Localisation Flashcards

1
Q

How does internal carotid artery occlusion present?

A

Like MCA

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2
Q

How does ACA occlusion present?

A

Weak, numb CL leg (and arm)

Face is spared

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3
Q

How does MCA occlusion present?

A

CL hemiparesis, hemisensory loss (face and arm particularly)
CL homonymous hemianopia
Cognitive change - dysphasia, visuo-spatial disturbance

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4
Q

How does PCA occlusion present?

A

VFDs and poor visual functioning
- CL homonymous hemianopia (macula sparing), agnosia
Aphasia
Memory problems

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5
Q

How does vertebrobasilar occlusion present?

A
Hemianopia, cortical blindness, diplopia
Vertigo, nystagmus, ataxia
Dysarthria, dysphasia
Hemi/quadriplegia
UL/BL sensory symptoms, hiccups, coma
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6
Q

What is lateral medullary syndrome?

A

Infarction of the brainstem (vertebral artery/posterior cerebellar artery):

Vertigo, vomiting, dysphagia (swallowing), nystagmus, IL ataxia,
Soft palate paralysis, IL horner’s syndrome
Sensory loss (pin prick) - IL face, CL body

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7
Q

What is locked in syndrome?

A

Pontine artery occlusion:

Unable to move, retain full cognition

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8
Q

What artery occlusions result in ‘dizzy+’ conditions?

A

SCA - dizzy
AICA - dizzy + deaf
PICA - dizzy + dysphagia + dysphonia

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9
Q

What spinal levels do common reflexes test for?

A
S1-2 = ankle 
L3-4 = knee
C5-6 = biceps
C7-8 = triceps
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10
Q

What are focal cortical signs?

A

4 As - aphasia, apraxia, agnosia, …anopia
Memory and personality involvement
UMN: increased tone, brisk reflexes, plantar extensors
May have motor/sensory involvement if PMC/PSC are involved

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11
Q

What are focal cerebellar signs?

A
DDANISH
Dysdiadokinesia - rapid pro/supination 
Dysmetria 
Ataxia (bi/ipsi)
Nystagmus
Intention tremor 
Speech
Hypotonia

Ipsilateral

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12
Q

What are focal brainstem signs?

A

Hemiparesis/sensory loss, brisk reflexes, plantar extensors

CN:
III, IV, VI = diplopia (double vision)
V = decreased facial sensation
VII = drooping face
VIII = deaf, dizzy
IX, X, XII = dysarthria (unclear articulation), dysphagia
XI = decreased neck and shoulder strength

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13
Q

What information do dorsal columns carry?

A

Deep touch
Proprioception
Vibration

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14
Q

Where do dorsal columns cross?

A

At the medulla

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15
Q

What information does the ventral corticospinal tract carry?

A

Gross motor

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16
Q

Where does the ventral corticospinal tract cross?

A

At spinal cord

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17
Q

What information does the lateral corticospinal tract carry?

A

Fine motor

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18
Q

Where does the lateral corticospinal tract cross?

A

At the medulla

19
Q

What information does the spinothalamic tract carry?

A

Ventral - light touch

Lateral - pain, temperature

20
Q

Where does the spinothalamic tract cross?

A

At the spinal cord

21
Q

What are the causes of anterior spinal cord lesions?

A

Anterior spinal artery infarct

Trauma

22
Q

How do anterior spinal cord lesions present?

A

Loss of pain, temperature and motor

Preserved vibration and proprioception

23
Q

What are the causes of posterior spinal cord lesions?

A

Low B12

Friedrich’s ataxia

24
Q

How do posterior spinal cord lesions present?

A

Loss of vibration, proprioception and reflexes

Preserved pain and temperature

25
Q

What are the causes of lateral spinal cord lesions?

A

Brown-Sequard

26
Q

What are the symptoms of lateral spinal cord lesions?

A

CL loss of pain and temperature

IL loss of vibration, proprioception and motor

27
Q

What are the symptoms of central spinal cord lesions?

A

BL loss of pain and temperature

Syringomyelia - cape distribution

28
Q

How do spinal root lesions present?

A

Sensory (dorsal) - asymmetrical loss of a dermatome

Motor (ventral) - asymmetrical loss of a myotome, reduced/absent reflexes

29
Q

How does peripheral neuropathy present?

A

Distal weakness
Sensory loss
Weak/absent reflexes
Plantar flexion

30
Q

What is the innervation of the deltoid?

A

C5-6 - axillary

Shoulder abduction

31
Q

What is the innervation of the biceps?

A

C5-6 - musculocutaneous

Flexion at the elbow

32
Q

What is the innervation of the triceps?

A

C6-8 - radial

Extension at the elbow

33
Q

What is the innervation of the ECR?

A

C5-6 - radial

Dorsiflexion at the wrist

34
Q

What is the innervation of the abductor pollicis brevis?

A

C8-T1 - median

Abduction of the thumb

35
Q

What is the innervation of the interossei?

A

C8-T1 - ulnar

Abduction of fingers

36
Q

What is the innervation of the iliopsoas?

A

L1-3 - femoral

Hip flexion

37
Q

What is the innervation of the quadriceps?

A

L2-4 - femoral

Knee extension

38
Q

What is the innervation of the hamstrings?

A

L5-S2 - sciatic

Knee flexion

39
Q

What is the innervation of the tibialis anterior?

A

L4-5 - deep peroneal

Ankle dorsiflexion

40
Q

What is the innervation of the gastro/soleus?

A

S1-2 - tibial

Ankle plantarflexion

41
Q

What are the signs of UMN damage?

A

Increased wasting, brisk reflexes, plantar extensors

42
Q

What are the signs of LMN damage?

A

Muscle wasting, fasciculation, decreased tone. reduced/absent reflexes, plantar flexors

43
Q

What nerve is affected first by raised ICP?

A

CNVI