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Neuro Nerves Flashcards

(44 cards)

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1
Q

CN I Olfactory

A

Sensory : smell

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2
Q

CN II Optic

A

Sensory: Sight

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3
Q

CN III Occulomotor

A

Motor: MR, SR, IR, IO, LPS
Parasympathetic: sphincter pupillae (light constriction)

Signs= fixed dilated, ptosis, outward deviation (down + out)

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4
Q

CN IV Trochlear

A

Motor: SO
signs: vertical diplopia (up + out), tilt head to compensate for function loss

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5
Q

CN V Trigeminal

A

Sensory: ophthalmic V1 + maxillary V2
(touch, pain, pressure, temperature, muscles of mastication: face, scalp, cornea, nasal, oral cavity, anterior 2/3 of tongue)

Motor: ophthalmic + maxillary + mandibular V3
(muscles of mastication, tensor, tympani muscles)

Signs: reduced sensation or dysesthesia, weakness of jaw clenching, side to side movement, jaw deviates to weaker side if LMN lesion

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6
Q

CN VI Abducens

A

Motor: LR
signs: inability to look laterally, eye deviated medially

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7
Q

CN VII Facial

A

Sensory: taste anterior 2/3 tongue

Motor: muscles of facial expression, upper face bilaterally innervated, lower face contralaterally innervated by motor cortex

Parasympathetic: lacrimal, submandibular, sublingual salivary glands

Signs: facial weakness, forehead paralysed/spared in LMN/UMN

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8
Q

CN VIII Vestibulocochlear

A

Sensory: hearing + balance
Signs: deafness, tinnitus

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9
Q

CN IX Glossopharyngeal

A

Sensory:
- taste posterior 1/3 tongue,
- general sensation: touch, pain, temp in pharynx, eustachian tube posterior 1/3 tongue

Motor: 1 pharynx muscle

Parasympathetic: parotid gland

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10
Q

CN X Vagus

A

Sensory: general sensation to pharynx, larynx, oesophagus, external auditory meatus, tympanic membrane

Motor: muscles of soft palate, pharynx, larynx (swallowing)

Parasympathetic: thoracic and abdominal viscera

Signs: palatal weakness can cause “nasal speech”, palate assymetrical when patient opens mouth, “bovine cough”, hoarseness

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11
Q

CN XI Accessory

A

Motor: sternocleidomastoid + trapezius muscles

Signs: weakness and wasting of those muscles

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12
Q

CN XII Hypoglossal

A

Motor: tongue muscles

Signs: wasting of ipsilateral side of tongue, fasciculations, tongue deviated towards affected side (away from lesion)

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13
Q

Which nerve is affected in Carpel Tunnel Syndrome?

A

Entrapment of Median Nerve

Causes: hypothyroidism, DM, pregnancy, acromegaly

S+S:
- aching pain esp at night, relieved by dangling,
- paraesthesia in thumb, index finger, middle finger,
- sensory loss and weakness of abductor pollicis brevis and thenar eminent

I: EMG shows slowing of conduction, Phalens + Tinels Test (tapping)

M: wrist splint, steroids, decompression surgery

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14
Q

Reflexes

A

S1-S2: Ankle
L3-L4: Knee
C5-C6: Biceps (flex elbow)
C7-C8: Triceps (extend elbow)

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15
Q

Foot Drop?

A

L5: common peroneal nerve (L4-S1), cannot dorsiflex –> inversion foot

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16
Q

Motor Exam/Myotomes

A

C5: elbow flexion
C6: wrist extension
C7: elbow extension
C8: finger flexion
T1: finger abduction
L2: hip flexion
L3: knee extension
L4: ankle dorsiflexion
L5: toe extension
S1: ankle plantar flexion

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17
Q

Dermatomes

A

C4: clavicles
T1: medial side of arms
T4: nipples
T10: umbilicus
L2-3: anterior + inner thigh
L4: knee
L5, S1, S2: posterior + lateral leg
S4: perianal area

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18
Q

Median Nerve (C6-T1)

Study These Flashcards
A

nerve of precision grip
wasting of muscles at base of thumb

19
Q

Ulnar Nerve (C7-T1)

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A
  • vulnerable to elbow trauma
  • wasting of: medial wrist flexors, interossei (can’t cross fingers), medial 2 lumbricals (claw hand)
  • wasting of hypothenar eminence: weak little finger abduction
  • sensory loss over medial 1.5 fingers
  • flexion of 4th and 5th DIP joint weak
20
Q

Radial Nerve (C5-T1)

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A
  • wrist + finger drop when elbow flex + pronated
  • dorsal aspect of thumb root sensory loss
  • damage at axilla = triceps affected
21
Q

Brachial Plexus (C5-T1)

Study These Flashcards
A
  • pain/paraesthesia + weakness in affected arm
22
Q

Phrenic Nerve (C3-5)

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A

phrenic palsy if orthopnoea with raised hemidiaphragm

23
Q

Sciatic Nerve (L4-S3)

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A

damanged by pelvic tumour/fractures to pelvis/femur

24
Q

Tibial Nerve (L3-S3)

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A

inability to tip toe, sensory loss over sole

25
Syringomyelia: Causes
Chiari malformation, trauma, tumours, idiopathic
26
Syringomyelia: S+S
1. Impairment of lateral spinothalamic tracts: - Cape-like (neck, shoulders, arm) loss of sensation to pain and temperature - but preserved light touch, proprioception + vibration (due to crossing of spinothalamic tracts) 2. Impairment of ventral horns - spastic weakness - neuropathic pain - upgoing planters - bladder bowel dysfunction
27
Syringomyelia: I+M
MRI contrast to exclude tumour + tethered cord MRI brain for chiari malformation Treatment: shunt
28
B12 Subacute Degeneration fo Spinal Cord
BILATERAL! 1. Impairment of dorsal column: (affected 1st) - tingling, proprioception, vibration loss 2. Impairment of lateral corticospinal: - UMN: muscle weakness, hyperreflexia, spasticity, brisk knee reflexes, absent ankle jerks, extensor plantars, legs first 3. Impairment of spinocerebellar tracts: - sensory ataxia and +ve Rombergs
29
Brown Sequerd Syndrome (spinal cord hemisection)
UNILATERAL! 1. Impairment of dorsal column: (affected 1st) - (ipsilateral) tingling, proprioception, vibration loss 2. Impairment of lateral corticospinal: - (ipsilateral below lesion) UMN: muscle weakness, hyperreflexia, spasticity, brisk knee reflexes, absent ankle jerks, extensor plantars, legs first 3. Impairment of lateral spinothalamic tracts: - (contralateral) loss of pain and temp sensation
30
Friedrich's Ataxia
BILATERAL! (same as B12 DEF SCDOSC) 1. Impairment of dorsal column: (affected 1st) - tingling, proprioception, vibration loss 2. Impairment of lateral corticospinal: - UMN: muscle weakness, hyperreflexia, spasticity, brisk knee reflexes, absent ankle jerks, extensor plantars, legs first 3. Impairment of spinocerebellar tracts: - sensory + cerebellar ataxia (intention tremor) and +ve Rombergs
31
Neurosyphilis
SENSORY only: dorsal columns: loss of proprioception, vibration and sensation
32
Parietal Lobe Lesions
- sensory inattention - apraxia (can understand but can't do) - tactile agnosia (can't recognise things by touch) - inferior homonymous quadrantanopia Gerstmann's Syndrome: lesion of dominant parietal - alexia, acalculia, finger agnosia, right-left disorientation
33
Occipital Lobe Lesions
- homonymous hemianopia (with macula spared) - cortical blindness - visual agnosia
34
Frontal Lobe Lesions
- Broco's aphasia (inferior frontal gyrus- left superior MCA) - disinhibition - perseveration - anosmia
35
Temporal Lobe Lesions
- Werknicke's aphasia (superior temporal gyrus- left inferior MCA) - auditory agnosia - prosopagnosia
36
Cerebellum Lesions
- midline lesions: gait + truncal ataxia - hemisphere lesions: intention tremor, past pointing, dysdiadokinosis, nystagmus
37
Amygdala Lesions
Kluver Bucy Syndrome: hypersex, hyperoral, hyperphagia, visual agnosia
38
Most common tumour causing brain metastases
(LBBSK) Lung Breast Bowel Skin Kidney
39
Most common tumour causing bone metastases
(LBPTK) Lung Breast Prostate Thyroid Kidney Most common site: Spine Pelvis Ribs Skull Long bones
40
Brain tumours
Glioblastoma Multiforme (most common): disruption of BBB Meningioma (2nd most common): benign, compression sx, in falx cerebri or superior sagitttal sinus Pituitary adenoma: ACTH/GH/prolactin/TSH producing Pilocytic Astrocytoma: children Medullablastoma: children, aggressive Oligodendroma: benign, frontal lobe "fried egg" Hemangioblastoma: cerebellum, von hippel lindau Craniopharynglioma: children, Rathke's pouch: early morning headache, vomiting, polydipsia, polyuria, and visual changes, benign tumor near the pituitary gland and hypothalamus.
41
First order Horners causes
- MS - tumours - Wallenberg's Stroke anhidrosis in face, arm, trunk
42
Second order Horners causes
- Pancoast tumours - Thyroid malignancies - Trauma anhidrosis in face
43
Third order Horners causes
- Carotid artery dissections - Cavernous sinus thrombosis - Cluster headaches no anhidrosis failure to dilate if add hydroxyamphethamine
44
Congenital Horners
- Iris heterochromia

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