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58 Cards in this Set

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At which artery in the circle of willis is the most common place of aneurysm? You often see visual symptoms
Anterior communicating artery
aneurysm here causes CN III palsy
Posterior communicating artery
This artery comes off of middle cerebral artery and supply internal capsule, caudate, putamen, globus pallidus
Lateral Striate
In general, in stroke of anterior circle you would see what kind of deficits?
Sensory and motor dysfunction, aphasias
how will a stroke of posterior circle will manifest?
Cranial nerve deficits, (vertigo, visual deficit), coma, cerabellar deficints (ataxia).
You would ask the patient to say this to test CN X (vagus)
Kuh-kuh-kuh
La la la tests which CN?
XII - Hypoglossal (innervation of the tongue)
Mi mi mi tests which CN?
VII - Facial (innervation of lips)
This nuclei confers visceral Sensory information (eg: taste, gut distension)
Nucleus Solitarius (VII, IX, X)
Nucleus aMbiguus confers Motor innervation of what part of the body?
pharynx, larynx, and upper esophagus (IX, X, XI)
This nucleus sends parasympathetic fibers to the vicera of thorax and abdomen (inc heart and lungs)
Dorsal motor nucleus
patient's tongue deviates to the left
left CN XII
Patient's jaw deviates toward the left
left CN V
patient tends to fall toward the left side
left lesion of the cerebellum
Patient's uvula deviate to the left
right CN X lesion
Patient's shoulder droop on the left
left CN XI lesion
Patient has weakness turning head to the left
right CN XI lesion
Which of the following herniations can cause compression on the brain stem that can result in coma and death? 1. Cingulate herniation 2. Transtentorial herniation 3. Uncal herniation 4. Cerebellar tonsillar herniation
1 herniates under the falx cerebri and does not cause coma and death. 2. Transtectoral, 3. Uncal, and 4. tonsillar herniations can
Uncal herniation can cause the following clinical signs, name their causes 1. Ipsilateral dilated pupil, ptosis
Stretching of CN III
Uncal herniation can cause the following clinical signs, name their causes 2. Contralateral homonymous hemianopsia
Compression of ipsilateral posterior cerebral artery
Uncal herniation can cause the following clinical signs, name their causes 3. Ipsilateral paresis
Compression of contralateral crus cerebri (Kernohan's notch)
Uncal herniation can cause the following clinical signs, name their causes 4. Duret hemorrhage
Caudal displacement of brain stem
The dorsal columns have 2 tracts. The Fasciculus ____ carries nerve fibers for _____(part of the body). The fasciculus ____ carries tract from ____ (part of the body)
Cuneatus, upper body and extremities. Gracilis, lower body and extremities
The lateral cortical spinal tract carries what type of fibers, and how are they arranged in the spinal cord?
motor fibers, arms medially, legs laterally
What tract carries pain and temperature sensation? Where is it located on the spinal cord?
Spinal Thalamic tract, ventral part
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease in grey matter, affect lower motor neuron only, cause flaccid paralysis
Poliomyelitis / Werdnig-Hoffmann disease
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease Mostly white matter of Cervical region, lesion are asymmetric and random
Multiple sclerosis
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease grey matter, and motor tracts: upper and lower motor neuron deficits
Amyotrophic Lateral Sclerosis
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease everywhere, but spares the dorsal columns
Ventral artery occlusion
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease dorsal column, impairs propioception and causes locomotor ataxia
Tabes dorsalis (tertiary syphilis)
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease Dorsal column, lateral corticospinal tracts and spinocerebellar tracts
Vitamin B12 Neuropathy/Friedreich's ataxia
Play this game: Where is the Lesion?? Pt II Ill name its common location on the spinal cord, you name the disease central white commisure and ventral horns
Syringomyelia
Mr. Brown-Sequard was struck on the spinal cord that resulted in the hemisection of the spinal cord at T3 level. Give me 4 symptoms that you may find in him
1. Ipsilateral motor paralysis 2. Ipsilateral loss of tactile, vibration, proprioception senses 3. Contralateral pain and temperature loss 4. Ipsilateral loss of ALL sensation at the T3 level
What are the signs of Lower Motor neuron lesion?
everything lowered: ↓ muscle mass, ↓ muscle tone, ↓ reflexes, downgoing toes
What are the signs of Upper Motor neuron lesion?
Upper = everything up (tone, DTRs, toes)
True or False: Upper motor neuron lesion of the face causes contralateral weakness of lower face only
TRUE, this lesion causes contralateral weakness of the lower face only
True or False: Lower motor neuron lesion of the face causes contralateral weakness of lower face only
FALSE: ipsilateral weakness of both upper and lower face seen
A patient comes in with facial paralysis and inability to close the eye on one side of the face, suggesting Bell's Palsy. What diseases might you see in him that could have caused his condition?
ALexanger Bell with STD: AIDS, Lyme, Sarcoid, Tumors, Diabetes
Upper motor neuron lesion of CNVII result in what?
contralateral paralysis of lower quadrant
What is the difference between alpha and gamma motor neurons?
alpha fibers participates in the reflex arc and cause extrafusal contraction. Gamma neurons are stimulated by CNS to contract intrafusal fiber to increase sensitivity of reflex arc
What are the 5 divisions/parts of the bracial plexus?
Roots Trunks Divisions Cords Branches (Randy Travis Drinks Cold Beer)
Play this game: Where is the Upper Limb nerve Lesion?? Claw hand
Trunk of C8 and T1
Play this game: Where is the Upper Limb nerve Lesion?? Wingled Scapula
Long thoracic nerve
Play this game: Where is the Upper Limb nerve Lesion?? Decreased thumb function, Pope's blessing
median nerve
Play this game: Where is the Upper Limb nerve Lesion?? Patient comes into the ER with trauma injury that broke his humerus bone. Two weeks later when you examined him, you noticed that his wrist is dropped. Neuro exam showed that the triceps and brachioradialis reflexes of the same arm are absent. What was the injured nerve?
radial nerve (innervates BEST!) Brachioradialis, Extensors of wrist and fingers, Supinator, and Triceps
Play this game: Where is the Upper Limb nerve Lesion?? Patient has lost power of his arm muscles. He could not longer flex his wrist or fingers, and has trouble with thumb movements. History showed that he broke his had a suprecondylar fracture (of the humerus) What was the injured nerve?
median nerve
Play this game: Where is the Upper Limb nerve Lesion?? Patient has clawed hand. Exam showed that he has imparied wrist flexion and adduction, impaired adduction of thumb and last 2 fingers. He also has lost of sensation over medial palm and pinky finger. What was the injured nerve?
ulnar nerve
Play this game: Where is the Upper Limb nerve Lesion?? Patient dislocates his shoulder and could no longer use his deltoid.
axillary nerve
Play this game: Where is the Upper Limb nerve Lesion?? Patient could no longer flex at his elbow joint and supination of his forearm is weakened. Exam shows loss of biceps reflex and variable sensory loss of his forearm
musculocutaneous nerve
Play this game: Where is the Upper Limb nerve Lesion?? Following a blow to his shoulders, the patient presents with limb hanging by side (paralysis of abductors), medially rotated (paralysis of lateral rotators), and protonated forearm (loss of biceps). Eponym?
C5 and C6 roots. Known as Erb-Duchenne palsy
Thoracic outlet syndrome leads to loss of the compression of ____ artery and ____ trunk of brachial plexus
Subclavian, inferior (C8. T1)
In thoracic outlet syndrome, when the patient turn his head toward the opposite side, you notice the dissapearance of _____ (what physical finding?)
radial pulse
What muscles would you expect to be atrophied as a result of thoracic outlet syndrome?
thenar and hypothenar eminences, innterosseous
What neurological symptoms would you see in thoracic outlet syndrome?
sensory deficits of medial side of forearm and hand
What nerve root do you test for if you illecit the following reflexes? 1. Biceps
C5
What nerve root do you test for if you illecit the following reflexes? 2. Triceps
C7
What nerve root do you test for if you illecit the following reflexes? 3. Patella
L4
What nerve root do you test for if you illecit the following reflexes? 4. Achilles
S1