Pastest Flashcards
(114 cards)
1
Q
cranial nerve that passes through rotundum
A
maxillary division of trigeminal
2
Q
innervates parotid
A
glossopharyngeal
3
Q
innervates lateral gaze
A
abducens
4
Q
superior oblique is innervated by
A
trochlear
5
Q
laryngeal muscles are innervated by
A
branches of the vagus
6
Q
only part of laryngeal muscles not innervated by recurrent laryngeal branch of vagus
A
cricothyroid - by external laryngeal nerve
7
Q
innervates the anterior 2/3rd of tongue
A
facial
8
Q
innervates posterior 1/3 of tongue
A
glossopharyngeal
9
Q
unilateral headache > 50 yrs
A
temporal arteritis
10
Q
first line investigation for temporal arteritis
A
ESR
11
Q
age when migraines first present
A
young woman/man
12
Q
why no COCP in migraine
A
oestrogen precipitates migrane
13
Q
raised ICP will have what symptoms
A
morning headaches and postural (leaning forward)
14
Q
triad of parkinson
A
- resting tremor
- rigidity
- bradykinesia
15
Q
pathophysiology of parkinsons
A
neurodegeneration and deposition of inclusion bodies in v pars compact of the substantianigra (midbrain) causing disruption/loss of dopaminergic transmission in basal ganglia
16
Q
parkinson signs distribution: symmetric or asymmetric
A
asymmetrical
17
Q
therapy given in parkinson
A
levodopa (L-dopa)
18
Q
non ‘triad’ symptoms of parkinson
A
stooped posture
shuffling gate
reduced arm swing
monotone voice –> slurring dysarthria
19
Q
what is normal pressure hydrocephalus
A
increases ventricle space and CSF without an increase in CSF pressure, usually due to inability of CSF to drain out of brain. Can be a late consequence of subarachnoid haemorrhage
20
Q
who gets normal pressure hydrocephalus
A
old people
21
Q
symptoms of normal pressure hydrocephalus
A
dementia, urinary incontinenece, gait abnormalities (shuffling)
22
Q
molloscum contagiosa indicates what
A
HIV
23
Q
HIV+ get what type of meningitis
A
cryptococcal neoformans
24
Q
sudden onset severe headache
A
subarachnoid haemorrhage
25
most common area of subarachnoid haemorrhage pain
occipital
26
treatment for cryptococcal meningitis
anti fungal: amphotericin +/- fluctosine
27
what type of organism is cryptococcal neoformans
fungus
28
risk factors for subarachnoid haemorrhage
berry aneurism or atriovenous malformations
29
diagnosis of sub arachnid haemorrhage
CT if neg, then CSF
30
3 classical signs of BACTERIAL meningitis
fever, headache, neck stiffness
31
name for meningococcal (neisseria meningitidis) rash
petechial rash
32
treatment for suspected meningococcal meningitis
IM cefotaxime/ceftriaxone
33
who gets benign intracranial hypertension
fat woman
34
what is benign intracranial hypertension
increase in CSF production WITHOUT increase in ventricle size
35
how may benign intracranial hypertension present
headaches and visual disturbance (papilloedema)
36
what drugs can cause benign intracranial hypertension
steroids and tetracycline therapy
37
treatment for benign intracranial hypertension
diaretics: thiazides & acetazolamide + weight loss
38
what will you look for in CSF if suspect sub arachnid haemorrhage but CT doesn't show anything
xanthochromia (bilirubin from broken RBCs in CSF)
39
tie scale for xanthocromia
12 hours after onset of symptoms
40
when will you do angiography in suspected subarachnoid haemorrhage
if want to try fix it
41
morning headache + vomiting =
raised ICP usually due to space occupying lesion
42
SOL/bleeds in temporal lobe of brain will cause what visual defects
homonymous superior quadrantanopia (on opposite side of lesion) **PITS: parietal = inferior, temporal = superior**
43
SOL/bleeds in parietal lobe of brain will cause what visual defects
homonymous inferior quadrantanopia (on opposite side of lesion) **PITS: parietal = inferior, temporal = superior**
44
SOL/bleeds in chiasm of brain will cause what visual defects
bi-temporal heminopia
45
loss of vision on just one side L/R heminopia
optic tract on opposite side
46
unilateral vision loss
eye/optic nerve on SAME side
47
what test is usually abnormal in delirium of any cause
electroencephalogram
48
what part of brain affected in huntingtons
caudate nucleus degeneration
49
condition where you get ticks and choreosthesis
huntingtons
50
dementia in stepwise fashion
vascular
51
what will be common in someone with vascular dementia
hypertension, heart problems, arrhythmia and diabetes
52
'butterfly pattern' on CT
huntingtons
53
what part of brain will show 'butterfly pattern' on CT
caudate nucleus
54
best imaging for vascular dementia lesions
MRI (not seen on CT)
55
accessory nerve innervates what
traps and sternocleidomastoid
56
accessory nerve arrives from
C1 - 5
57
accessory passes out skull via
jugular
58
when does the accessory nerve cross into posterior triangle of neck (where it is prone to injury)
3rd of the way down sternocleidomastoid
59
a sub dural haematoma lies between what layers
dura and arachnoid
60
meninigi layer closest to brain
pia
61
outermost layer of meningis
dura
62
dura mater has how many layers
2
63
what is in-between 2 layers of dura mater
venus sinuses
64
names of 2 layers of dura mater
outer: endosteal layer
inner: meningeal layer
65
the inner meningeal layer of dura mater forms what 4 structures
4 fibrous septa:
- diaphragma sellae
- falx cerebri
- falx cerebelli
- tentorium cerebelli
66
function of 4 fibrous flanges/septa of dura mater
stop rotatory displacement of brain
67
dura mater well innervated?
yes (causes headache)
68
archnoid mater is attached to what other layer and by what?
pia via filamentous processes
69
where is CSF located
in sub arachnoid space (between arachnid and pia mater)
70
extradural heamatoma is located where
between skull and endosteal layer of dura
71
most common blood vessel implicated in extradural haematoma
middle meningeal artery
72
middle meningeal artsy located where
beneath pterion
73
location of subdural haematoma
venous bleeding into gap between dura and arachniod
74
who gets subdural haematoma and why
elderly and alcoholics due to brain shrinkage, this damages overlying veins, because veins it is usually a slow bleed
75
blood vessel involved (artery/vein):
subdural haematoma -
extradural heamatoma -
subarachnoid haematoma -
subdural haematoma - vein
extradural heamatoma - artery (middle meningeal)
subarachnoid haematoma -artery (from circle of willis)
76
facial nerve supplies what glands
lacrimal (eye), submandibular, sublingual
77
oculomotor innervates what eye muscle
levator palpebrae superioris (lift eye lid)
78
blinking/screwin eye shut is what cranial nerve
facial
79
what nerve innervates muscles of mastication
mandibular division of trigeminal
80
bells palsy, upper or lower motor neurone
lower (facial)
81
which has forehead sparing: stroke or bells palsy
stroke
82
why can you get hypersensitivity to sound in bells palsy
because facial nerve innervates stapedius muscles (which dampens down sound)
83
what is myasthenia gravis
auto Ab to ACh receptors on post synaptic membrane
84
how may myasthenia gravis present
double vision, weakness and fatigueabiltiy, worse in evening
85
diagnostic test for myasthenia gravis
nerve conduction study with repetitive nerve stimulation
86
myasthenia gravis associated with what other condition
thymic hyperplasia or thymus tumour
87
after diagnosis of myasthenia gravis what other test will you do and why
chest CT because of associating with thymic hyperplasia or thymus tumour
88
'panda eyes'
fracture of floor of anterior cranial fossa
89
crescent shape haematoma on CT
sub-dural haematoma
90
skull x-ray won't show base of anterior fossa fracture, but what might you see
fluid leven in spenoidal sinus lateral view
91
treatment for sub dural haematoma
urgent surgery
92
wil x-ray show sub dural haematoma
No
93
first line investigation for extra and sub-dural maenatoma
CT
94
which head injury do you get lucid interval
extradural haematoma
95
fasciculations and atrophy indicate what a lesion location
lower motor neurone
96
tongue will deviate to what side in a lower motor lesion
same (ipsilateral)
97
what nerve affects tongue
hypoglossal
98
tongue will deviate to what side in a upper motor lesion
opposite side (contralateral)
99
nerve for motor supply to tongue
hypoglossal
100
what nerve for sensory and somatic innervation to posterior 1/3rd of tongue
glossopharyngeal
101
nerve responsible for sensory role in gag reflex
glossopharyngeal
102
nerve responsable for efferent limb in gag reflex
vagus
103
things facial nerve supplies: (many)
motor:
- muscles of facial expression
- buccinator
- stapiduim muscle
parasympathetic:
- lacrimal gland
- sublingual and submandibular salivary glands
- blinking
sensory: taste to anterior 2/3rds
104
anterior cerebral arteries supply what area of brain
medial aspect of frontal and parietal lobes
105
stroke in anterior cerebral artery regions will affect what part of body
opposite side, lower limb
106
middle cerebral arteries supply where
lateral frontal, parietal and superior temporal lobes
107
occlusion of middle cerebral artery will have what features
upper limb weakness
speech problems
facial weakness
auditory comprehension problems
108
posterior cerebral artery supplies where
occipital lobe
inferior temporal
thalamus
posterior limb of internal capsule
109
how will a posterior artery stroke present
weakness in both upper and lower limbs
vision field defects
loss of sensation
110
3rd nerve palsy present with:
ptosis (eyelid droop)
mydriasis (dilated pupil)
down and out
horizontal and vertical binocular diplopia (double vision)
111
3rd nerve innervates what eye muscles
superior, inferior, medial rectus muscles, inferior oblique, levator palpera superioris
112
shine light into left eye, no changes in left eye but consentual in right, what does this tell me?
optic never intact: recognises light
| occulomotor not: light is being sensed but not pupillary response
113
trochlear innervates what eye muscles
superior obligue
114
abducens innervates what eye muscle
lateral rectus
