Neurology

Question 1

What are the two categories that make up the nervous system?

Answer 1

Central Nervous system and Peripheral nervous system

Question 2

Name of the components of the CNS and PNS

Answer 2

CNS:

• cortex
• Cerebrum
• Spinal Cord

PNS:

• Cranial Nerves
• Spinal Nerves

Question 3

what is the Function of the cerebrum + its two components?

Answer 3

Higher order functions such as planning, meaningful thoughts and speech.

Divided in to the cortex (Gray matter) and sub-cortex (white matter)

Question 4

What is the function of the Thalamus?

Answer 4

It is the maximal relay centre to the cerebral cortex

Question 5

What is the function of the hypothalamus?

Answer 5

Anterior pituitary control, controls balance of the autonomic nervous system, also secretes ADH.

Question 6

What does the basal ganglia do?

Answer 6

Controls the fluidity of movements and is link to the thalamus at the base of the brain.

Question 7

Name the lobes of the brain

Answer 7

Frontal
Parietal
Occipital
Temporal

Question 8

List the functions of each lobe

Answer 8

Frontal
-key role in communicative abilities/personality, emotional expression, problem solving, memory, language, judgment and sexual function

Parietal
-Processes sensory information from the outside world (IE. Temp, touch, taste, proprioception)

Occipital
-visual processing

Temporal
-Processes sensory input into derived meanings for appropriate retention of visual memory, language, comprehension and emotional association.

Question 9

Components of the brain stem

Answer 9

Thalamus (superior) Midbrain, pons, medulla, spinal cord

Question 10

Function of the midbrain

Answer 10

Responsible for vision, hearing, motor control, sleep, wakefulness and temperature regulation

Question 11

Function of the pons

Answer 11

Primarily deal with sleep, respiration, swallowing, bladder control, hearing, equilibrium, taste, eye movement, facial sensation and posture.

Question 12

Function of the Medulla Oblongata

Answer 12

Responsible for autonomic functions ranging from vomiting to sneezing

Question 13

Function of the cerebellum

Answer 13

Coordination of voluntary movements (motor skills, coordination).

Question 14

What is the blood brain barrier (make-up and function)

Answer 14

The BBB is a highly selective semi-permeable border made up of endothelial cells that prevents solutes from the circulation to cross into the CNS ECF

Question 15

What is CSF and how is it drained?

Answer 15

CSF is fluid that assists the brain in nourishment and waste removal

20-30ml/h produced

Created in the lateral ventricles and drained via superior sagittal sinus–> jugular veins.

Question 16

How many cranial nerves are there in total, and where do the majority exist?

Answer 16

12 CN total.

11 Housed in the brain stem

Question 17

Where is broca’s area located?

Answer 17

The frontal lobe

Question 18

Where is wernickes area located

Answer 18

The temporal lobe

Question 19

Describe the physiology of an embolic CVA

Answer 19

Defined as a blockage in an artery that supplies blood to the brain.

Accounts for 87% of strokes

Question 20

What is a TIA?

Answer 20

Temporary blockage of blood flow to the brain that is self resolving.

Warning sign for more to come!!

Question 21

Hemorrhagic Stroke

Answer 21

May occur in any vessel in cerebral circulation.

Accounts for 13% of strokes

Question 22

What is a subarachnoid hemorrhage and where does in occur within the brain?

Answer 22

Hemorrhage within the space surrounding the brain.

-Usually occurs in the circle of willis.

85% are aneurysmal
15% are AVM’s and cocaine induced.

Question 23

List three signs/symptoms of SAH?

Do you need all three??

Answer 23

headache, photophobia, nuchal rigidity.

Question 24

Physical exam findings of SAH?

Answer 24

Focal deficits, GCS (specifically motor deficits), CN exam

Question 25

Tx for SAH

Answer 25

- ABC like always! - Avoid hypertension and fluid admin if needed-->SBP goal is less than 140mmg - Promote CSF drainage (head 30 deg. Goodluck)

Question 26

What is a seizure?

Answer 26

Sudden, uncontrolled electrical disturbance in the brain leading to disregulation of electrical conduction and activation of neurons.

Question 27

Define Status, and refractory seizures

Answer 27

Status -Last greater than 5min OR 2 consecutive seizures without a return to Neuro baseline Refractory -Any seizure that cannot be terminated by antiepileptic medication (Benzos...then what?)

Question 28

List 4 major causes of Seizures

Answer 28

Drugs, infection, metabolic, structural pathology

Question 29

How many vertabrae make up the spine?

Answer 29

33 individual vertebrae

Question 30

What is the role of the spine?

Answer 30

Protect the spinal cord, and serve as anchor points for ligaments.

Question 31

Name the 5 spinal regions

Answer 31

``` Cervical (7) Thoracic (12) Lumbar (5) Sacrum (5) Coccyx (4) ```

Question 32

Describe CNS communication from the skin to muscle fibre

Answer 32

Skin--> afferent nerve-->spinal cord-->efferent nerve-->muscle

Question 33

What is Cauda Equina?

Answer 33

it is a bundle of nerves and their roots which are typically found at L1-L5 that give motor and sensory innervation to the legs, bladder, anus, and perineum.

Question 34

What is a dermatome?

Answer 34

An area of skin that is mainly supplied by afferent nerve fibres.

Question 35

CPG Managment for seizures

Answer 35

-ABC -Correct hypoglycaemia -Midazolam IV/IO-2-5mg IM-5-10MG Max dose is 30mg!

Question 36

Resuscitation plan for TBI

Answer 36

ABC management-->Oxygenate, ventilate Spo2- target 90% SBP 110mmhg

Question 37

Hemodynamic Targets | general pop, TBI, SCI

Answer 37

General -MAP >60 or SBP >90 TBI -SBP 110 SCI -MAP >80