Flashcards in Neurology Deck (112)
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1
UMN vs LMN lesion
UMN: contralateral paralysis lower face
LMN: ipsilateral paralysis upper and lower face
2
CN XI
Accessory: Head turning, shoulder shrugging
3
CN XII
Hypoglossal: Tongue movement
4
CN XI
Glossopharyngeal: Taste post 2/3 tongue, swallow, salivation (parotid) carotid body, gag reflex
5
Innervation swallowing
CN IX, X
6
Innervation salivation
CN VII (submand, subling), XI (parotid)
7
Innervation tongue
Sensation: V, VII (taste ant 2/3), IX (taste post 1/3)
Movement: XII
8
Innervation carotid body, arch, sinus
CN IX: carotid body and sinus chemo and baro
CN X: cartoid arch chem and baro
9
Lateral corticospinal tract
Movement contralateral limbs
10
Dorsal column
Fine touch, vibration, conscious proprioception
11
Spinothalamic
Pain, temperature (crosses at level of spinal courd)
12
Clinical reflexes:
Biceps
Triceps
Patella
Achilles
Babinski
Biceps: C5, 6
Triceps: C7,8
Patella: L3,4
Achilles: S1,2
Babinski: UMN, normal first year
13
Presents with: Aphasia or neglect, contralateral paresis and sensory loss face and arm, gaze towards lesion, homonymous hemianopsia
MCA infarct
14
Presents with: Contralateral paresis and sensory loss in leg, cognitive or personality changes
ACA infarct
15
Presents with: Homonymous hemianopsia, memory deficit, dyslexia/alexia
PCA infarct
16
Presents with: Coma, "locked in" syndrome, CN palsies, apnea, crossed weakness and sensory loss of face/body
Basilar artery infarct
17
Presents with: Pure motor or sensory stroke, dysarthria-clumsy hand syndrome, ataxic hemiparesis
Basal ganglia lacunar infarct
18
Imaging for stroke
Emergent CT without contrast (rule out bleed)
19
Mnemonic: 4Ds of posterior circulation strokes
Diplopia
Dizziness
Dysphagia
Dysarthria
20
When can tPA and intraarterial thrombolysis be administered?
tPA: within 3 hrs
intraarterial thrombolysis: within 6 hrs
21
What can decr morbidity mortality within 48hrs of stroke
ASA
22
Treatment if incr ICP after stroke
Mannitol, hyperventilation
23
Target INR for AF and prosthetic valve
AF: INR 2-3
Prosthetic valve: INR 3-4
24
Drug for long term prevention after stroke
ASA, clopidogrel
25
Presents as: abrupt-onset, intensely painful thunderclap headache: dx, etiologies
SAH
Trauma, berry aneurysm, AVM
26
When is carotid endarterectomy indicated?
>60% in symptomatic
>70% in asymptomatic
contraindicated in 100% occlusion
27
What is associated with CNIII palsy with pupillary involvement
Berry aneurysm
28
What are first or second diagnostic procedures if SAH suspected?
1. CT without contrast
2. If neg, LP (Look for RBC, xantochromia)
29
Complications after SAH and prevention
Vasospasm: 5-7 days after, Ca channel blockers
Rebleeding: keep BP
30