Intensive Neurology 2021

Flashcards for Intensive Neurology 2021 lecture notes.

Central Nervous System (CNS)

Composed of the brain and spinal cord.

Brain

Composed of two cerebral hemispheres (right and left), basal ganglia, and the brain stem.

Frontal Lobe

Involved in personality, emotional control, social behavior, micturition centers, and voluntary motor control.

Parietal Lobe

Involved in language (speech), calculation, visual-spatial and constructional skills, memory centers, optic tract, and somatic sensation.

Temporal Lobe

Involved in auditory processing, verbal memory, and smell centers.

Occipital Lobe

Contains visual centers.

Basal Ganglia

Functions as part of the extrapyramidal system.

Brain Stem

Composed of the midbrain, pons, and medulla oblongata; contains sensory and motor pathways, cranial nerve nuclei (except I & II), and centers for respiration, consciousness, and sympathetic control.

Cerebellum

Involved in coordination (balance) of peripheral and axial body movements and balance of eye and ear function; composed of lateral hemispheres, vermis, and flocculonodular lobe.

Spinal Cord

Composed of 31 segments, ending at L1 with conus medullaris and cauda equina; contains gray matter (motor and sensory nuclei, reflexes) and white matter (afferent and efferent fibers).

Gray Matter (Spinal Cord)

Contains anterior horn cells (motor nuclei), posterior horn cells (sensory nuclei), and cells responsible for lower-order reflexes.

White Matter (Spinal Cord)

Contains afferent and efferent fibers of motor and sensory tracts and stabilizes the spinal cord.

Peripheral Nervous System (PNS)

(Spinal nerves + Cranial nerves). Components include the anterior horn cell of the spinal cord segment, peripheral spinal nerve, neuromuscular junction, and muscles.

Motor System

Composed of the pyramidal tract (voluntary movements) and extrapyramidal tract (involuntary movements).

Pyramidal Tract

Also known as the corticospinal tract (CST) and corticobulbar tract (CBT), responsible for voluntary movements.

Extrapyramidal Tract

Responsible for involuntary movements; function of basal ganglia.

Corticospinal Tract (CST)

Motor cortex → posterior limb of internal capsule → midbrain → pons → medulla oblongata (decussation) → spinal cord → anterior horn cells → peripheral spinal nerves.

Upper Motor Neuron Lesion (UMNL)

Lesion of the corticospinal tract (CST).

Lower Motor Neuron Lesion (LMNL)

Lesion of the peripheral nervous system (PNS).

Cerebellar Ataxia

Type of clinical lesion that can be caused by structural issues, toxins, infections, degeneration, inflammation, metabolic issues or vascular issues.

Sensory Ataxia

A type of ataxia affecting the sensory system.

Vestibular Ataxia

A type of ataxia affecting the vestibular system.

Broca's Aphasia

A type of dysphasia.

Wernicke's Aphasia

A type of dysphasia.

Dysarthria

Speech abnormality that can be staccato, slurred, or monotone.

Anterior Cerebral Artery (ACA)

Supplies the frontal lobe. If affected, results in contralateral hemiplegia/paresis, LL > UL & face.

Middle Cerebral Artery (MCA)

Supplies the temporal and parietal lobe. If affected, results in contralateral hemiplegia/paresis, UL & face > LL.

Posterior Cerebral Artery (PCA)

Supplies the visual centers. If affected, results in hemiplegia/paresis of face & UL > LL.

Basilar Artery

Supplies the brain stem and cerebellum.

Cerebrovascular Accident (CVA)

Acute focal neurological defect due to vascular cause.

Ischemic CVA

Most commonly caused by embolism (often from the heart, e.g., A. Fib), thrombosis, hypotension, arteriosclerosis, vasculitis, or space-occupying lesion.

Hemorrhagic CVA

Caused by bleeds.

Locked-in Syndrome

Loss of consciousness, can move eyelid, associated with Basilar occlusion (Brain stem infarction).

Transient Ischemic Attack (TIA)

Acute focal neurological defect due to vascular cause lasting <24hr.

Horner's Syndrome

Partial ptosis, meiosis, anhydrosis, enophthalmos, associated with Lateral medullary syndrome.

Lumbar Puncture Contraindications

Space-occupying lesion, clinical signs of raised intracranial pressure (papilloedema), patient is confused, thrombocytopenia or disseminated intravascular coagulation, warfarin or heparin therapy Hypotension, infection near site.

Multiple Sclerosis (MS)

Multiple neurological sclerosing defect separated by space & Time.

Motor Neuron Disease MND/Lateral Amylotrophic Sclerosis

progressive disorder of unknown etiology which results in degeneration of Cranial Nerve Nuclei, AHC, & pyramidal tract. S&S of UMNL&LMNL.

Guillain-Barré Syndrome (GBS)

Acute inflammatory ascending polyneuropathy post infections 1-4weeks, Polyneuropathy: Motor, CN involvement & Sensory.

Myasthenia Gravis

Progressive neuromuscular junction disorder due to effect on receptor, Msc weakness characteristic: at end of day.

Eaton Lambert Syndrome

A Myasthenia disorder associated with malignancy (sq.c.c), Ms weakness trunk & pelvic girdle ( improves by movement).

Parkinsonism

Clinical syndrome due to defect in neuro striatal Dopaminergic pathway, C/P: Rigidity 2/static tremor Resting 3/Loss of facial expression 4/Loss of blinking of eye but eye movements are normal.