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Flashcards in Pastest Deck (114)
1

cranial nerve that passes through rotundum

maxillary division of trigeminal

2

innervates parotid

glossopharyngeal

3

innervates lateral gaze

abducens

4

superior oblique is innervated by

trochlear

5

laryngeal muscles are innervated by

branches of the vagus

6

only part of laryngeal muscles not innervated by recurrent laryngeal branch of vagus

cricothyroid - by external laryngeal nerve

7

innervates the anterior 2/3rd of tongue

facial

8

innervates posterior 1/3 of tongue

glossopharyngeal

9

unilateral headache > 50 yrs

temporal arteritis

10

first line investigation for temporal arteritis

ESR

11

age when migraines first present

young woman/man

12

why no COCP in migraine

oestrogen precipitates migrane

13

raised ICP will have what symptoms

morning headaches and postural (leaning forward)

14

triad of parkinson

- resting tremor
- rigidity
- bradykinesia

15

pathophysiology of parkinsons

neurodegeneration and deposition of inclusion bodies in v pars compact of the substantianigra (midbrain) causing disruption/loss of dopaminergic transmission in basal ganglia

16

parkinson signs distribution: symmetric or asymmetric

asymmetrical

17

therapy given in parkinson

levodopa (L-dopa)

18

non 'triad' symptoms of parkinson

stooped posture
shuffling gate
reduced arm swing
monotone voice --> slurring dysarthria

19

what is normal pressure hydrocephalus

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

who gets normal pressure hydrocephalus

old people

21

symptoms of normal pressure hydrocephalus

dementia, urinary incontinenece, gait abnormalities (shuffling)

22

molloscum contagiosa indicates what

HIV

23

HIV+ get what type of meningitis

cryptococcal neoformans

24

sudden onset severe headache

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