Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

My sem 3 > case 5 > Flashcards

case 5 Flashcards

1
Q

GAD

A

6 months of persistent anxiety without cause. anxiety about a wide range of issues rather than a specific event like phobia, free floating not linked to a cause. more common in females. 1/20, 20yr. projections from amygdala to PAG and diffuse modulatory result in anxiety, projections to hypothalamus maintain state of anxiety. hippocampus inhibits CRH release, can become saturated and die, benzodiazepines/SSRIs first line treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

signs and symptoms

A

psychological symptoms-worry, dread, poor conc, irritability
physical symptoms-trembling, nausea, shortness breath, headaches, irritability, sleep, restless.
behavioural symptoms-putting things off, avoidance, drug taking. 6/12 in ICD10. last longer than 6 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

aphasia

A

inability to speak write or understand spoken or written work from a lesion to brain. sensory, motor, conductive, global.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

wernikes

A

found in superior temporal gyrus identify and comprehend words that are performed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

circuit for spoken language

A
  • When a person hears a sentence, this is transmitted via the auditory apparatus to the primary auditory cortex in the temporal lobe.
  • This then connects to Wernicke’s area, which decodes the language into meaning.
  • If the sentence is to be repeated, or replied to, the information has to be transmitted forwards to Broca’s area (expressive speech) in the frontal lobe (via the arcuate fasciculus).
  • Broca’s area then produces speech via the motor programmes of the motor cortex, which activate the tongue and laryngeal muscles.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

circuit for understanding written language

A
  • Visual input is transmitted to the visual cortex in the occipital lobe.
  • Input from the visual association area is sent to the left angular gyrus, where the objects are recognized and named.
  • Input then goes to Wernicke’s area, where words are assembled into sentences, and the appropriate messages are sent via the arcuate and superior longitudinal fasciculi to Broca’s area.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

test for CN I

A

olfactory. occlude one nostril, different smells. eyes closed. ask strength of smell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CN II

A

optic. snellen chart one eye at a time-visual acuity. visual fields, look at me, cover one eye, say now when can see. 8 times per eye. Opthalmoscope-Optic disc, fovea, pupil reactions rate of reflex, look ahead. into distance then at finger. accomodation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CN III

A

occulomotor. pupillary light reflex. H test up down and medially. ask if double vision. hold head.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CN IV

A

trochlear, superior oblique, H test down and medial.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CN V

A

trigeminal. muscles mastication-masseter whilst bite, open against resistence, temporalis whilst bite, side to side against resistence. sensation of face sharp or dull. first on clavicle. corneal reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CN VI

A

abducens-lateral rectus H test laterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CN VII

A

facial. raise eyebrows, blow cheecks, prize lips or eyes open taste ant 2/3.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CN VIII

A

vestibulocochlear- rienne and weber test. distract one ear whilst say something in other. hearing machine for frequencies heard.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CN IX

A

glossopharyngeal-gag, taste post1/3 say aahh inspect palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CN X

A

vagus-swallow, speak, say aahh,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CN XI

A

accessory-raise trapezius and SCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CN XII

A

hypoglossal-stick out tongue move side to side. see if twitch.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

recovery after brain injury

A

.axonal sprouting-formation new connections in cortex. Neurogenesis-formation new neurons. Angiogenesis-new blood vessels. Growth factor regulation such as FGFs and EPO to promote erecovery. Oligodendrocyte precurser cells. hypoexcitability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

neuroplasticity

A

cellular changes and cortical remapping. ability to learn and modify. strongest in childhood. children recover from stroke better as brains still developing plastic state make circuit connections needed to repair. synaptic pruning-weaker connections are eliminated whilst stronger ones are strengthened.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

lower motor neurons

A

those that innervate the arms are in the cervical enlargement those that innervate the leg aer in the lumbar enlargment. spinal cord segments that innervate a large amount of muscles have a swollen ventral horn. Directly innervated by local circuit in SC or CS, or indirectly in higher centres. Y fibres regulate sensory input to set intrafusal muscle fibre length.
damage is loss of reflex, paralysis, loss muscle tone, atrophy, fibrillations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

lateral spinothalamic tract

A

pain and temperature. nerve cell body of 1st order neurons in dorsal root ganglion. terminate in dorsal horn. deccusate, ascend in contralateral lateral spinothalamic tract, pass through spinal lemniscus and terminate in VP nucleus of thalamus. Third order neurons project to somatosensory cortex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ventral spinothalamic tract

A

crude touch and pressure. NCB in dorsal root ganglion. terminate in dorsal horn. asend segments before decussating then ascend in contralateral spinothalamic tract, pass in spinal lemniscuc and terminate in VP nucleus of thalamus. Third order neurons to somatosensory cortex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

dorsal columns

A

proprioception, discriminative touch and vibration. gracilis from lower limb. cell bodies in dorsal root ganglion, ascend in ipsilateral sorsal column to the medulla. axons in fasciculus gracilis terminate in cucleus gracilis etc. second order neurons deccusate and ascend in medial lemniscus terminate in VP of thalamus. third order neurons project to somatosensory cortex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ascending pathways of the head-trigeminothalamic pathway

A

first order neurons synapse in trigeminal nucleus-mesencephalic propriception. chief touch and pressure. spinal pain and temperature. facial glossopharyngeal and vagus nerve also convey some general sens info from head and neck. second order neurons deccusate and ascend in contralateral trigeminothalamic tract, terminate in VP nucleus of thalamus. third order go to somatosensory cortex of postcentral gyrus. parietal lobe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

corticospinal/pyramidal tract

A

cell bodies of UMN are in PMC. pass through the corona radiata, through posterior limb of internal capsule, through midbrain in crus cerebri. 25-90% deccusate in medulla enter lateral corticospinal tract, remaining desend ipsilateral in ventral corticospinal tract, these decussate near termination. UMN synapse to LMN in ventral horn. LMN axons terminate in neuromusc junction

27
Q

corticubulbar

A

precentral gyrus, corona radiata, internal capsule, superior cerebral peduncle. brainstem. synapse with motor nuclei of CN. contralateral, bilaterally innervated apart from hypoglossal and facial. facial above eye bilateral.

28
Q

spinocerebellar tract

A

Ascending tract which carries information from muscle spindles, Golgi tendon organs and tactile receptors to the cerebellum. It is involved in the control of posture and coordination of movement.

29
Q

vestibulospinal

A

Descending tract which originates in the vestibular nucleus. Controls extensor muscle tone and is involved in the maintenance of posture. regulates head position by reflex by activating neck muscles in responce to semicircular canals. VOR.

30
Q

reticulospinal

A

Descending tract which originates in the reticular formation of the pons and medulla. Mediates the pressor and depressor effects of the cardiovascular system and the control of breathing.

31
Q

tectospinal tracts

A

Descending tract which originates in the superior colliculus. Most fibres terminate in the cervical region of the spinal cord and it is thought to mediate reflex movements in response to visual stimuli.

32
Q

rubrospinal tract

A

Descending tract which originates from the red nucleus of the midbrain. It controls the tone of limb flexor muscles. It receives afferent fibres from the motor cortex and the cerebellum.

33
Q

spinoreticulothalamic

A

Ascending tract that arises in the spinal cord and ascends to the reticular formation. Reticulothalamic fibres ascend to the thalamus and synapse with thalamocortical fibres. It is thought to provide a route by which dull aching pain is consciously recognized.

34
Q

ischaemic stroke

A

brain artery blocked, 80% strokes. embolic-forms outside brain. thrombotic-forms in brain.

35
Q

haemorrhagic

A

brain artery burst. intracerebral-blood enters into substance of brain. subarachnoid-blood enters spaces surrounding brain.

36
Q

occlusion in anterior cerebral artery

A

paralysis and sensory loss in contralateral leg.

37
Q

occlusion in middle cerebral artery

A

most common site. contralateral paralysis in face or arm. somatosensory deficits. speech defects.

38
Q

occlusion in basilar and posterior cerebral artery

A

coma or blindness.

39
Q

spinal cord arteries

A

spinal and radicular arteries. occlusion, anterior cord syndrome, paraplegia.

40
Q

penumbra area

A

surrounding region to stroke, blood S compromised cell under threat, can be rescued if treatment early.

41
Q

risk factors of stroke

A

Asian/black. Age above 40. Male, hypertension, hypercholesterolemia, diabetes, smoking, family history, cardiac disease

42
Q

stroke definition

A

rapid onset of cerebral deficit lasting greater then 24hr or death with no other cause than vascular

43
Q

completed stroke

A

deficit is maximal usually in 6 hrs.

44
Q

Stroke in evolution

A

progression in first 24hrs

45
Q

Transient Ischaemic attach

A

sudden focal deficit lasting less than 24hrs with complete recovery. tendancy to reacur.

46
Q

small vessel/lacunar infarcts

A

supply deep structures. like BG, thalamus, IC, brainstem. usually by hypertension.

47
Q

epidemiology

A

second common cause death. uncommon below 40. death rate 20%

48
Q

3 things that cause ischaemic damage

A

neurotransmitters glutamate, ions Ca and Na, free radicals abnormal O2.
lead to excitotoxicity, reperfusion injury, free radical formation, apoptosis, inflamation, periinfarct depolarisation

49
Q

exocitoxicity

A

hypoxia leads to inadequate supply ATP, failure membrane pumps. inc release glutamate into extracellular fluid. influx Ca and Na. Ca overload causes formation of free radicals. mitochondrial injury, inc NO, protease activation, phospholipase activation, result cell death through necrosis.

50
Q

reperfusion injury

A

restoration of BF to an ischaemic area leads to inflamation and oxidative stress which causes death of more neurons.

51
Q

oxidative stress/free radical formation

A

FORMATION no AND SUPEROXIDE TO FORM SUPEROXYNITRATE. RESULTS IN LIPID PEROXIDATION, PROTEIN OXIDATION, dna DAMAGE

52
Q

apoptosis

A

programmed cell death. oxidative stress causes mitochondrial injury, realeases cytochrome C which activates paracaspases into caspases. DNA damage and cell death.

53
Q

inflamation

A

doesnt normally occur in brain, occurs due to brain damage, compromised BBB, microglia degrade extracellular matrix, neutrophils from liver can accsess BBB. outcome poor if already have inflam disease like obesity and arthritus.

54
Q

purpose investigation

A

Distuinguish what type, look for underlying causes and direct treatment, exclude other causes.

55
Q

imaging

A

Non contrast CT show heamorrhage. MRI shows changes due infarction. Diffusion weighted MRI can detect infarction. doppler ultrsound, carotid bruit heard in ICA stenosis. ECH to show if acrdioembolic source. look for cardiac enzymes to see if MI.

56
Q

amaurosis fungax

A

– sudden loss of vision in one eye. This is due to an embolus in the retinal arteries.

57
Q

treatment

A

drugs for hypertension, endarectomy, speech therapy, anticoag(warfarin/heparin) antiplatlet(aspirin/clopedigrol) tPa, heamorrhagic stroke:anticonvulsants, osmotic diuretic, antihypertensive

58
Q

Long term managment

A

antihypertensive, anticoag, antiplatlet.

59
Q

NIH assessment scale.

A

11 items between 0-4. 0 is normal function. conciousness, eye movement, visual field, facial palsy, motor arm, motor leg, limb ataxia, sensory, language, speech, extinction and inattention.

60
Q

MRC grading muscle power

A

0-5 5 being normal power

61
Q

watershed infarcts

A

affects two arteries like ACA MCA cause by occlusion ICA

62
Q

saccular aneurysms

A

develop in circle of wilils

63
Q

sub arachnoid and sub dural heamorrhage. extradural

A

in artery aneurysm,
in vein.
rupture middle meningeal artery. fracture temporal bone

My sem 3 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions