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MY NEURO > Kumar and clark 2 > Flashcards

Kumar and clark 2 Flashcards

1
Q

modalities of vagus

A

largely motor, - muscles of pharynx (gag reflex), larynx (vocal cords), upper oesophagus. sensory fibres from larynx. parasympathetic to heart and abdominal viscera

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2
Q

accessory supplies

A

trapezius and sternocleidomastoid

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3
Q

hypoglossal modaliteit

A

motor to tongue muscles

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4
Q

what recurrent laryngeal is more commonly injured

A

left as it loops beneath the aorta

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5
Q

hypoglossal nerve palsy cause tongue to go to what side

A

the weaker side of the pathology

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6
Q

what is bulbar palsy

A

LMN weakness of muscles whose cranial nerve nuclei lie in the medulla (bulb) (9,10,11), myasthenia graves, botulism , muscle disease

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7
Q

bulbar palsy causes what to tongue

A

spastic tongue

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8
Q

things that can cause bulbar palsy

A

MND, supranuclear palsy, MS

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9
Q

motor control systems

A

corticospinal (pyramidal), extrapyramidal, cerebellum

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10
Q

weakness or paralysis, spasticity , changes in reflex is what system

A

pyramidal

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11
Q

bradykinesia, stiffness, tremor, chorea is what system

A

extra pyramidal

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12
Q

what is ataxia

A

unsteady and very movements

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13
Q

what system is ataxia, past pointing, action tremor, incoordination, gait ataxia

A

cerebellum

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14
Q

where does the pyramidal system cross

A

medulla

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15
Q

pyramidal system, disease of which causes what lesions

A

UMN

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16
Q

pyramidal is used interchangeably with what word

A

UMN

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17
Q

extensors plantar response is what lesion

A

upper motor neurone

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18
Q

unilateral pyramidal lesion above decussation of medulla causes weakness in what limbs

A

opposite

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19
Q

what happens to fingers and toes in upper motor neurone lesions

A

loss of skilled finger/toe movements

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20
Q

internal capsule infarct causes

A

hemiplegia - pyramidal tract

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21
Q

what is spasticity characterised b y

A

sudden changing resistance to rapid passive movement

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22
Q

what can emerge in spasticity

A

clonus

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23
Q

paraparesis is

A

weakness of lower limbs

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24
Q

paraparesis is usually diagnostic of

A

cord lesion

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25
Q

weakness and or skilled movement confined to one contralateral limb - arm or leg - or part of limb eg hand. Is lesion where. aphasia or focal epilepsy may occur with this

A

motor cortex

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26
Q

sudden dense contralateral hemiplegia

A

middle cerebral artery infarction - internal capsule (corticospinal fibres are tightly packed in the internal capsule)

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27
Q

lesion in pons (MS plaque) causes

A

affects abducens and facial nerve - diplopia, facial weakness, INO, lateral gaze palsy with contralateral hemiparesis

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28
Q

spinal cord injury causes what signs

A

ipsilateral UMN lesion ??? not sure about this - page 819

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29
Q

paraparesis is usually due to damage of what

A

cord

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30
Q

what is a general term for basal ganglia motor systems

A

extrapyramidal systen

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31
Q

basal ganglia motor systems include

A

corpus striatum ( caudate nucleus, globus pallidus and putamen), sub thalamic nucleus, substantia nigra an parts of the thalamus

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32
Q

features of extrapyramidal systems

A

bradykinesia or akinesia (no movement) with MUSCLE RIGIDITY OR HYPERKINETIC MOVEMENTS( tremor, chorea, dystonia, tics, myoclonus)

33
Q

most common extra pyramidal disorder

A

Parkinson

34
Q

levels of GABA in Parkinsons and Huntington’s is

A

decreased

35
Q

side effect of levodopa

A

unwanted dyskinesias

36
Q

what is characteristic of cerebellum

A

ataxia ie unsteadiness

37
Q

what is the midline structure in the cerebellum

A

vermis

38
Q

expanding lesions where can cause hydrocephalus

A

cerebellum as obstructs the aqueduct

39
Q

gait in cerebellar lesions

A

tilts towards the side of lesion

40
Q

rotatory hand movements becomes disorganised in

A

cerebellar lesions

41
Q

intention tremor is seen in cerebellar lesions and what is this

A

action tremor with past pointing

42
Q

lesions of the flocculondoualr lobe cause what signs

A

vertigo and vomit

43
Q

3 physics drugs that can cause tremor

A

sodium valproate, lamotrigine, lithium

44
Q

intention tremor is

A

tremor exacerbated by action

45
Q

LMN pathway originates in

A

anterior horn cell

46
Q

LMN lesion at cranial nerve nuclei is

A

Bells palsy

47
Q

LMN lesion at anterior horn cell is

A

MND

48
Q

LMN lesion at spinal root is

A

radiculopathy

49
Q

pain on straight leg raise

A

lumbar disc prolapse

50
Q

cough and straining increase pain in what

A

spinal subarachnoid space

51
Q

what are common causes of spinal root lesions

A

cervical and lumbar disc protrusions

52
Q

clumsiness can bet caused by

A

spinal cord lesions

53
Q

in a spinal cord lesion what is lost below the lesion

A

position sense ( produces a stamping gait) , vibration , light touch , two point discrimination

54
Q

what is lhermittes phenomenal

A

electric shock sensation down trunk and limbs on neck flexion- points to a cervical cord lesion. common in exacerbations of MS, cervical myeloapthy

55
Q

contralteal loss of pain nd temp (spinothalmic tract lesions) typically seen in

A

syringomyelia

56
Q

central cord lesion affects what fibres first

A

deeper

57
Q

what does cord compression causee

A

progressive spastic paraparesis with sensory loss below the level of the lesion

58
Q

what disturbance is common in spinal cord compression

A

sphincter

59
Q

pontine lesions causes

A

loss of all forms of sensation on side opposite the lesion and combination of cranial nerves can be affected

60
Q

constant pain after stroke could be

A

thalamic lesion

61
Q

brown squared affects what limbs

A

legs

62
Q

central cord lesions affects what

A

chest and arms

63
Q

what disease is from a dorsal column lesion

A

MS

64
Q

spinothalmic tract is for

A

pain localisation

65
Q

spin-reticular tract is for

A

emotional component of pain

66
Q

diminished proprioception and light touch affects where

A

posterior columns

67
Q

aspirin, paracetamol NSaids and opiates are all

A

analgesics

68
Q

some opioids such as tamadolol and tapentadol have what

A

monoamine reuptake inhibition mechanism

69
Q

what is licensed for chronic migraine

A

botulinum

70
Q

bilateral UMN lesion spinal cord can cause what

A

urinary frequency and incontinecne

71
Q

scan for carotid stenosis

A

US - Doppler

72
Q

what can detect arteiorvenous malformations

A

catheter angiography

73
Q

what’s main use is to characterise epilepsy syndromes

A

electroencephalography

74
Q

what are hallmarks of epilepsy on EEG

A

SPIKES - but often have normal EEG between spikes

75
Q

slow wAVE EEG IS IN

A

encephalopathy, encephalitis and prion disease

76
Q

studies for nerve function

A

electromyography and nerve conduction

77
Q

electroencephalography measures

A

brain electrical activity

78
Q

conduction block and slowing of conducting velocity indicates what

A

demyelinating neuroapthy

79
Q

what is receptive nerve stimulation used for

A

NMJ conduction disorders (myasthenia)

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