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MY NEURO > Kumar and clark > Flashcards

Kumar and clark Flashcards

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1
Q

what can worsen symptoms of demyelination

A

warm baths

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2
Q

what stimuli can trigger epilepsy

A

sensory

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3
Q

headaches worse on waking and on lying flat suggests

A

raised ICP

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4
Q

3 inherited neurological disorders

A

Huntingtons chorea, myotonic dystrophy, Charctot Marie Tooth disease

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5
Q

global lesions typically affect

A

cognition and consciousness

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6
Q

focal lesions resultant signs may eb

A

asymmetric

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7
Q

is up going planters upper or lower motor neurone

A

upper

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8
Q

if upper motor neurone lesions have a pyramidal pattern where stronger muscles overwhelm weaker then which ones are stronger

A

upper limb flexors and lower limb extensors

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9
Q

if there is contralateral UMN signs then where is the lesion

A

cerebral cortex/ internal capsule

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10
Q

if got nystagmus where is the lesion

A

cerebellum

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11
Q

lesions in the brainstem cause what symptoms

A

impaired consciousness, global signs, cranial nerve abnormalities

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12
Q

spinal cord lesions presents as

A

UMN paraplegia/ quadriplegia with sensory level

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13
Q

nerve root lesion signs

A

LMN myotomal signs, dermatomal signs

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14
Q

single peripheral nerve lesion signs

A

LMN signs and sensory loss according to distributions of nerve

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15
Q

lesion in all peripheral nerves cause what signs

A

length dependent LMN signs ( worse in hands and feet) , glove and stocking sensory loss

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16
Q

what are signs of neuromuscular junction lesions

A

only motor signs present. fatiguability common, wasting and fasciculation

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17
Q

lesions in cerebral cortex ad spinal cord cause – signs and lesions in nerves cause — signs

A

UMN, LMN

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18
Q

spasticity is more pronounced in what kind of muscles

A

extensors

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19
Q

what is clonus

A

involuntary extensor rhythmic leg jerking

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20
Q

clonus can occur in

A

spasticity

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21
Q

what is the gait like in Parkinson

A

shuffling

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22
Q

what are uncommon in Parkinsons expcept in later stage disease and may indicate a Parkinson’s plus syndrome

A

falls

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23
Q

gait becomes broad based in what

A

lateral cerebellar lobe disease e.g when walking they veer towards the affected side of the cerebellar lobe

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24
Q

peripheral sensory loss(polyneuropathy) causes what kind of gait

A

stamping- broad based, high stepping

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25
rombergs test is positive in what
sensory ataxia (peripheral sensory loss)
26
what can cause a slap noise when walking
common peroneal nerve palsy
27
walking becomes a waddle in what
weakness of Proximal leg muscles
28
what can show normal sensory and motor function on couch but when walking it can be shuffling with small steps, gait ignition failure and hesitancy with fear of falling
frontal lobe disease- diffuse cerebrovascular disease, normal pressure hydrocephalus
29
what tests joint position
small movements of DIP joints in toes and fingers
30
dysgraphaethesia and asterogenesis
cortical sensory loss
31
normal muscle power is grade
5
32
what are the 3 inhibitory neurotransmitters
GABA, histamine and glycine
33
synaptic transmission is mediated by
neurotransmitters released by action potentials passing down an axon
34
aphasia means what area of brain is not working
dominant frontal lobe
35
hemiparesis has what area of brain not working
internal capsule
36
synchronous discharge of neurones by irritate lesions cause
epilepsy
37
the dominant hemisphere and the one that for most people affects language is
left
38
temporal lesions effects
visual hallucinations, complex partial seizures, memory disturbance eg deja vu
39
brocas area is in what lobe
frontal
40
wernickes is in what area
temporo- parietal
41
words are muddled, insertion of a few incorrect or unnecessary words or profuse outpouring of jargon (non existent words)
wernickes
41
disjointed words and and failure to construct sentences
brocas
42
what is nominal aphasia. It is an early detection in all types of aphasia
difficulty naming objects
43
what aphasia includes brocas and werniceks and is the most common aphasia after a severe left hemisphere infarct
global aphasia
44
what is dysarthria
slurred speech. language is intact
45
gravelly speech in
pseudo bulbar palsy
46
jerky speech of what lesions
cerebellar
47
hypophonic monotone speech of
parkinsons
48
speech that fatigues and dies away
myasthenia
49
what disorders are difficult to recognise ins right handed patents
right hemisphere lesions
50
semantic memory is
knowledge of word meaning
51
what is implicit memory
not conscious eg riding a bike
52
what lesions are necessary to cause amnesia
bilateral
53
tumours of the olfactory groove can cause loss of smell eg
meningioma
54
each --- carries information from the contralateral visual hemifield
optic tract
55
what is normal acuity
6/6
56
white and red targets and fingers used to assess
visual fields(peripheral and central)
57
difference between temporal and parietal lesion in visual pathway
temporal affects superior region and parietal affects inferior region
58
what is the hallmark of an optic nerve lesion
unilateral visual loss, with a scotoma
59
optic nerve lesions particularly affect what parts of vision
central vision and colour vision
60
what does a total optic nerve lesion cause
unilateral blindness with loss of pupillary light reflex
61
pale disc reflects
optic atrophy
62
papilloedema is
swelling of the optic disc
63
visual symptoms of papilloedema
few if any visual symptoms, other than momentary visual obscurations with changes in posture. the blind spot is enlarged but this is not noticed by the patient. however over time visual fields are affected and eventually leading to optic atrophy
64
what is almost universal in optic neuritis
pain on eye movement
65
how does disc usually appear in optic neuritis
normal
66
most common cause of optic neuritis
plaque of demyelination within the optic nerve
67
what should be done for optic neuritis
steriods
68
common causes of bitemporal hemianopia/ quadrantanopia
pituitary tumours meningioma craniopharyngioma
69
what lobe lesions causes upper quadratic defects and what causes lower
upper- temporal lobe lesions lower- parietal lobe lesions
70
what eye things can unilateral posterior cerebral artery infarction cause
homonymous hemianopia defects
71
what causes a dilated pupil and a afferent pupillary defect
optic nerve lesion
72
features of corners syndrome
constricted pupil (miosis) partial ptosis loss of sweating on the same side
73
horners syndrome is damage to the
sympathetic nerve supply
74
argyll robertson pupil is occassionalky seen in diabetes or MS and what is it
small and irregular pupil, it is fixed to light but constricts on convergence
75
what cranial nerves supply the extraocular muscles
oculomotor, trochlear and abducens
76
nystagmus can indicate what lesions
cerebellar or brainstem pathology
77
occipital cortex is concerned with
tracking objects
78
vestibular nuclei is involved with
linking eye movements with the position of head and neck
79
what causes internuclear ophthalmoplegia
damage to one medial longitudinal fasciculus
80
in internuclear ophthalmoplegia the other eye that is able to abduct develops nystagmus
81
what is almost pathognomonic for MS
Bilateral INO
82
what examination is of diagnostic value in coma
vestibulo ocular reflex
83
failure of upgaze can be seen in
dorsal midbrain lesion, progressive supranuclear palsy
84
most common cause of trochlear nerve palsy ( two objects when looking down)
head injury
85
what can damage the abducence nerve
MS or brainstem infarction, raised ICP, tumours
86
what is the largest cn
trigeminal
87
modalities of trigeminal
mainly sensory with motor component to muscles of mastication
88
diminution of the corneal reflex can be a sign of
trigeminal nerve lesion
89
in trigeminal lesion causes what to jaw when mouth opens
it deviates to side of pathology
90
facial nerve main modality
mainly motor supplying muscles of facial expression. sensory to anterior 2/3 of tongue and motor to stapedius
91
upper motor neurone lesions cause what to face
weakness of the lower part of the face on the opposite side. frontalis is spared. can furrow brow, close eyes and blink.
92
complete unilateral lower motor neurone lesion causes
ipsilateral weakness of all facial expression muscles. frontalis and eye closure are weak
93
most common cause of UMN lesion in face
hemispheric stroke
94
lateral rectus nerve palsy and unilateral LMN facial weakness causes are
glioma, MS and infarction. This is at the PONS where the facial nerve loops around the abducens
95
what virus causes bells palsy
herpes simplex
96
what is common at onset with bells palsy
pain behind the ear
97
vague altered facial sensation is often reported in bells palsy but what
examination of facial sensation id normal
98
even though bells palsy is caused by virus what treatment
steriods as poor evidence for antivirals
99
vesicles alongside bells palsy
Ramsay hunt syndrome
100
treatment for Ramsay hunt
antiviral alongside steriods
101
outside the skull, glossopharyngeal, vagus, spinal accessory and hypoglossal lie close to the
carotid artery and sympathetic trunk
102
modalities of glossopharyngeal
largely sensory supply sensation and taste to posterior 1/3 of tongue and pharynx. motor to pharyngeal muscles and parasympathetic to parotid

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