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Flashcards in pastest 2 Deck (108)
1

where does the saphenous nerve supple

anetriomedial aspect of the knee, leg and medial malleolus

2

when can saphenous nerve be damaged

during femoral vein catheterisation

3

ankle reflex

L1/L2

4

knee reflex

L3/L4

5

biceps reflex

C5/C6

6

triceps reflex

C7/C8

7

femoral nerve give rise to what nerve

anterior cutaneous and saphenous

8

where does femoral nerve bifurcate

inch below inguinal ligament

9

lateral cuteness of thigh arises from

branch of lumbar plexus

10

posterior cutaneous nerve of thigh arises from

sacral plexus

11

what nerve supplies dorsum of foot

peroneal nerve

12

peroneal nerve splits into superficial and deep, which does each innervate

superficial innervates all of dorsum except web space between 1st and 2nd toe which is innervated by deep peroneal

13

sural nerve supplies where

posterolateral lower leg, lateral heel, lateral aspect of foot and pinky

14

what is the thenar eminence

muscles at base of thumb

15

wasting of thenar eminence indicates what pathology

carpal tunnel syndrome (usually chronic in wasting)

16

wrist drop: what nerve

radial nerve

17

radial nerve supplies sensory to where

dorsal aspect of hand

18

what pathology causes a non-communicating hydrocephalus

pineal gland tumour

19

why do you get hydrocephalus with a pineal gland tumour

blocked CSF from lateral and 3rd ventricle flowing into 4th ventricle and subarachnoid space

20

how do you treat non communicating hydrocephalus

shunt between 3rd and 4th ventricle

21

wrist drop =

radial nerve

22

radia lnerev is what part of brachial plexus

terminal branch of posterior cord

23

radial nerve carries fibres from which levels

C5-C8

24

radial nerve sensory is from which level

T1

25

what muscles do radial nerve innervate

muscles of dorsal arm: anconuos and triceps bracii
extrinsic extensors of the wrist and hand

26

where does radial provide sensory

back of hand

27

axillary nerve originates in ____ cord of the brachial plexus

posterior cord

28

axillary nerve carries fibre from which levels

C5 and C6

29

axillary nerve innervates what muscles (3)

deltoids
long head of triceps brace
teres minor

30

median nerve is formed from which brachial plexus cords

lateral and median cords

31

median cord originated from which roots

C8 and T1

32

lateral cord originate from what levels

C5, C6, C7

33

brachial plexus made up of

C5, C6, C7, C8 and T1

34

sensory loss to lateral side of forearm

musculocutaneous nerve

35

what nerve if weak supination and flexion at elbow

musculocutaneous nerve

36

ulnar nerve comes from which cord of brachial plexus

medial cord

37

ulnar nerve originates from which nerve roots

C8 and T1

38

nerve impingement in elbow called

cubital tunnel syndrom: ulnar nerve

39

ulnar nerve sensory to where

pinky and lateral half of 4th digit

40

the main descending motor pathway

cortical spinal pathway

41

corticospinal tract fine details

motor cortex to alpha motor neurones in ventral horn of spinal cord

42

signs of upper motor neurone lesions

weakness, wasting, hyperflexia and fasciculations

43

ash leaf, cafe olay

tuberous sclerosis

44

cluster headache: uni or bi lateral

unilateral

45

migraine: uni or bilateral

unilateral

46

tension: uni or bilateral

bilateral

47

treatment for cluster head aches

high flow oxygen and sumatriptan

48

cluster headache prophylaxis

verapamil (calcium channel blocker)

49

what type of dementia has fluctuations

lewy body

50

dementia that has hallucinations

lewy body

51

eye looking in and down

4th nerve palsy

52

nerve palsy where the person may tilt their head

4th

53

how many CAG repeats result in fully penetrant huntingtons

41+

54

huntingtons inheritance

autosomal dominant

55

essential tremor inheritance

autosomal dominant

56

how many CAG repeats result in partial penetrance in huntingtons

36-40

57

what drug can help in huntingtons

tetrabenazine

58

neurofibromatosis 1 will have:

peripheral involvement
- cafe aule
- axillary and inguinal freckles
- skin neurifibromas

59

neurofibromatosis 2 will get:

central:
- bilateral acoustic neuromas
- cranial nerve and CNS tumours

60

what is ramsay hunt syndrome

herpes zoster of external acoustic meatus

61

bells palsy symptoms + facial spasm =

MS

62

parkinsons is

reduced dopamine production from the substantial nigra of the basal ganglia

63

in parkinsons, why can't we just replace dopamine

it doesn't cross BBB

64

treatment for parkinson

L-dopa (levodopa)

65

what is levodopa

dopamine precursor (that can cross BBB)

66

what other drug must be given along with levodopa

a dopa decarboxylase inhibitor (can't cross BBB) such as carbidopa

67

what does carbidopa do?

inhibits peripheral dopa decarboxylase which converts levodopa to dopamine (stops formation of peripheral dopamine which has bad side effects)

68

side main effects of levodopa (peripheral dopamine)

low BP
nausea
vomiting

69

what enzyme in brain breaks down dopamine

MAO-B (monoamine oxidase B)

70

what drug can you give to inhibit monoamine oxidase B (MAO-B)

selegiline - increases dopamine and increase L-dopa activity

71

when is MAO-B inhibitors most effective

early and late stages of parkinsons

72

which enzyme eliminates L-dopa

COMT - acetechol-O-methyltransferase

73

what drug do you give to inhibit L-dopa clearance by COMT (acetechol-O-methyltransferase)

entacapone

74

good drug for resting tremor

muscarinic antagonists: benzatropine

75

in 3rd nerve palsy you will see:

ptosis (drooping eye lid)
mydriasis (big pupil)

76

horners syndrom you wil see:

ptosis (drooping eye)
mitosis (small pupil)
anhydrosis

77

what causes horners

lesion of sympathetic truck (if smokes, apical lesion of lung)

78

age when motor neurone disease occurs

middle age

79

what is the mainly affected area in motor neurone disease

anterior horn of spinal cord (hence why only motor affected) and motor neurones in motor cortex

80

UMN or LMN symptoms seen in motor neurone disease

Both

81

fasciculations in motor neurone disease?

yes, prominent

82

most common form of motor neurone disease

amyotrophic lateral sclerosis (ALS)

83

glove and stocking weakness

guillen-barre syndrome

84

ascending paralysis

guillen-barre syndrome

85

high protein and lymphocytes in CSF indicates

viral meningits
** can also be TB but viral more common**

86

anti epileptic drug that causes cerebellar symptoms

phenytoin

87

phenytoin is a

anti epileptic

88

risk of taking phenytoin and why

phenytoin toxicity - small therapeutic window

89

rinies test will normally show what findings

conduction (air) louder than sensoneural (bone)

90

normal webber test will show

sound central

91

webber test: louder in left ear following normal rinses indicates what?

loss of neurosensory in right ear

92

findings in conductive hearing loss

rinnies: bone will be louder than air
weber: sond localises to affected ear

93

head injury with lucid period

extradural

94

common complication of subdural haematoma

recurrent bleed

95

alpha beta amyloid in brain =

familial alzheimers

96

familial alzheimers is also called

early onset

97

familial alzheimers is due to mutation in what

amyloid precursor protein (APP)

98

what is normal processing of amyloid precursor protein (APP) and how does it go wrong in early onset alzheimers

normally cleaved by gamma and alpha secretase, instead cleaved by gamma and bets secretes forming alpha beta -amylase. this accumulates and causes early onset.

99

young, neurological and psychiatric symptoms

wilsons

100

how do you diagnose wilsons

24 hour urine collection - will show higher than normal copper content

101

dementia + hallucinations

lewy body dementia

102

lewy body dementia: histological findings

alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas

103

what part of brain is more pale in parkinsons

substantia nigra

104

part of brain affected in lewy body (3)

substantia nigra, paralimbic and neocortical

105

which 2 dementias are strongly interlinked

lewy and alzheimers

106

what drugs should be avoided in lewy body

neuroleptics (antipsychotics)

107

what avoid antipsychotics in lewy body

cause irreversible parkinsonism

108

lewy body diagnosis

- clinical
- single-photon emission computed tomography (SPECT)