
Q

Clinical features of blepharospasm

A

Increased blink rate, forced eye closure, difficulty opening eyes

567
Q

What is photopsia

A

A visual disturbance with bright flashes, streaks, or balls of light

568
Q

Which type of sleep occurs early in the night?

A

NREM

569
Q

Which type of sleep occurs later in the night?

A

REM

570
Q

What proportion of sleep is NREM in young adults?

A

75%

571
Q

Physiological changes in NREM sleep

A

Reduced HR, BP, tidal volumeNon-narrative images

572
Q

EEG activity in NREM sleep

A

Synchronised, rhymic

573
Q

EEG activity in REM sleep

A

Fast

574
Q

Which type of sleep is important in early brain development?

A

REM

575
Q

Which psychiatric drugs suppress REM sleep?

A

Tricyclics

576
Q

Proportion of REM sleep in neonates

A

50%

577
Q

Peaks of sleepiness

A

Midnight - 6am large peakAfternoon smaller peak

578
Q

Normal circadian rhythm length

A

24h20m - 25h

579
Q

REM parasomnias

A

Dreaming, simple behaviours

580
Q

Non-REM parasomnias

A

Confusional arousals, sleep walking, sleep terrors, paralysis, bruxis, restless legs,periodic limb movements of sleep

581
Q

Onset peaks in narcolepsy

A

Age 15 and 36

582
Q

Features of narcolepsy

A

Daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis

583
Q

Investigations in narcolepsy

A

Overnight polysomnography (sleep study)Multiple sleep latency test

584
Q

Which substance is found in CSF in abnormally low levels in narcolepsy?

A

Hypocretin

585
Q

Histological appearance of acute neuronal injury

A

Red neuron after ~12-24 hours:Shrinking and angulation of nuclei, loss of nucleolus, red cytoplasm

586
Q

Which embryonic tissue are glial cells derived from?

A

Neuroectoderm

587
Q

Main cell of repair and scar formation in the CNS

A

Astrocyte

588
Q

Appearance of gliosis

A

Hyperplasia and hypertroph of astrocytesEnlargement of nucleusExpansion of cytoplasmRamifying processes extend

589
Q

M1 vs M2 microglia

A

M1 - pro-inflammatory, found in chronic injuryM2 - anti-inflammatory, phagocytic, found in acute injury

590
Q

Mechanism of excitotoxicity

A

Energy failure (from hypoxia etc.) results in glutamate release and oxygen free radical formation, leading to calcium influx, mitochondrial dysfunction, oxidative stress, and apoptosis and necrosis

591
Q

Mechanism of cytotoxic oedema

A

Dying cells accumulate water as Na and Cl move into the cells

592
Q

Mechanism of vasogenic oedema

A

Disruption of tight junctions in the BBB allows plasma proteins to cross into the extracellular space and bring water with them

593
Q

Areas supplied by ACA

A

Midline portions of frontal lobes and superior medial parietal lobes

594
Q

Areas supplied by MCA

A

Lateral cerebral cortex, anterior temporal lobes, insula

595
Q

Areas supplied by PCA

A

Posterior brain (occipital lobe)

596
Q

Most common artery for atheroma to form

A

Basilar

597
Q

Appearance of stroke at 12-24 hours

A

Macro: pale, soft, swollen. Ill-defined margin between injured and normal brainMicro: red neuron, oedema

598
Q

Appearance of stroke at 2-14 days

A

Macro: Brain gelatinous. Reduction in surrounding tissue oedema demarcates lesionMicro: microglia become predominant cell type. Reactive gliosis occurs

599
Q

Appearance of stroke after several months

A

Macro: increased liquification, eventual formation of cavity lined by dark grey tissueMicro: Ongoing phagocytosis, gliotic scar formation

600
Q

When does neutrophil infiltration decrease after stroke?

A

~48 hours

601
Q

How does carotid artery stroke present?

A

Contralateral weakness or sensory lossIf dominant hemisphere, aphasia or apraxia may be present

602
Q

Presentation of middle cerebral artery lesion

A

Weakness predominantly contralateral face and arm

603
Q

Presentation of anterior cerebral artery lesion

A

Weakness and sensory loss in contralateral leg

604
Q

Presentation of vertebrobasilar artery disease

A

Vertigo, ataxia, dysarthria, dysphasia

605
Q

Presentation of subarachnoid haemorrhage

A

Abrupt onset of severe headache, vomiting, and LOC. Meningeal signs may be present

606
Q

Peak age of MS onset

A

20-30 years

607
Q

Appearance of demyelination on MRI

A

Hyperintense regions on T2-weighted scans

608
Q

Appearance of MS plaques

A

Well circumscribed, well demarcated, irregularly shaped areas with glassy appearance.

609
Q

Which virus may be implicated in development of MS?

A

EBV

610
Q

MS genetic association

A

HLA DRB1

611
Q

Secondary causes of dementia

A

Vascular dementia, infection, (HIV, syphilis), trauma, metabolic causes, alcohol, B12 deficiency, paraneoplastic syndromes, SOL, and chronic hydrocephalus

612
Q

Why is there increased Alzheimer’s in trisomy 21?

A

Amyloid precursor protein is a product of genes on chromosome 21

613
Q

Which areas of the brain do not undergo atrophy in Alzheimer’s?

A

Occipital lobe, brainstem, cerebellum

614
Q

What are neurofibrillary tangles composed of?

A

Insoluble microtubules,Tau

615
Q

What are neuritic plaques composed of?

A

Dilated, tortous neuritic processes surrounding a central amyloid core

616
Q

Most common familial cause of Alzheimer’

A

Mutation of apolipoprotein E e4 allele

617
Q

What is amyloid angiopathy?

A

Accumulation of amyloid AB pleated sheets in the walls of arterioles

618
Q

What are Lewy bodies?

A

Eosinophilic cytoplasmic inclusions consisting of a dense core surrounded by fibrils of alpha-synuclein and ubiquitin

619
Q

Macroscopic changes in Huntington’s

A

Atrophy of basal ganglia, and later cortex. Expansion of lateral and third ventricles

620
Q

Presentation of Pick’s disease

A

Progressive changes in character and social deterioration leading to impairment of intellect, memory, and language.

621
Q

Factors distinguishing vascular dementia from Alzheimer’s

A

Abrupt onset, stepwise progression, history of HTN/stroke, stroke on imaging

622
Q

What is subfalcine herniation?

A

Expansion of a cerebral hemisphere displaces the cingulate gyrus under the falx cerebri

623
Q

What is tentorial herniation?

A

Medial aspect of temporal lobe herniates over tentorium cerebelli. Results in 3rd nerve palsy

624
Q

What is tonsillar herniation?

A

Displacement of the cerebellar tonsils through the foramen magnum. Causes brainstem compression

625
Q

What is transcalvarial herniation?

A

Swollen brain herniates through defects in dura and skull.

626
Q

Most common malignant brain tumour

A

Astrocytoma

627
Q

Most common benign brain tumour

A

Meningioma

628
Q

How do subdural haematomas occur?

A

Disruption of bridging veins that extend from the surface of the brain into the subdural space

629
Q

Presentation of optic neuritis

A

Painful visual loss over 1-2 weeks, with colour vision being lost first

630
Q

Management of fatigue in MS

A

Amantadine, modafinil, hyperbaric oxygen

631
Q

Management of acure exacerbation of MS

A

Mild - symptomatic

Moderate - oral steroids

Severe - admitted for IV steroids

632
Q

Management of sensory symptoms in MS

A

Gabapentin, amitriptyline, TENS, acupuncture, lignocaine

633
Q

First line disease modifying therapy for MS

A

Interferon beta, glitiramer acetate, tecfedira

634
Q

Second line disease modifying therapy in MS

A

Monoclonal antibodies, fingolimod

635
Q

Third line disease modifying therapy in MS

A

Mitoxantrone

636
Q

How does fingolimod work?

A

Spingosine-1-phosphate (S1P) modulator

637
Q

Which MS patients are monoclonal antibodies used for?

A

Rapidly evolving severe relapsing remittingPatients with high disease activity despite interferon treatment

638
Q

Action of NSAIDs

A

Inhibition of cyclooxygenase and decreased prostaglandin synthesis

639
Q

Action of gabapentin

A

Binding to presynaptic voltage-dependent Ca channels

640
Q

What is pseudoathetosis?

A

Abnormal writhing movements, usually of the fingers, caused by a failure of proprioception

641
Q

What is Charcot-Marie-Tooth also known as?

A

Hereditary sensory motor neuropathy

642
Q

Presentation of Guillain-Barre syndrome

A

Progressive paraplegia occurs over days-4 weeks, with sensory symptoms preceding weakness. Peak symptoms 10-14 days after onset

643
Q

Treatment of GBS

A

Immunoglobulin infusion, plasma exchange

644
Q

Inheritance of hereditary motor sensory neuropathy type 1

A

Autosomal dominant

645
Q

Presentation of hereditary motor sensory neuropathy

A

Nerve abnormalities in legs and feet - tingling, weakness, spinothalamic deficits, as well as open sores and muscle wasting. With progression, can spread to upper limb

646
Q

Drugs causing axonal neuropathy

A

Alcohol

Amiodarone

Phenytoin

Chemo (cisplatin, vincristine)

647
Q

Treatment of vasculitis-related neuropathy

A

IV methylprednisolone and cyclophosphamide

648
Q

Presentation of cervical disc prolapse

A

Arm pain in dermatomal and myotomal pattern, LMN deficits

649
Q

Relieving factors for spinal claudication

A

Rest, spine flexion

650
Q

Presentation of cervical myelopathy

A

‘Numb clumsy hands’

651
Q

What is Hoffman’s reflex test?

A

Loosely hold middle finger and flick it downwards, allowing finger to flick upward reflexively.Pos response - ipsilateral thumb flexion and adduction, suggests hypertonia

652
Q

What is Lhermitte’s sign?

A

An ‘electrical’ sensation through back and into limbs, elicited by bending head forward or whacking them in the neck. Caused by posterior column deficit

653
Q

Causes of SAH

A

Berry aneurysm, AVM, idiopathic

654
Q

Gold standard investigation for SAH

A

Cerebral angiography

655
Q

When does delayed ischaemic neurological deficit occur after SAH?

A

3-12 days

656
Q

Treatment of delayed ischaemic neurological deficit

A

NimodipineTriple H therapy - induction of hypertension, hypervolaemia, and haemodilution

657
Q

Presentation of central cord syndrome

A

Predominantly distal upper limb weakness

Cape-like spinothalamic sensory loss

658
Q

Which gene defect is associated with ALS and FTD?

A

C9ORF hexanucleotide repeat expansions

659
Q

Wasting of which muscles of the hand is common in ALS?

A

Thenar - known as split hand

660
Q

Action of riluzole

A

Blocks TTX-sensitive Na channels, which are associated with damaged neurons

661
Q

What drug is used in MND?

A

Riluzole

662
Q

Which inclusions are found in most MND?

A

TD943

663
Q

Pathways affected in MND

A

Ubiquitin proteasome pathwayAggregration of prion-like proteins leading to neuroinflammation

664
Q

Which areas of the brain are involved in modifying nociceptive input?

A

PAGNucleus raphe magnusLocus coeruleus

665
Q

Action of opioids:

A

G protein-coupled receptors signal to produce inhibition of voltage-activated Ca channels (presyn), opening of K channels (postsyn), and inhibition of adenylate cycl\se

666
Q

Which opioid receptors are responsible for most of the analgesic effect?

A

Mu/MOP

667
Q

Which opioid receptors are proconvulsant?

A

Delta

668
Q

Which opioid receptors are associated with sedation, dysphoria, and hallucinations?

A

Kappa

669
Q

Which opioid receptors are involved in respiratory side effects?

A

Mu and delta

670
Q

Which opioid receptors are involved in GI side effects?

A

Mu and kappa

671
Q

First line treatment of trigeminal neuralgia

A

Carbamazepine

672
Q

Presentation of facial nerve UMN lesion

A

Paralysis of lower half of face, forehead spared

673
Q

Presentation of facial nerve LMN lesions

A

Paralysis of half of face including forehead (Bell’s palsy)

674
Q

Which structures does the anterior longitudinal ligament connect?

A

Anterolateral aspects of vertebral bodies and IV discs

675
Q

Layers LP needle passes through

A

SkinFasciaSupraspinous ligamentInterspinous ligamentLigamentum flavumEpidural spaceDura

676
Q

Most common locations for lumbar disc herniation

A

L4/5, L5/S1

677
Q

Presentation of L5/S1 prolapsed disc

A

Pain along posterior thigh radiating to heelSometimes weakness of plantarflexionSensory loss lateral footReduced/absent ankle jerk

678
Q

Presentation of L4/5 prolapsed disc

A

Pain posterior/posterolateral thigh radiating to dorsum and great toeWeakness of dorsiflexionParaesthesia dorsum and great toe

679
Q

Presentation of L3/4 prolapsed disc

A

Pain anterior thighWasting quadricepsWeakness quadricecps, dorsiflexionDiminished sensation anterior thigh, knee, medial legReduced knee jerk

680
Q

Which area of the brain contains the angular gyrus?

A

Inferior parietal lobe

681
Q

Presentation of frontal lobe tumour

A

Contralateral weakness

Personality changes

Urinary incontinence (micturition inhibition centre)

Gaze abnormalities

Seizures

Expressive dysphasia if left Broca’s area involved

682
Q

WHO classification of brain tumours

A

I - no morphological featuresII - atypia aloneIII - atypia and mitosisIV - atypia and mitosis with vascular proliferation or necrosis

683
Q

Appearance of glioblastoma

A

Heterogeneously enhancing SOL, with areas of necrosis, and sometimes ‘butterfly’ appearance

684
Q

Which inherited condition predisposes to optic pathway gliomas?

A

NF1

685
Q

Which inherited condition predisposes to meningioma?

A

NF2

686
Q

What is Foster-Kennedy syndrome?

A

Optic atrophy in ipsilateral eye and papilloedema in contralateral eye, can occur in meningioma in olfactory groove

687
Q

Presentation of prolactinoma

A

Amenorrhoea, infertility, galactorrhoea, loss of libido, ED

688
Q

Presentation of growth hormone secreting tumour

A

Gigantism (if before puberty), acromegaly (if after puberty).Diabetes, osteoarthritis, arthralgia, sleep apnoea, headaches…

689
Q

Test for GH secreting tumour

A

Measure GH levels after oral glucose loading

690
Q

Presentation of ACTH-secreting tumour

A

(Cushing’s disease)Central obesity, hirsutism, abdominal striae, acne, hypertension, glucose intolerance, muscle wasting, osteoporosis, puffy face

691
Q

Test for ACTH-secreting tumour

A

Low-dose dexamethasone suppression test

692
Q

Presentation of thyrotropinoma

A

Palpitations, weight loss, insomnia, anxiety, goiter

693
Q

Most common cause of chiasmal compression in adults

A

Pituitary macroadenoma

694
Q

Medical management of GH-secreting tumours

A

Pegivisomant

Somatostatin analogues such as octreotide

695
Q

Which condition should be suspected in bilateral acoustic neuroma in a young person?

A

NF2

696
Q

Which tumour are Verocay bodies found in?

A

Acoustic neuroma

697
Q

Which condition are haemangioblastomas most commonly associated with?

A

Hippel-Landau syndrome

698
Q

Level of carotid bifurcation

A

C4

699
Q

Which artery runs in the Sylvian fissure?

A

MCA

700
Q

Appearance of cavernous malformation on MRI

A

Focal lesion with popcorn-like appearance, surrounded by ring of hypo-intensity

701
Q

Diseases associated with cerebral aneurysm

A

Polycystic kidney diseaseFibromuscular dysplaseEDS 4

702
Q

Most common aneurysm locations in circle of Willis

A

Junction of ACA and ACommAJunction of PCommA with ICA

703
Q

Which cranial nerve can be compressed by a posterior communicating artery aneurysm?

A

III

704
Q

Which cranial nerve can be compressed by a anterior communicating artery aneurysm?

A

Optic (chiasm)

705
Q

Components of ABCD2 score for stroke risk in TIA

A

Age (>60 1 point)BP (>140/90 1 point)Clinical features (speech - 1 limb weakness - 2)Duration (min) (10-59 - 1pt >59 - 2pts)Diabetes (Yes - 1 pt)

706
Q

Which cranial nerves originate in the pons?

A

5, 6, 7, 8

707
Q

Which nerves are involved in the pupillary light reflex?

A

Afferent - opticEfferent - oculomotor

708
Q

What is neuromyelitis optica (Devic’s disease)?

A

Demyelinating disorder characterised by bilateral severe optic neuritis and transverse myelitis in three or more vertebral columns. IgG antibodies against AQP4

709
Q

What is anterior ischaemic optic neuropathy?

A

Optic neuritis occuring due to damage to the optic nerve as the result of ischaemia, common in elderly.

710
Q

Which drug can be used to confirm Horner’s syndrome?

A

Topical apraclonidine (alpha-1 receptor agonist) - Horner’s pupil will dilate, normal won’t.

711
Q

Presentation of lateral medullary syndrome (Wallenberg’s syndrome)

A

Vertigo, vomiting, nystagus, Horner’s, spinothalamic loss, dysphagia, hoarseness

712
Q

What is Adie’s pupil?

A

Anisocoria (large affected pupil) and blurring on near vision due to slow accomodation, absent light reflex.Due to loss of postganglionic sympathetic innervation to iris sphincter and ciliary muscle e.g. damage to ciliary ganglion

713
Q

What is Holmes-Adie syndrome?

A

Adie’s pupil + diminished/absent lower limb reflexes

714
Q

Which drug can be used to confirm Adie’s pupil

A

Low dose topical pilocarpine - Adie’s pupil constricts, normal doesn’t.

715
Q

What is Argyll Robertson pupil

A

Bilateral, irregular, small pupils, unreactive to light but with normal accomodation.Caused by neurosyphilis, diabetes

716
Q

Visual lesion caused by pituitary adenoma

A

Bilateral superior quadrantanopia progressing to bitemporal hemianopia

717
Q

Visual lesion resulting from craniopharyngioma

A

Bilateral inferior quadrantanopia progessing to bitemporal hemianopia

718
Q

Visual defect caused by tuberculum sellae meningioma

A

Junctional scotoma

719
Q

What is Weber’s syndrome

A

Stroke affecting ventral midbrain, characterised by ipsilateral third nerve palsy with contralateral hemiparesis

720
Q

What is Benedikt’s syndrome?

A

Stroke affecting dorsal midbrain, characterised by ipsilateral third nerve palsy with contralateral tremor, ataxia, or chorea

721
Q

Presentation of IV nerve palsy

A

Vertical diplopia (worse looking down)

Hypertropia

Limited depression of eye

Compensatory head tilt

722
Q

Presentation of VI nerve palsy

A

Horizontal diplopia

Esotropia

Limited abduction

723
Q

In which condition does ptosis improve after application of ice?

A

Myasthenia gravis

724
Q

Features of NF1

A

Neurofibromas, cafe au lait spots, axillary freckling, optic nerve glioma, plexiform neurofibromas of eyelid

725
Q

Management of benign essential blepharospasm

A

Artificial tearsBotox

726
Q

Features of cavernous sinus syndrome

A

Ptosis and opthalmoplegia, loss of corneal reflex, maxillary sensory loss, Horner’s, periorbital swelling

727
Q

Decorticate posturing

A

Abnormal flexion of arms, hands clenched into fists, legs extended and feet turned inward

728
Q

Decerebrate posturing

A

Head arches back, both arms and legs extended

729
Q

Most common cause of congenital hydrocephalus

A

Aqueductal stenosis

730
Q

Chiari I vs Chiari II

A

Caudal displacement of cerebellar tonsils below the foramen magnum in both, but II, which is more severe, has herniation of the 4th ventricle

731
Q

What drug is used to reverse benzos?

A

Flumazenil

732
Q

Which neurotransmitter is increased in schizophrenia?

A

Dopamine

733
Q

What is the action of ADH?

A

Increases blood volume by increasing water permeability in the collecting ducts

734
Q

Which anti-epileptics alter efficacy of COCP?

A

Carbamazepine, oxcarbazepine, phenobarbitol, phenytoin, primidone, topiramate(by inducing hepatic enzymes)

735
Q

Which structure separates the scala vestibuli from the scala media?

A

Reissner’s membrane

736
Q

Which structure separates the scala tympani from the scala media?

A

Basilar membrane

737
Q

Which two cavities of the cochlea are continuous?

A

Scala tympani and scala vestibuli

738
Q

Which cavity of the cochlea connects to the oval window?

A

Scala tympani

739
Q

Which cavity of the cochlea connects to the round window?

A

Scala vestibuli

740
Q

Which type of hair cell mainly provides afferent signals to the auditory nerve?

A

Inner

741
Q

Which hair cells have a motor protein composed of prestin which changes the length of the cell?

A

Outer

742
Q

What is the effect of furosemide in the inner ear?

A

Inactivates the membrane motor in outer hair cells so the cell cannot change length

743
Q

Which part of the brain generates an interaural time difference for determining the location of sound?

A

Medial superior olive

744
Q

Which part of the brain receives excitatory input from the ipsilateral anteroventral cochlear nucleus and inhibitory input from the contralateral?

A

Lateral superior olive

745
Q

Which structures of the vestibular system detect angular acceleration (e.g. rotation) of the head?

A

Semicircular canals

746
Q

Which structures of the vestibular system detect linear acceleration of the head?

A

Saccule and utricle

747
Q

Which structures of the vestibular system detect acceleration and gravity

A

Saccule and utricle

748
Q

Which otolith organ detects movement in the vertical plane?

A

Saccule

749
Q

Which otolith organ detects movement in the horizontal plane?

A

Utricle

750
Q

Why does vertigo occur when drunk?

A

The cupula becomes less dense than the surrounding endolymph and bends further from the ground, causing hair cells to bend as if you were rotating

751
Q

What are the triggers of ADH release?

A

Increased osmotic pressure detected by hypothalamusHypovolaemia detected by atrial baroreceptorsAngiotensin II

752
Q

Which type of neurons have their cell body in the PNS?

A

Unipolar

3rd year (6 decks)

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