anatomy Flashcards by Kelly MacWhorter

T1W brain MRI

CSF dark
white matter white
grey matter grey
gandolinium BRIGHT

good view of anatomy

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T2W

CSF bright
inflammation or injury bright
white and grey matter SWAPPED

good to look at inflammation and injury, but not the best since CSF is also bright

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T2W Flair

T2W but CSF is blacked out making it SUPER easy to see pathology (strokes, inflammation, white matter disease) - this is the go to!

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DWI

STROKE view, will be BRIGHT; pair with ADC image, will make acute stroke lesion dark - if bright in both then it is a chronic process

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T2 series

microhemorrhages

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dural sinus thrombosis

essentially DVT surrounding the brain; evaluate with venography

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CTA

arteries of head and neck

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limitation of CTA

pt with poor renal function GFR < 30

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how long for ischemic stroke to be visualized in CT

up to 6 hrs; best used to evaluate hemorrhagic

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subdural hemorrhage

bridging veins

old patient

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epidural hemorrhage
middle meningeal artery
risk of herniation
surgical drainage

skull fracture/trauma

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what makes an enhanced CT?

Is there contrast in the blood vessels?

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Which structure on MRI can you look to determine type?

Corpus collosum - should be white; cortex should be grey

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achilles reflex

S1 + tibial

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patellar reflex

L2,3,4 + femoral

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brachioradialis reflex

C5,6

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biceps reflex

C 5,6 + musculocutaneous

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triceps reflex

C 6,7

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finger jerk

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pectoral reflex

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medial hamstring reflex

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carpal tunnel syndrome is impingement of this nerve

median

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shoulder abduction

C5 + axillary

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elbow flexion

C5,6 + musculocutaneous

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elbow extension

C6,7 + triceps

wrist extension

C6,7 + radial

finger extension

C7,8 + radial

wrist flexor/pronato

C6,7 + medial/ulnar

distal thumb flexors

C8 + median

finger abduction

C8,T1 + ulnar

hip flexion

L1,2 + femoral

hip abduction

L5 + superior gluteal

hip adduction

L2,3,4 + obturator

knee extension

L2,3,4 + femoral

knee flexion

L5, S1 + sciatic

ankle dorsiflexion

L4,5 + deep fibular

plantar flexion

S1,2 + tibial

toe extension

L5 + deep fibular

ankle inversion

L5 + tibial

NMJ disease, automimmune, CXR to evaluate thymus, attack of ACh receptor, fatigable weakness - diplopia and ptosis, scary risk of breathing issues, worsened by many abx

Myasthenia Gravis

dysfunctional peripheral nerve myelin; weakness, atrophy and sensory loss; foot deformity

CMT; type 1A is common AD type w/ loss of intrinsic hand and foot muscles

sporadic myopathy, weakness, elevated CK, muscle tenderness and atrophy, dx with muscle biopsy and EMG

inclusion body myositis (if rash, would need to rule out dermatomyositis)

immune mediated inflammation, peripheral nerve myelin of spinal nerve roots, recent GI or respiratory infx, ascending weakness, tx with IVIG and plasma exchange, CSF with cytoalbuminologic dissociation, EMG/NCS 2wks following

Guillan Barre

fatigue, focal onset weakness, muscle wasting, brisk reflexes, fasiculations that progress over time; UMN and LMN, EMG/NCS critical to dx, Riluzole to delay symptoms + symptom mgmt

ALS

progressive muscle weakness, X-linked genetic conditions, dysfunction in muscle protein leading to breakdown and replacement by fatty tissue, elevated CK, cardiomyopathy, prednisone delays progression

muscular dystrophy; Duchenne develops YOUNG, whereas Becker can present later and progress slower

initial labs for peripheral neuropathy

B12, A1C, Thyroid function, serum electrophoresis + immunofixation, ESR

causes to consider if rapid onset of neuropathy, 1 month or less

toxin/drug, GBS, infection, vasculitis, prophyria

rx to lessen neuropathy

tricyclics (amitryptaline), venlafaxine/duloxetine, gabapentin/pregabalin, topical lidocaine/capsaicin, carbamazepime

pernicious anemia and nitrous oxide are common causes of _____ deficiency

B12

B12 deficiency leads to high levels of ____

Methylmalonic acid (MMA) - toxic to nerves

low B12/high MMA causes

peripheral neuropathy + degeneration of dorsal colums ( ataxia, proprioceptive loss) + corticospinal tract degeneration ( weakness)

corticospinal tract

motor

ventral horn

motor tracts

sudden onset right hemiplegia and aphasia

left cerebral hemspheric infarction

papilledema and subacute onset amenhorrhea and bitemporal hemianopia

pituitary tumor

weakness of right abductor pollicis brevis and numbers of the first 3 1/2 digits of hand

median neuropathy/CTS

progressive diffuse weakness, atrophy, fasciulation, spasticity + loss of anterior horn cells and degeneration of corticospinal tracts

ALS

progressive loss of virbation and propriocipeton in B12 deficiency is due to syfunction in

posterior colum

delirium, mydriasis, hypertension, dry mouth, urinary retention, constipation

atropine overdose, blockade of muscarinic cholinergic receptors

these sx are due to damage where? | CN deficits, imparied LOC, crossed or bilateral mortor or sensory deficits

brainstem

lesion here would cause ataxia, tremor, nystagmus

cerebellum

lesion here would cause LOC or memory disturbances, hemisensory loss and/or pain, hemiataxia, neglect or aphasia

thalamus

lesion here would cause chorea, athetosis, dystonia, tremor, rigidity

basal ganglia

symptmos of enecephalopathy (cerebral cortex)

hemilgeia and/or hemisensory loss, apphasia, neglect, hemianpia, dementia, seziure

if patient has apahasia, where can you locate the lesion

dominant hemisphere (left for 95% of people)

where is fascial nerve nucleus located

pons

if patient has upper and lower fascial weakness, where could lesion sbe

pontinue or peripheral nerve

these two CN pass through cerebelloponinte anlge which could be compromised by a tumor

VII and VIII

weakness, twitching and cramping are the most common symptoms of this motor neuron disease

ALS

motor neuron diseases that affect LMN older

spinal muscular atrophy, spinobulbar muscular atrophy, viral (polio, HIV, westnile), rare paraneoplastic syndromes

motor neuron disease affecting mixed LMN and UMN

ALS

motor neuron disease that affects UMN only

primary lateral sclerosis

ALS Crorf72 can also have

frontotemporal dementia

difficulty swallowing due to neuromuscular etiology likely to present as difficulty swallowing _____

liquids

if mechanical cause of swallowing, will have difficulty with ____

solids

dementia associated with ALS

frontotemporal dementia

3 sites of pathology in ALSO

loss of anterior horn cells, degeneration of corticospinal tract, loss of betz cells in the cortex

OTC migraine sx tx

naproxen, excedrin, advil

DHE is what type of abortive migraine tx

ergotamine

anatomy Flashcards

(79 cards)