Kumar and clark 2 Flashcards by Lucy Miller

modalities of vagus

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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accessory supplies

trapezius and sternocleidomastoid

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hypoglossal modaliteit

motor to tongue muscles

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what recurrent laryngeal is more commonly injured

left as it loops beneath the aorta

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hypoglossal nerve palsy cause tongue to go to what side

the weaker side of the pathology

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what is bulbar palsy

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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bulbar palsy causes what to tongue

spastic tongue

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things that can cause bulbar palsy

MND, supranuclear palsy, MS

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motor control systems

corticospinal (pyramidal), extrapyramidal, cerebellum

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

pyramidal

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bradykinesia, stiffness, tremor, chorea is what system

extra pyramidal

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what is ataxia

unsteady and very movements

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

cerebellum

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where does the pyramidal system cross

medulla

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pyramidal system, disease of which causes what lesions

UMN

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pyramidal is used interchangeably with what word

UMN

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extensors plantar response is what lesion

upper motor neurone

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

opposite

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what happens to fingers and toes in upper motor neurone lesions

loss of skilled finger/toe movements

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internal capsule infarct causes

hemiplegia - pyramidal tract

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what is spasticity characterised b y

sudden changing resistance to rapid passive movement

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what can emerge in spasticity

clonus

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paraparesis is

weakness of lower limbs

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paraparesis is usually diagnostic of

cord lesion

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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

motor cortex

sudden dense contralateral hemiplegia

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

lesion in pons (MS plaque) causes

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

spinal cord injury causes what signs

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

paraparesis is usually due to damage of what

cord

what is a general term for basal ganglia motor systems

extrapyramidal systen

basal ganglia motor systems include

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

features of extrapyramidal systems

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

most common extra pyramidal disorder

Parkinson

levels of GABA in Parkinsons and Huntington's is

decreased

side effect of levodopa

unwanted dyskinesias

what is characteristic of cerebellum

ataxia ie unsteadiness

what is the midline structure in the cerebellum

vermis

expanding lesions where can cause hydrocephalus

cerebellum as obstructs the aqueduct

gait in cerebellar lesions

tilts towards the side of lesion

rotatory hand movements becomes disorganised in

cerebellar lesions

intention tremor is seen in cerebellar lesions and what is this

action tremor with past pointing

lesions of the flocculondoualr lobe cause what signs

vertigo and vomit

3 physics drugs that can cause tremor

sodium valproate, lamotrigine, lithium

intention tremor is

tremor exacerbated by action

LMN pathway originates in

anterior horn cell

LMN lesion at cranial nerve nuclei is

Bells palsy

LMN lesion at anterior horn cell is

MND

LMN lesion at spinal root is

radiculopathy

pain on straight leg raise

lumbar disc prolapse

cough and straining increase pain in what

spinal subarachnoid space

what are common causes of spinal root lesions

cervical and lumbar disc protrusions

clumsiness can bet caused by

spinal cord lesions

in a spinal cord lesion what is lost below the lesion

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

what is lhermittes phenomenal

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

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

syringomyelia

central cord lesion affects what fibres first

deeper

what does cord compression causee

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

what disturbance is common in spinal cord compression

sphincter

pontine lesions causes

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

constant pain after stroke could be

thalamic lesion

brown squared affects what limbs

legs

central cord lesions affects what

chest and arms

what disease is from a dorsal column lesion

spinothalmic tract is for

pain localisation

spin-reticular tract is for

emotional component of pain

diminished proprioception and light touch affects where

posterior columns

aspirin, paracetamol NSaids and opiates are all

analgesics

some opioids such as tamadolol and tapentadol have what

monoamine reuptake inhibition mechanism

what is licensed for chronic migraine

botulinum

bilateral UMN lesion spinal cord can cause what

urinary frequency and incontinecne

scan for carotid stenosis

US - Doppler

what can detect arteiorvenous malformations

catheter angiography

what's main use is to characterise epilepsy syndromes

electroencephalography

what are hallmarks of epilepsy on EEG

SPIKES - but often have normal EEG between spikes

slow wAVE EEG IS IN

encephalopathy, encephalitis and prion disease

studies for nerve function

electromyography and nerve conduction

electroencephalography measures

brain electrical activity

conduction block and slowing of conducting velocity indicates what

demyelinating neuroapthy

what is receptive nerve stimulation used for

NMJ conduction disorders (myasthenia)

Kumar and clark 2 Flashcards

(79 cards)