Neuro intro Flashcards
(37 cards)
How do messages pass from the brain to muscle and which motor neurone are they?
UMN:
Primary motor cortex
Medulla oblongata
Decussation in pyrmaids/spinal cord
Anterior horn
LMN:
Motor neurone
Neuromuscular junction
skeletal muscle
For the PNS, what investigations can you do to check its working?
Nerve conduction study
EMG (Electromyography)
On Nerve conduction study, what does it mean if it is small or slow?
small = axon loss
slow = demyelination (MS, GBS)
On EMG, what does it mean if there is myopathy?
low motor unit with same/normal NCS - MND
For the CNS, what investigations can you do to check its working?
EEG (Seizure classifying)
Evoked potentials Test
Non contrast CT
MRI
What is a non contrast CT used to see?
1st modality for stroke, intracranial bleed, high ICP
when would you add contrast to a CT in neurology?
if there is an abscess
what is an MRI and evoked potentials test used to detect?
MRI = MS, myelopathy
EPT = Optic neuritis, optic glaucoma - Dx eye and brain effect by pathology
what is included in a Mini neurology exam?
Vitals = BP, HR, Temp, RR, Sp02
GCS
Lateralsining signs (near Sx)
Pupils
What is examined in a full neurology exam?
cognitive testing (GCS)
Cranial nerves
motor strength and control
walking (gait)
reflexes
mental status
What does GCS stand for?
what is it out of?
acronym for it?
glasgow coma scale
/15
MoVE
What does each section assess and score?
Motor /6
Verbal /5
Eyes /4
on GCS, what do these mean?
15/15
<8/15
<3/15
good
intubate
comatose
What are the 6 points from motor?
- No response
- Abnormal extension (bad)
- Abnormal flexion
- withdraw from painful stimulus
- incomprehensible sounds to painful stimulus
- obeys commands
What are the 5 points for verbal?
- No speech
- incoherent speech
- inappropriate words
- confused
- orientated
What are the GCS 4 points for eyes?
- no eye opening
- eyes to painful stimulus
- eyes open to voice
- Spontaneous open eyes
What does lateralising signs mean?
Localise CNS pathology
eg. pronator drift, homonymous hemianopia, unilateral weakness
What are the tracts divided into?
ascending
descending
Name me 4 ascending tracts?
DCML
Spinothalamic
Spinocerebellar
Spinoreticular
For the DCML tract, how does it go up the cord, where does it decussate and terminate, and what is it responsible for?
Fasiculus cuneautus (inner) - upper body –> cuneate tubercule (medulla)
Fasicilus gracilis (outer) - lower body –> gracile tubercule
Decussate at medulla
Fine touch, 2pt discrimination, vibration, proprioception
Spinothalamic tract
what is it responsible for?
Where does it decussate?
pathway?
lateral = pain and temp
medical = crude touch
spine –> anterior horn –> thalamus
decussate 1-2 spinal levels above anterior horn (spinal cord)
Spinocerebellar and spinoreticular tracts, what are they responsible for?
spinocerebellar = proprioception
Spinoreticular = deep/chronic pain
What are the 2 categories of the decending tracts?
pyramidal (conscious)
Extrapyramidal (unconscious)
What does pyramidal and extrapyramidal mean?
pyramidal = medulla decussation, voluntary muscle control, originate from cerebral cortex and brainstem
extrapyramidal = Non medulla decussating, autonomic muscle control, originate in brainstem
