L1: Introduction to Neurology Flashcards
(120 cards)
1
Q
Def of Neurology
A
The branch of medicine that deals with diseases of the nervous system & diseases of the muscles & myoneural junction.
2
Q
What is the structural & Functional unit of Nervous System?
A
Neuron
3
Q
Neurons Grey & White Matters
A
4
Q
Classifications of Nervous System
A
Anatomical & Physiological
5
Q
Anatomical Classification of Nervous System
A
6
Q
Two cerebral hemispheres connected to
- Each other → …..
- The brain stem → ……
A
- by corpus callosum
- by cerebral peduncles.
7
Q
The surface of each hemisphere is divided into 4 LOBES ……
A
1) Frontal.
2) Parietal.
3) Temporal.
4) Occipital.
8
Q
Cerebral Lobes Histology
A
9
Q
Basal Nuclei
A
10
Q
What is Brainstem Formed of?
A
11
Q
What is Brainstem Connected to?
A
- Cerebral hemispheres → by cerebral beduncles
- Cerebellum → by cerebellar peduncles.
12
Q
Site of Cerebellum
A
lies at the BACK & the BOTTOM of the cranium behind the brain stem, in the posterior cranial fossa.
13
Q
What is Cerebellum formed of?
A
Two cerebellar hemispheres connected to each other by the ‘vermis’
14
Q
Composition of Cerebellum
A
15
Q
Connection of Cerebellum
A
Connected to brain stem by superior, middle & inferior cerebellar peduncles.
16
Q
Site of Spinal Cord
A
It lies in the spinal canal.
17
Q
End of Spinal Cord
A
It ends at the lower border of the 1st lumbar vertebra (L1).
18
Q
Segments of Spinal Cord
A
19
Q
Def of Conus medullaris
A
The lowermost 3 segments of the spinal cord (53, 4, 5).
20
Q
Def of Epiconus
A
The 4 segments above the conus medullaris (L4, 5, S1, 2).
21
Q
what does a section in spinal cord show?
A
Grey matter (cells) surrounded by white matter (fibers).
22
Q
Spinal Cord Grey Matter
A
23
Q
Spinal Cord white Matter
A
24
Q
Def of Cauda Equina
A
Collection of Lumbosacral roots
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Functional Classification of Nervous System
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Site of **Cauda Equina**
- It fills the lower part of the spinal canal.
- It starts at the lower border of the 1st lumbar vertebra (L1).
26
Compare Between Cranial Nerves & Spinal Nerves in terms of:
- Number
- Origin
- Exit
- Supply
- Course
27
What are cortical senstations?
the ability of the cortical sensory area to LOCALIZE the sensations perceived by the thalamus.
28
Parts of **Voluntary Motor System**
- Pyramidal System (UMN)
- Extrapyramidal System
- Cerebellar System
- LMN
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Origin of **Pyramidal System (UMN)**
the cerebral cortex (motor area "4" & premotor area "6").
30
Termination of **Pyramidal System (UMN)**
At the AHCs of the different levels of the spinal cord.
31
Control by **Pyramidal System (UMN)**
controls the opposite side
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Functions of **Pyramidal System (UMN)**
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Origin of **Extrapyramidal System**
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Termination of **Extrapyramidal System**
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Control of **Extrapyramidal System**
It controls the opposite side of the body.
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Functions of **Extrapyramidal System**
- REGULATION et the voluntary motor activity.
- Regulation of the emotional & associated movements.
- Inbibition of muscle tone.
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Origin of **Cerebellar System**
- From the cerebellum.
38
Termination of **Cerebellar System**
At the AHCs of the different levels of the spinal cord.
39
Control by **Cerebellar System**
It controls the same side of the body.
40
Functions of **Cerebellar System**
- Co-ordination the voluntary motor activity initiated by pyramidal system.
- Maintenance of equilibrium
41
Origin of **LMN**
- In the AHCS of the different levels of the spinal cord.
42
Termination of **LMN**
At the voluntary muscles.
43
Functions of **LMN**
Transmission of the motor impulse from the AHCS to the voluntary muscles.
44
Components of **LMN**
AHCS, PN, NMJ & Voluntary muscles.
45
Read Voluntary Motor pathway & Reflex arc from Notes
...
46
Def of **Deep Reflex (Tendon Jerk)**
This is an INDUCED (Dynamic) local axon stretch reflex.
47
What is **Deep Reflex (Tendon Jerk)** Induced by?
It is induced by:
- Sudden stretch of the muscle by tapping the tendon with a hammer.
- This induced sudden stretch will suddenly & temporarily activate the local axon reflex → this will result in sudden transient contraction of the muscle (jerk).
48
Components of **Deep Reflex**
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Types of **Deep Reflex**
- Normal deep reflex (Tendon Jerk).
- Pathological deep reflex.
50
Def of **Pathological Reflexes**
- reflexes which are normally absent → its presence indicates U.M.N.L. (Don't elicit them in patient with normal or hyporeflexia)
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Examples of **Pathological Reflexes**
adductor, patellar and finger flexion reflexes
52
Effect of Pyramidal System on **Deep Reflexes**
The deep reflex receives inhibition from the Pyramidal system
53
UMNL & **Deep Reflexes**
UMNL results in loss of inhibition on the deep reflex, leading to:
- Increased deep reflex (hyperreflexia) below the level of the lesion.
- Appearance of pathological reflexes.
54
LMNL & **Deep Reflexes**
LMNL results in interruption of the reflex arc, leading to:
- Decreased deep reflex (hyporeflexia) at the level of the lesion.
55
Def of **Muscle Tone**
This is a SPONTANEOUS (Static) local axon stretch reflex:
56
Why is **Muscle Tone** spontaneous?
It is spontaneous because:
- The length of any skeletal muscle is shorter than the distance between the origin & the insertion (bone growth is faster than soft tissue growth) → so any muscle is always in a state of persistent spontaneous slight stretch.
- This spontaneous persistent stretch will persistently activate the local axon reflex → this will result in persistent (maintained) contraction of the muscle (tone).
57
Pyramidal & Extrapyramidal system & **Muscle Tone**
The Muscle tone receives inhibition from the Pyramidal & Extrapyramidal systems
58
UMNL & **Muscle Tone**
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LMNL & **Muscle Tone**
LMNL results in interruption of the reflex arc, leading to:
- Decreased muscle tone (flaccidity) at the level of the lesion.
60
Def of **Clonus**
- Sudden sustained stretch of the muscle tendon
- Results in: Rapid, Rhythmic, Regular contractions.
61
What does **Clonus** Indicate?
Severe pyramidal lesion due to loss of inhibition on the stretch reflex.
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Sites of **Clonus**
Ankle, patella, wrist.
63
When does **Clonus** stop?
The stretch is stopped.
64
Def of **Superficial Reflex**
- Reflex whose afferent is a superficial sensory. → (E.g. Planter reflex & abdominal reflex).
- Take facilitator fibers from both U.M.N. & L.M.N. so, they are absent in both U.M.N. L. (below the level) & L.M.N.L (at the level)
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**examples of Superficial Reflex**
- Plantar Reflex
- Abdominal Reflex
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Stimulus in **Plantar Reflex**
Scratching of the skin at the lateral side of the sole.
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Center of **Plantar Reflex**
S1
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Types of Responses in **Plantar Reflex**
- Normal (flexor response): Flexion of toes.
- Babinski sign (extensor respone)
- Absent (equivocal) response:
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Normal reflex for **Plantar Reflex**
Flexion of toes.
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Babniski sign in **Plantar Reflex**
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Absent Reflex in **Plantar Reflex**
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Stimulus in **Abdominal Reflex**
Scratch from lateral to medial.
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Response in **Abdominal Reflex**
Abdominal muscle contraction.
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Control of **Abdominal Reflex**
Stimulated by pyramidal tract
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When is **Abdominal Reflex** Lost?
Pyramidal tract lesion
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Def of **Fasiculations**
oscillatory movements of the muscles caused by an irritating lesion of the AHCs
77
Compare between **UMNL** & **LMNL**
78
what are somatic Sensations?
79
What are visceral sensations?
All sensations from internal viscera reaching the CNS via the Cautonomic nerves"
80
what are special sensations?
Including vision, hearing, smell & taste reaching the CNS via the Cranial nerves"
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Sesnory Pathways
82
Areas of frontal Lobe
- Motor Area
- Premotor area
- Area of VCEM
- Broca's Area
- Exner's Area
- Prefrontal Area
- Paracentral Area
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Function of **Motor Area (Area 4)**
84
Effect of Lesion in **Motor Area (Area 4)**
85
Function of **Premotor Area (Area 6)**
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Lesion of **Premotor Area (Area 6)**
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Function of **Area of Voluntary Conjugate Eye Movement (Area 8)**
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Effect of Lesion in **Area of Voluntary Conjugate Eye Movement (Area 8)**
89
Site of **Broca's Area (Area 44)**
90
Function of **Broca's Area (Area 44)**
91
Lesion in **Broca's Area (Area 44)**
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Site of **Exner's Area (Area 45)**
93
Function of **Exner's Area (Area 45)**
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Lesion in **Exner's Area (Area 45)**
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Function of **Prefrontal Area**
96
Lesion in **Prefrontal Area**
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Function of **Paracentral Lobe**
98
Lesion in **Paracentral Lobe**
99
What are Parietal Lobe Areas?
100
Function of **Cortical Sensory Area (Area 3,1,2)**
101
Lesion in **Cortical Sensory Area (Area 3,1,2)**
102
Function of
- ANGULAR GYRUS (AREA 39) → IN THE DOMIÑANT HEMISPHERE)
- SUPRA-MARGINAL GYRUS AREA 40) → IN THE DOMINANT HEMISPHERE)
103
Lesion in
- ANGULAR GYRUS (AREA 39) → IN THE DOMIÑANT HEMISPHERE)
- SUPRA-MARGINAL GYRUS AREA 40) → IN THE DOMINANT HEMISPHERE)
104
Areas of Temporal Lobe
105
Lesion in **Auditory Sensory Area (Area 41,42)**
106
Function of **Auditory Association Area (Area 22)**
(Wernicke Area)
106
Site of **Auditory Association Area (Area 22)**
(Wernicke Area)
107
Lesion in **Auditory Association Area (Area 22)**
(Wernicke Area)
108
Auditory agnosia
the patient hears but does not understand (recognize) what he hears
109
Word deafness
Inability to understand spoken words but Speech production, reading and writing are normal
110
Sensory or receptive aphasia
- Inability to understand spoken or written words.
- The patient's speech is fluent, but words are used inappropriately leading to neologism
111
Jargon / central / syntactical aphasia
Form of severe receptive aphasia with failure to produce correct words leading to neologisms and paragrammatism
112
Function of **Limbic System**
113
Lesion in **Limbic System**
114
Areas of Occipital Lobe
115
Function of **Visual Sesory area (area 17)**
116
Lesion in **Visual Sesory area (area 17)**
117
Function of **Visual Associative Area (Area 18,19)**
118
Lesion in **Visual Associative Area (Area 18,19)**
