Neurology Flashcards
(112 cards)
UMN vs LMN lesion
UMN: contralateral paralysis lower face
LMN: ipsilateral paralysis upper and lower face
CN XI
Accessory: Head turning, shoulder shrugging
CN XII
Hypoglossal: Tongue movement
CN XI
Glossopharyngeal: Taste post 2/3 tongue, swallow, salivation (parotid) carotid body, gag reflex
Innervation swallowing
CN IX, X
Innervation salivation
CN VII (submand, subling), XI (parotid)
Innervation tongue
Sensation: V, VII (taste ant 2/3), IX (taste post 1/3)
Movement: XII
Innervation carotid body, arch, sinus
CN IX: carotid body and sinus chemo and baro
CN X: cartoid arch chem and baro
Lateral corticospinal tract
Movement contralateral limbs
Dorsal column
Fine touch, vibration, conscious proprioception
Spinothalamic
Pain, temperature (crosses at level of spinal courd)
Clinical reflexes: Biceps Triceps Patella Achilles Babinski
Biceps: C5, 6 Triceps: C7,8 Patella: L3,4 Achilles: S1,2 Babinski: UMN, normal first year
Presents with: Aphasia or neglect, contralateral paresis and sensory loss face and arm, gaze towards lesion, homonymous hemianopsia
MCA infarct
Presents with: Contralateral paresis and sensory loss in leg, cognitive or personality changes
ACA infarct
Presents with: Homonymous hemianopsia, memory deficit, dyslexia/alexia
PCA infarct
Presents with: Coma, “locked in” syndrome, CN palsies, apnea, crossed weakness and sensory loss of face/body
Basilar artery infarct
Presents with: Pure motor or sensory stroke, dysarthria-clumsy hand syndrome, ataxic hemiparesis
Basal ganglia lacunar infarct
Imaging for stroke
Emergent CT without contrast (rule out bleed)
Mnemonic: 4Ds of posterior circulation strokes
Diplopia
Dizziness
Dysphagia
Dysarthria
When can tPA and intraarterial thrombolysis be administered?
tPA: within 3 hrs
intraarterial thrombolysis: within 6 hrs
What can decr morbidity mortality within 48hrs of stroke
ASA
Treatment if incr ICP after stroke
Mannitol, hyperventilation
Target INR for AF and prosthetic valve
AF: INR 2-3
Prosthetic valve: INR 3-4
Drug for long term prevention after stroke
ASA, clopidogrel