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3rd year self made > Neurology > Flashcards

Neurology Flashcards

1
Q

What are the 2 types of stroke

A

ischemic and haemorhagic

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2
Q

What is the most common type of stroke

A

ischemic

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3
Q

what are the 2 main arteries supplying the brain

A

vertebral arteries (posterior supply)internal carotid arteries (anterior supply)h

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4
Q

what do the vertebral arteries arise from and then form in the brain

A

arise from subclavian arteriesform the basilar artery

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5
Q

what is a TACS

A

total anterior circulation stroke

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6
Q

what happens in TACS

A

large cortical stroke, affecting parts of the brain supplied by middle and anterior cerebral arteries

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7
Q

what is the criteria for diagnosing TACS

A

all 3 must be present:1. unilateral weakness (and/or) sensory deficit of face/ arm or leg2. homonymous hemianopia3. higher cerebral dysfunction

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8
Q

what is PACS

A

partial anterior circulation stroke

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9
Q

what occurs in PACS

A

large cortical stroke, affecting parts of the brain supplied by middle and anterior cerebral arteries (Sae as TACS)

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10
Q

what is the criteria for diagnosing PACS

A

only 2/3 must be present:1. unilateral weakness (and/or) sensory deficit of face/ arm or leg2. homonymous hemianopia3. higher cerebral dysfunction

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11
Q

what is POCS

A

posterior circulation syndrome

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12
Q

what is the criteria for diagnosing POCS

A

1 or more needs to be present:1. cerebellar or brain stem syndromes (ataxia, nystagmus, vertigo)2. loss of consciousness3. isolated homonymous hemianopia

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13
Q

what is LACS

A

lacunar syndrome

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14
Q

what happens in LACS

A

subcortical stroke- due to small vessel disease

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15
Q

what is the criteria for diagnosing LACS

A

1 or more needs to be present1. unilateral weakness/ sensory deficit (arm, face, leg or all 3)2. pure sensory stroke3. ataxic hemiparesis

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16
Q

what is chorea

A

movement disorder that causes sudden, unintended, and uncontrollable jerky movements of the arms, legs, and facial muscles(dance like)

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17
Q

what conditions would you see chorea in

A

Huntingtons diseaseSLE

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18
Q

what is ataxia

A

term for a group of disorders that affect co-ordination, balance and speech

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19
Q

what conditions would you see ataxia in

A

stroke, MS, brain tumour

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20
Q

what is nystagmus

A

Rhythmical, repetitive and involuntary movement of the eyes. It is usually from side to sidePerson has no control over their eye movements

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21
Q

What conditions would you see nystagmus in

A

diseases affecting the inner ear balance mechanisms or the brainstem or cerebellum

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22
Q

what is myoclonus

A

sudden, brief involuntary twitching or jerking of a muscle or group of muscles(think of sleep starts)

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23
Q

what diseases might you see myoclonus in

A

DystoniaMultiple sclerosisParkinson’s diseaseHuntington diseaseAlzheimer’s disease

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24
Q

what is spasticity

A

abnormal muscle tightness due to prolonged muscle contraction.Velocity dependant- exaggeration of stretch reflexWill feel it catch

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25
what conditions would you see spastcity in?
cerebral palsybrain injurystrokeMS
26
What is rigidity
when muscles become stiff or inflexibleindependent of velocity
27
what causes spasticity
damage to the pyramidal tracts
28
what conditions cause rigidity
parkinsons
29
what are the signs of an upper motor lesion
minimal atropy or contracturesincreased tone (spasticity/ rigidity) pyramidal pattern of weakness in power (extensors weaker than flexors in arm, and vise versa in legs)hyperreflexiaupgoing plantars
30
what are the signs of an lower motor lesion
marked atrophyfasiculationsreduced tonereduced or absent reflexpower is reduced in distribution of affected nerve (flexors weaker in arms than extensors, and vise versa in legs)
31
where does an upper motor neuron lesion occur
CNS (brain + spinal cord)
32
where does a lower motor neuron lesion occur
anywhere from anterior horn cell to the muscle
33
what conditions present as an upper motor neuron lesion
strokeALS (Motor neuron disease)MS
34
what conditions present as lower motor neuron lesions
peripheral nerve trauma/ compressionspinal muscular atrophyALS (motor neurone disease)guillaine-barre syndrome
35
Exampls of dopaminergic drugs
LevadopaDopamine agonistsMonoamine oxydase type B inhibitors
36
What is the main indication for dopaminergic drug use eg. levadopa
Treatment of parkinsons
37
Why do dopaminergic drugs help parkinsons
alleviates motor symptoms
38
MOA of dopaminergic drugs
Increase the concentration of dopamine in the brain
39
Contraindications of dopaminergic drugs
History of addiction, OCD, impulsive personality
40
Side effects of dopaminergic drugs
Nauseadaytime somnolencepostural hypotensionhallucinationsmotor symptom complications (dyskinesia)
41
Examples of anti-convulsants
IamotriginePhenytoinCarbamazepine
42
What is the main indication of anti-convulsants
Prevent epileptic seizures
43
Side effects of anti-convulsants
Induce hepatic enzymes- can alter efficacy of combined oral contraceptiveDon't use progesterone only pill
44
Examples of cholinesterase inhibitors
Rivastigmine, donepezil
45
What is the main indication for cholinesterase inhibitors
Slow the cognitive decline in some forms of dementia
46
MOA of cholinesterase inhibitors
Inhibit cholinesterase receptors
47
Side effects of cholinesterase inhibitors
GI- nausea and diarrhoeaHeadacheMuscle crampsBradykinesia
48
Examples of opioid analgesics
Morphinediamorphinefentanylbuprenorphinetramadol
49
MOA of opioid analgesics
Act on G-protein-coupled opioid receptors
50
Side effects of opioids
Dependence/ addictionapnoeanausea, vomittingconstipationorthostatic hypotension
51
Examples of opioid receptor antagonists
Naloxone
52
What is the main indication for ORA
Reverse opioid toxicity
53
What is the main indication for opioid use
pain relief
54
What are the main indications for gabapentin and pregabalin
anti-epileptics (also chronic pain treatment)
55
What can carbamazepine also be used for apart from anti-convulsants
treatment for trigeminal neuralgia pain
56
what are fasiculi
tracts (bundles of nerve fibres)
57
where does information that is conscious get processes
the cerebral cortex
58
where does information that is subconscious get processed
cerebellum
59
what is another name for the 1st order neuron
primary afferent neuron
60
do 1st order neurons decussate or stay ipsilateral
ipsilateral
61
do 2nd order neurons decussate or stay ipsilateral
ducussate
62
where does ducussation occur
thalamus or medulla oblongata
63
where are the 3rd order neurons located
cell body is in the thalamus, and it's axons pass to the somatosensory cortex
64
what information does the fasciculus gracilis contain
information from lower limb
65
what information does the fasciculus cutaneous contain
information from the upper limb
66
what are the 3 ascending tracts
dorsal columns (fasciculus cutaneous and gracilis)spinothalamicspinocerebellarwhat are the
67
what are the 2 divisions of the descending tracts
pyramidal and extra-pyramidal
68
what are the 4 extra-pyramidal tracts
rubrospinaltectospinalvestibulospinalreticulospinal
69
what is the pyramidal tract
corticospinal
70
what information does the dorsal columns carry
fine touch, proprioception and vibration
71
what information does the anterior portion of the spinothalamic tract carry
pain and temperature
72
what information does the lateral portion of the spinothalamic tract carry
crude touch
73
What information does the spinocerebellar tract carry
proprioception
74
What information does the rubrospinal tract carry
responsible for limb flexor
75
What information does the tectospinal tract carry
movement in response to visual sensory information
76
What information does the vestibulospinal tract carry
maintains posture
77
What information does the reticulospinal tract carry
reflexes and muscle tone
78
what information does the lateral portion of the corticospinal tract carry
skilled voluntary movement
79
what information does the anterior portion of the corticospinal tract carry
axial motor information
80
What are the 2 main arteries supplying the brain
internal carotid and vertebral arteries
81
what is the course of the vertebral arteries
vertebral => basilar arteries => posterior cerebral arteries
82
what is the course of the internal carotid arteries
internal carotid => anterior and middle cerebral arteries
83
what is the venous system of the brain
dural venous sinuses => internal jugular vein
84
what areas of the brain does the anterior cerebral artery supply
frontal and parietal cortex
85
Are ACA stroke common or rare
rare
86
What is the clinical presentation of an ACA stroke
motor deficits of the contralateral lower limbcontralateral face and arm paresissensory deficits/ memory impairments
87
what areas of the brain does the middle cerebral artery supply
temporal lobesprecentral/ postcentral gyrus
88
What is the clinical presentation of an MCA stroke
If precentral gyrus:Contralateral loss of motor innervation for the head, upper limbs or trunkIf postcentral gyrus:loss of sensation from head, upper limb and trunkCan involve broca's/ wernicke's area => asphasia (affects speech)
89
What is the most common artery involved in stroke
MCA
90
what areas of the brain does the posterior cerebral artery supply
occipital lobe
91
What is the clinical presentation of an PCA stroke
headachedizzinessvisual changes (loss, diplopia, "curtain coming down")

3rd year self made (6 decks)

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