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Neurology Year 3 > Physiology x > Flashcards

Physiology x Flashcards

(75 cards)

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1
Q

How to assess for acessory nerve function

A

Should inspect the shoulders for loss of muscle bulk, ask the patient to shrug their shoulders against resistance, and turn their head against resistance

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2
Q

When is the ankle reflec delayed?

A

It is typically delayed in L5 and S1 disk prolapses.

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3
Q

What nerve roots does the ankle reflex test?

A

The ankle reflex is elicited by tapping the Achilles tendon with a tendon hammer. It tests the S1 and S2 nerve roots

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4
Q

The anterior interosseous nerve (volar interosseous nerve)

A

A branch of the median nerve that supplies the deep muscles on the front of the forearm, except the ulnar half of the flexor digitorum profundus.

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5
Q

Brachial artery journey

A

The brachial artery begins at the lower border of teres major as a continuation of the axillary artery. It terminates in the cubital fossa at the level of the neck of the radius by dividing into the radial and ulnar arteries

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6
Q

How is the brachial artery seperated from the median cubital vein?

A

In the cubital fossa it is separated from the median cubital vein by the bicipital aponeurosis.

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7
Q

Mamilliary body

A

Function is recollective memory. Memory information begins within the hippocampus. Theta waves activate CA3 neurons in the hippocampus. Information about memory transmits through the fornix to the mammillary bodies.

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8
Q

Anyglada function

A

The main job of the amygdala is to regulate emotions, such as fear and aggression. The amygdala is also involved in tying emotional meaning to our memories. reward processing, and decision-making.

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9
Q

What are the cavernous sinuses?

A

The cavernous sinuses are paired and are situated on the body of the sphenoid bone. It runs from the superior orbital fissure to the petrous temporal bone

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10
Q

Where is the common pernoeal nerve derived from?

A

Derived from the dorsal divisions of the sacral plexus (L4, L5, S1 and S2).

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11
Q

Common peroneal nerve functions

A

This nerve supplies the skin and fascia of the anterolateral surface of the leg and the dorsum of the foot. It also innervates the muscles of the anterior and peroneal compartments of the leg, extensor digitorum brevis as well as the knee, ankle and foot joints.

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12
Q

Branches of the common peroneal nerve in the thigh

A 
Nerve to the short head of biceps
Articular branch (knee)
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13
Q

Branches of the common peroneal nerve in the popliteal fossa

A

Lateral cutaneous nerve of the calf

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14
Q

Branches of the common peroneal nerve at the neck of fibula

A

Superficial and deep peroneal nerves

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15
Q

The cranial venous sinuses

A

The cranial venous sinuses are located within the dura mater. They have no valves which is important in the potential for spreading sepsis. They eventually drain into the internal jugular vein.

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16
Q

Occulomotor nerve palsy features

A

Ptosis
Eye down and out
Unable to move the eye superiorly, inferiorly, medially
Pupil fixed and dilated

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17
Q

Trochlear nerve palsy features

A 
Vertical diplopia (diplopia on descending the stairs)
Unable to look down and in
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18
Q

Abducens nerve palsy features

A

Convergence of eyes in primary position
Lateral diplopia towards side of lesion
Eye deviates medially

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19
Q

Location of jugular and stylomastoid foramen

A

Temporal bone

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20
Q

Location of foramen magnum

A

Occipital bone

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21
Q

Location of Foramen ovale, spinosum, rotundum & lacerum

A

Sphenoid bone

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22
Q

Damage to what nerve causes a Trendelenberg gait?

A

Damage to the superior gluteal nerve will result in the patient developing a Trendelenberg gait

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23
Q

Superior gluteal nerve (L5, S1)

A

Gluteus medius
Gluteus minimis
Tensor fascia lata

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24
Q

Inferior gluteal nerve

A

Gluteus maximus

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25
Ventromedial nucleus
Satiety centre. Lesions → hyperphagia
26
Paraventricular nucleus
Produces oxytocin + ADH. Lesions → diabetes insipidus
27
Supraoptic nucleus
Produces antidiuretic hormone (ADH). Lesions → diabetes insipidus
28
Suprachiasmatic nuclues
Regulars circadian rhythm
29
Septal nucleus
Regulates sexual desire
30
Posterior nucleus of hypothalamus
Heating (conservation and increased production) - damage results in poikilothermia Stimulates sympathetic nervous system
31
Lateral nucleus of hypothalamus
Stimulation → increased appetite | Lesions → anorexia
32
Anterior nucleus of hypothalamus
Cooling by stimulation of parasympathetic nervous system
33
Long thoracic nerve injury
Winging of Scapula occurs in long thoracic nerve injury (most common) or from spinal accessory nerve injury (which denervates the trapezius) or a dorsal scapular nerve injury
34
Lumbar punctuure procedure
The supraspinous ligament which connects the tips of spinous processes and the interspinous ligaments between adjacent borders of spinous processes Then the needle passes through the ligamentum flavum, which may cause a give as it is penetrated A second give represents penetration of the needle through the dura mater into the subarachnoid space. Clear CSF should be obtained at this point
35
Median nerve motor supply in hand
Motor supply (LOAF) Lateral 2 lumbricals Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis
36
Median merve sensory supply in hand
Over thumb and lateral 2 ½ fingers
37
Median nerve damage at wrist
carpal tunnel syndrome paralysis and wasting of thenar eminence muscles and opponens pollicis (ape hand deformity) sensory loss to palmar aspect of lateral (radial) 2 ½ fingers
38
The four infoldings of the dura mater
Falx cerebri: separates the cerebral hemispheres Tentorium cerebelli: separates the occipital lobes from cerebellum Falx cerebelli, vertical infolding: separates the cerebellar hemispheres Diaphragma sellae: covers the pituitary gland and sella turcica
39
Musculocutaneous nerve innervations
Coracobrachialis Biceps brachii Brachialis
40
Knee reflex nerve roots
L3-L4
41
Biceps reflex nerve root
C5-C6
42
Triceps reflex nerve root
C7-C8
43
Lateral geniculate nucleus
visual signals
44
Medial geniculate nucleus
Auditory signals
45
Lateral portion of the ventral posterior nucleus of thalamus
Body sensation (touch, pain, proprioception, pressure, vibration)
46
Medial portion of the ventral posterior nucleus (VML) of thalamus
Facial sensation
47
What are the different nuclei of the thalamus?
Lateral geniculate nucleus Medial geniculate nucleus Medial portion of the ventral posterior nucleus (VML) Ventral anterior/lateral nuclei Lateral portion of the ventral posterior nucleus
48
Features or Wernicke’s encephalopathy
``` nystagmus (the most common ocular sign) ophthalmoplegia ataxia confusion, altered GCS peripheral sensory neuropathy ```
49
Wallerian degenaeration
Is the process that occurs when a nerve is cut or crushed. - It occurs when the part of the axon separated from the neuron's cell nucleus degenerates. - It usually begins 24 hours following neuronal injury and the distal axon remains excitable up until this time.
50
Triptans
Triptans are specific 5-HT1B and 5-HT1D agonists used in the acute treatment of migraine. They are generally used first-line in combination therapy with an NSAID or paracetamol
51
Triptans side effects
triptan sensations' - tingling, heat, tightness (e.g. throat and chest), heaviness, pressure
52
Triptans contraindications
patients with a history of, or significant risk factors for, ischaemic heart disease or cerebrovascular disease
53
Clinical presentation of neurogenic Thoracic outlet syndrome
painless muscle wasting of hand muscles, with patients complaining of hand weakness e.g. grasping sensory symptoms such as numbness and tingling may be present if autonomic nerves are involved, the patient may experience cold hands, blanching or swelling
54
Clinical presentation of vascular Thoracic outlet syndrome
subclavian vein compression leads to painful diffuse arm swelling with distended veins subclavian artery compression leads to painful arm claudication and in severe cases, ulceration and gangrene
55
Subacute combined degeneration of spinal cord
due to vitamin B12 deficiency dorsal columns + lateral corticospinal tracts are affected joint position and vibration sense lost first then distal paraesthesia upper motor neuron signs typically develop in the legs, classically extensor plantars, brisk knee reflexes, absent ankle jerks if untreated stiffness and weakness persist
56
Syringomyelia features
``` Flacid paresis (typically affecting the intrinsic hand muscles) 2. Loss of pain and temperature sensation
57
Anterior spinal artery occlusion
1. Bilateral spastic paresis | 2. Bilateral loss of pain and temperature sensation
58
Friedrich's ataxia
1. Bilateral spastic paresis 2. Bilateral loss of proprioception and vibration sensation 3. Bilateral limb ataxia In addition cerebellar ataxia → other features e.g. intention tremor
59
Features of sciatic nerve lesion
motor: paralysis of knee flexion and all movements below knee sensory: loss below knee reflexes: ankle + plantar lost, knee jerk intact
60
Pathway of pupillary light reflex
afferent: retina → optic nerve → lateral geniculate body → midbrain efferent: Edinger-Westphal nucleus (midbrain) → oculomotor nerve
61
A relative afferent pupillary defect
Is found by the 'swinging light test'. It is caused by a lesion anterior to the optic chiasm i.e. optic nerve or retina When the test is performed in an eye with an afferent pupillary defect, light directed in the affected eye will cause only mild constriction of both pupils while light in the unaffected eye will cause a normal constriction of both pupils (due to an intact efferent path, and an intact consensual pupillary reflex).
62
Progressive supranuclear palsy features
postural instability and falls patients tend to have a stiff, broad-based gait impairment of vertical gaze (down gaze worse than up gaze - patients may complain of difficultly reading or descending stairs) parkinsonism bradykinesia is prominent cognitive impairment primarily frontal lobe dysfunction
63
Internuclear ophthalmoplegia features
Features impaired adduction of the eye on the same side as the lesion horizontal nystagmus of the abducting eye on the contralateral side
64
Internuclear ophthalmoplegia cause
due to a lesion in the medial longitudinal fasciculus (MLF) controls horizontal eye movements by interconnecting the IIIrd, IVth and VIth cranial nuclei located in the paramedian area of the midbrain and pons
65
Miller Fisher syndrome
variant of Guillain-Barre syndrome associated with ophthalmoplegia, areflexia and ataxia. The eye muscles are typically affected first usually presents as a descending paralysis rather than ascending as seen in other forms of Guillain-Barre syndrome anti-GQ1b antibodies are present in 90% of cases
66
Ethosuximide
Ethosuximide is an antiepileptic that is particularly indicated in patients with absence seizures
67
Ethosuximide mechanism of action
blocks T-type calcium channels in thalamic neurons
68
Enpty sella features
headaches hypertension rhinorrhoea
69
Empty sella
pituitary gland is flattened and on the posterior aspect of the sella turcica cause unknown more common in multiparous obese women
70
Chorioretinitis causes
``` syphilis cytomegalovirus toxoplasmosis sarcoidosis tuberculosis ```
71
Cerebellar syndrome/diseases causes
``` Friedreich's ataxia, ataxic telangiectasia neoplastic: cerebellar haemangioma stroke alcohol multiple sclerosis hypothyroidism drugs: phenytoin, lead poisoning paraneoplastic e.g. secondary to lung cancer ```
72
Cerebellar syndrome/disease features
D - Dysdiadochokinesia, Dysmetria (past-pointing), patients may appear 'Drunk' A - Ataxia (limb, truncal) N - Nystamus (horizontal = ipsilateral hemisphere) I - Intention tremour S - Slurred staccato speech, Scanning dysarthria H - Hypotonia
73
Frontal lobes lesions
``` expressive (Broca's) aphasia disinhibition perseveration anosmia inability to generate a list ```
74
Temporal lobe lesions
Wernicke's aphasia superior homonymous quadrantanopia auditory agnosia prosopagnosia (difficulty recognising faces
75
Parietal lobe lesions
``` sensory inattention apraxias astereognosis (tactile agnosia) inferior homonymous quadrantanopia Gerstmann's syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation ```

Neurology Year 3 (22 decks)

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