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Science to Clinical Practice 2 > Cognition, Movement and Senses > Flashcards

Cognition, Movement and Senses Flashcards

1
Q

What do these innervate?

a) Alpha motor neurones
b) Gamma motor neurones

A

a) Skeletal muscle

b) Muscle fibre of muscle spindle

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2
Q

What can be injected in cases of muscle overactivity e.g. dystonia/spascitiy?

A

Botox (botulinum toxin)

3 months duration, lessens contractions

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3
Q

Definition of:

a) Epilepsy
b) Epileptic seizure

A

a) tendency to repeatedly have epileptic seizures
2 unprovoked seizures happening >24 hr apart
b) abnormal synchronous firing of a large number of cortical neurons causing symptoms

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4
Q

3 main reasons why epileptic seizures happen

A

Loss of cortical microcircuit inhibition
Abnormal hyper excitable cortical neuronal firing
Abnormal connections in large-scale brain networks

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5
Q

What are 3 common epilepsy treatments?

A

Epileptic drugs - act as NT receptors +/ neuronal ion channels
Brain surgery - remove hyper excitable region/sever connections in abnormal large scale network
Neuromodulation - deep brain/vagus nerve stimulation

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6
Q

What are the three reasons signals decay along the axon?

A 
Membrane resistance (Rm)
Axial Resistance (Ri)
Membrane Capacitance (Cm)
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7
Q

Why are retinal images inverted along both axes?

A

Light from lateral visual field ==> nasal retina
Light from medial visual field ==> temporal retina
Light from superior ==> inferior parts of retina
Light from inferior ==> superior parts of retina

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8
Q

What part of the eye carries out most of its refraction?

A

Cornea

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9
Q

How does ciliary muscle and lens change shape depending on object distance?

A

Far away - ciliary relaxed, lens flat

Close up - ciliary contract, lens thicker + rounder

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10
Q

What is:

a) Emmetropia?
b) Myopia?
c) Hyperopia?

A

a) Normal vision
b) short- sighted, image focuses in front of retina
c) long-sighted, image focuses behind retina

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11
Q

Where are cones and rods concentrated?

A

Cones - fovea

Rods - peripheral retina

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12
Q

What is:

a) akinetopsia?
b) prosopagnosia?

A

a) inability to perceive movements

b) difficulties in face recognition

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13
Q

How are the stereocilia arranged in the ear?

A

Staircase arrangement with lower steps connected to upper steps with tip links

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14
Q

What ways do the stereocilia have to be bent to open the channels?

A

Up the stairs - K+ flow into cilia, stretches, open + depolarises
Down the stairs - relax, channel close, re/hyper polarize

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15
Q

What is dysarthria?

A

Motor speech disorder

Affects movement of speech muscles, X language problem

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16
Q

What condition can accompany dysarthria?

A

Dysphagia

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17
Q

What is PPA? (speech disorder)

A

Primary progressive aphasia - slowly + progressive worsens overtime
Results from stroke/brain injury/neurodegenerative e.g. Alzheimer’s

18
Q

What is cataplaxy?

A

Sudden loss of muscle tone, usu cos of strong emotion e.g. fear, laughter, anger

19
Q

Primary vs Secondary headaches

Examples

A

Primary - x caused by another underlying condition
e.g. migraine, tension, cluster
Secondary - caused by another underlying condition
e.g. trauma, infection

20
Q

What type of medication are tryptans?

A

5HT receptors agonists (serotonin receptor agonists)

21
Q

What are the 7 seizure markers?

A
  1. bitten tongue
  2. confusion following event
  3. head-turning to 1 side during TLOC
  4. x memory of abnormal behaviour that was witnessed before, during/after TLOC by someone else
  5. prodromal déjà vu/jamais vu
  6. prolonged limb-jerking (brief seizure-like activity can oft occur during uncomplicated faints)
  7. unusual posturing
22
Q

What are the classifications of nerve injuries? (3)

A

Neurapraxia - focal demyelination, axons intact to lesion
Axonotmesis - degeneration of some axons distal to lesion
Neurotmesis - nerve transected - all axons degenerate

23
Q

When is epilepsy considered to be resolved?

A

Remained seizure free for last 10 years with x seizure medicines for last 5 years

24
Q

How can you differentiate between a faint and a seizure depending on how the patient is after the event?

A

Faint - groggy

Seizure - prolonged period of confusion, drowsiness, irritability, disorientation

25
Q

What is a reflex seizure?

A

Occur consistently in response to a particular trigger

26
Q

What is the first line option for most forms of epilepsy?

What is first line for focal epilepsy?

A

Sodium valproate - increase GABA activity, relax brain

Carbamazepine

27
Q

Why is sodium valproate not used in girls and women of childbearing age?

A

Teratogenic - only use if no other option and strict measures to not get preggers

28
Q

Which types of seizures can carbamazepine exacerbate?

A

Myoclonic

Absence

29
Q

Difference between:

Functional neurological disorder vs factitious disorder vs malingering

A

Functional - unconsciously mediated
Factitious disorder - consciously feigned for psychological reasons
Malingering - consciously feigned for external gain

30
Q

What are the three red flag symptoms for cauda equina syndrome?

A

Bilateral sciatica, saddle anaesthesia, urinary retention

31
Q

When is a positive Babinski reflex normal?

A

In baby + infants up to walking age

32
Q

How long does it take for irreversible neuronal injury to begin during a stroke?

A

5 minutes after tissue hypoxia

33
Q

What cells and areas in the brain are most susceptible to hypoxia?

A

Neocortex
Hippocampus
Purkinje cells (cerebellum)
Watershed areas

34
Q

What are the watershed areas?

A

Region between 2 major vessels, least perfused + most susceptible to infection

35
Q

What is a contraindication for reperfusion therapy in the treatment of stroke?

A

Intracranial haemhorrhage

36
Q

Difference between TIA and stroke?

A

Stroke - rapidly developing symptoms, last >24 hrs, x apparent cause apart from vascular origin
TIA - symptoms lass < 24 hrs

37
Q

What is a crescendo TIA?

A

2/more TIAs within a week

Carries high risk of developing ==> stroke.

38
Q

What are the 4 main points that signify a cerebrovascular event?

A

Focal
Sudden onset
Negative symptoms - x tingling/arm jerking, more numbness + weakness
Maximum on onset

39
Q

How do EEGs differ in epileptic seizures and syncope?

A

Epileptic seizures - spiking of waves

Syncope - flattening/slowing of waves

40
Q

What type of cells cross BBB, starting the cascade of MS pathogenesis?

A

T cells

41
Q

How to test for relative afferent pupil defect?

A

Pt focuses on distant object in dark room
Shine light in one eye and assess for equal dilation + constriction
Shine light back + forth, pausing for 2 sec
Affected eye - pupil dilates

Science to Clinical Practice 2 (3 decks)

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