pastest 2 Flashcards
(108 cards)
1
Q
where does the saphenous nerve supple
A
anetriomedial aspect of the knee, leg and medial malleolus
2
Q
when can saphenous nerve be damaged
A
during femoral vein catheterisation
3
Q
ankle reflex
A
L1/L2
4
Q
knee reflex
A
L3/L4
5
Q
biceps reflex
A
C5/C6
6
Q
triceps reflex
A
C7/C8
7
Q
femoral nerve give rise to what nerve
A
anterior cutaneous and saphenous
8
Q
where does femoral nerve bifurcate
A
inch below inguinal ligament
9
Q
lateral cuteness of thigh arises from
A
branch of lumbar plexus
10
Q
posterior cutaneous nerve of thigh arises from
A
sacral plexus
11
Q
what nerve supplies dorsum of foot
A
peroneal nerve
12
Q
peroneal nerve splits into superficial and deep, which does each innervate
A
superficial innervates all of dorsum except web space between 1st and 2nd toe which is innervated by deep peroneal
13
Q
sural nerve supplies where
A
posterolateral lower leg, lateral heel, lateral aspect of foot and pinky
14
Q
what is the thenar eminence
A
muscles at base of thumb
15
Q
wasting of thenar eminence indicates what pathology
A
carpal tunnel syndrome (usually chronic in wasting)
16
Q
wrist drop: what nerve
A
radial nerve
17
Q
radial nerve supplies sensory to where
A
dorsal aspect of hand
18
Q
what pathology causes a non-communicating hydrocephalus
A
pineal gland tumour
19
Q
why do you get hydrocephalus with a pineal gland tumour
A
blocked CSF from lateral and 3rd ventricle flowing into 4th ventricle and subarachnoid space
20
Q
how do you treat non communicating hydrocephalus
A
shunt between 3rd and 4th ventricle
21
Q
wrist drop =
A
radial nerve
22
Q
radia lnerev is what part of brachial plexus
A
terminal branch of posterior cord
23
Q
radial nerve carries fibres from which levels
A
C5-C8
24
Q
radial nerve sensory is from which level
A
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)
