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Flashcards in Data - neurology Deck (42):
1

CSF interpretation
Appearance: Cloudy/turbid
Opening pressure: Elevated
WBC: Elevated
Glucose: Low
Protein: Elevated

Bacterial meningitis

2

CSF interpretation:
Appearance: Clear
Opening pressure: Normal/elevated
WBC: Elevated
Glucose: Normal
Protein: Elevated

Viral meningitis

3

CSF interpretation:
Appearance: Clear or cloudy
Opening pressure: Elevated
WBC: Elevated
Glucose: Low
Protein: Elevated

Fungal meningitis

4

CSF interpretation:
Appearance: Opaque
Opening pressure: Elevated
WBC: Elevated
Glucose: Low
Protein: very elevated

Tuberculosis meningitis

5

CSF interpretation:
Appearance: blood-stained/xanthochromia
Opening pressure: Elevated
WBC: Elevated
Glucose: Normal
Protein: Elevated

Subarachnoid haemorrhage

6

Difference in WBC between viral and bacterial meningitis?

In bacterial meningitis:
Primarily polymorphonuclear leukocytes (>90%)
In viral meningitis:
Primarily lymphocytes (PMN early on)

7

Olfactory nerve controls what?

CNI sense of smell

8

Optic nerve?

CNII - vision!

9

Oculomotor nerve?

CNIII - Eye movements - sup. inf. med. rectus muscles. Inf oblique muscle.
Levator palpabrae superioris

10

Trochlear nerve?

CNIV - Eye movements - superior oblique

11

Trigeminal nerve?

CNV - split into three nerves, supplying sensation to face.
Only mandibular division has motor function

12

Ophthalmic nerve?

CNV1
Sensation to upper face
Parasymp to lacrimal gland

13

Maxillary nerve?

CNV2
Sensation to mid face
Parasymp to lacrimal gland and nasal glands

14

Mandibular nerve?

CNV3
Sensation to lower face, mucous membranes, tongue
Parasymp to submandibular, sublingual and parotid glands
Motor muscles of mastication - temporalis, masseter, pterygoids. And also tensor veli palatini and tensor tympani

15

Abducens nerve?

CNVI -
Motor to lateral rectus

16

Facial nerve?

CNVII
Motor to muscles of facial expression
Anterior 2/3 tongue TASTE (chorda tympani)

17

Branches of facial nerve?

Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical

18

Vestibulocochlear nerve?

CNVIII
hearing and balance

19

Glossopharyngeal nerve?

CNIX
Motor to stylopharyngeus
Parasymp - parotid gland
Posterior 1/3 tongue TASTE
Sensory - oropharynx

20

Vagus nerve?

CNX
Motor - muscles of pharynx
Parasymp - trachea smooth muscle, bronchi, GI tract, heart

21

Accessory nerve?

CNXI
Motor - trapezius and SCM

22

Hypoglossal nerve?

CNXII
Motor to muscles of tongue (except palatoglossus CNX)

23

Where is the lesion
Uvula deviated toward the right?

Left glossopharyngeal nerve lesion

24

Where is the lesion
Bovine cough, dysphonia?

Recurrent laryngeal nerve - Vagus nerve

25

Where is the lesion
Tongue deviated to left, some wasting on left side?

Left hypoglossal nerve

26

Patient with:
- hemiparesis, affecting face and arm worse than lower limb
- anaethesia

MCA stroke - contralateral side to hemiparesis

27

Patient with:
- lower limb weakness unilaterally

ACA stroke - contralateral side to hemiparesis

28

Patient with:
homonymous hemianopia
ataxia
diplopia
nystagmus
facial weakness/numbness

PCA stroke - ipsilateral to weakness/numbness

29

Pattern of tonic clonic seizure?

Focal onset - aura (not always)
Tonic phase - LOC + body stiffness
Clonic phase - rhythmical jerking
Postictal phase

30

Kernig's sign?

Patient lying on back
Flexed knee and hip
Resisted knee extension
Positive for meningitis

31

Features of UMN lesion?

Increased tone (spasticity)
Weakness but not wasting
+ve Babinski's sign
Clonus
Brisk reflexes

32

Features of LMN lesion?

Weakness and wasting
Reduced tone (flaccidity)
Fasciculations
Reduced reflexes (may be absent)

33

Predictive features of SAH?

Age >40
Onset with exertion
Next stiffness/pain
Raised BP
Loss of consciousness
Vomiting

34

What is dysarthria?

Slurred speech caused by articulation problems due to motor deficit

35

What is dysphonia?

Loss of volume caused by laryngeal disorders

36

What is dysphasia?

Disturbance of language resulting in abnormalities of speech production

37

Common causative vessel of extradural haematoma?

Middle meningeal artery

38

Hemisection of spinal cord?

Brown-Sequard syndrome
Contralateral loss of pain and temp
Ipsilateral loss of touch, vibration, proprioception

39

Four causes of CVA?

Embolism - Most common
Thrombosis
Hypoperfusion (eg shock)
Haemorrhage

40

How to score GCS?

Eyes:
Not opening = 1
To pain = 2
To speech = 3
Spontaneously = 4

Verbal response
None = 1
Incomprehensible sounds =
Inappropriate words = 3
Patient confused = 4
Patient oriented = 5

Motor response
None = 1
Extends to pain = 2
Flexion to pain = 3
Withdraws from pain = 4
Localized to pain = 5
Obeys commands = 6

41

Where does lumbar puncture go?

L2/3 or L3/4

42

Layers met in lumbar puncture

Trying to get to subarachnoid space

Skin
Subcutaneous tissue
Interspinous ligament
Ligamentum flavum
Epidural space
Dura and arachnoid mater
Subarachnoid space