- Biceps: C5, C6?
- Brachioradialis: C6?
- Triceps: C7?
- Patellar: L4?
- Achiles tendon: S1?
30. Hearing tests
- Weber test: a normal response is hearing the tuning fork similarly in both ears?
- Weber test: a patient with a conductive hearing loss will hear the tuning fork louder in the unaffected ear?
- Weber test: a patient with sensorineural hearing loss will hear the tuning fork louder in the unaffected ear?
- Weber test: a patient with sensorineural hearing loss will hear the tuning fork similarly in both ears?
- Rinne test: in a patient with normal hearing, the sound will still be heard after the mastoid test?
- Rinne test: in a patient with sensorineurineal hearing loss, the sound will still be heard after the mastoid test?
29. POUND score
- Pulsatile quality?
- Onset for 24-48 hours?
- Unilateral?
- Nystagmus?
- Disabling intensity?
- 2 or more points – 60% likelihood migraine?
28. Tremor
- Cerebellar tremor: lesion on one side of the cerebellum produces a tremor in that same side of the body?
- Dystonic tremor: is often relieved after ingestion of small amount of ethanol?
- Parkinsonian tremor: allmost allways starts bilatarally?
- Essential tremor: may be accompanied by other manifestations of ataxia?
- Psychogenic tremor: it usually decreases or disappears when the patient is distracted?
- Cerebellar tremor: finger-nose test is positive?
27. The extrapyramidal tracts are:
- Rubrospinal tract?
- Reticulospinal tract?
- Nigrospinal tract?
- Vestibulospinal tract?
- Tectospinal tract?
- Lateral corticospinal tract?
26. Clinical features of essential tremor
- Bilateral, mostly symmetrical postural or kinetic tremor in hands or forearms?
- May be aggravated by emotional stress, fatigue, hypoglycemia or caffeine?
- One of the characteristic presentations is isolated voice tremor?
- Is not associated with rigidity, slowness of movement, or difficulty with walking?
- Ethanol in small doses characteristically improves tremor?
- Additional or isolated head tremor (yes-yes or no-no) may be found?
25. Parkinson’s disease
- Is a neurodegenerative diseases characterised by the abnormal accumulation of aggregates of tau protein in neurons?
- The main pathological characteristic of the disease is cell death in the substantia nigra pars reticulata?
- There is a reduced risk of the disease in cigarette smokers and coffee and tea drinkers?
- Idiopathic Parkinson’s disease usually has bilateral, symmetrical onset of symptoms?
- Levodopa is typically more effective at controlling symptoms in Parkinson plus syndromes than in PD?
- Parkinson-plus syndromes are usually more slowly progressive than the idiopathic Parkinson’s disease?
24. Response fluctuations in Parkinson’s disease
- Wearing off: a sudden, brief inability to start movement or to continue repeated movements?
- Protein related offs: transport of levodopa across the intestinal wall is decreased because of competition for facilitated transport by large amounts of neutral amino acids?
- Delayed on: a prolongation of the time required for levodopa effect to appear?
- Peak-dose dyskinesias: occurs at the time of peak levodopa plasma concentrations?
- Freezing: reemergence of parkinsonian symptoms before the next scheduled levodopa dose?
- Diphasic dyskinesia: a dyskinesia in which involuntary movements occur during both peak and trough levodopa concentrations?
23. Corticospinal tract
- The corticospinal tract is a motor pathway starting at the cortex that terminates on motor neurons in the brainstem or spinal cord and is involved in the control of motor functions of the body?
- About 80% of corticospinal neurons originate in the primary motor cortex?
- Pyramidal cells of Betz are the largest neurons in the central nervous system?
- Lateral corticospinal tract appears on transverse section of the spinal cord as an oval area in front of the posterior column and medial to the posterior spinocerebellar tract?
- All the fibers of the lateral corticospinal tract cross the midline in the medulla oblongata and control the limbs and digits?
- The anterior corticospinal tract becomes smaller as it descends, ending at the level of the mid-thoracic spinal cord?
22. Caudate nucleus (Nucleus caudatus)
- Is a C – shaped structure that lies on the lateral side of the thalamus?
- Stria terminalis and thalamostriate vein lie between thalamus and caudate nucleus?
- Together with putamen it forms the ventral striatum?
- Its head forms the floor of the anterior horn of the lateral ventricle?
- Caudate nucleus nucleus has motor and behavioral functions?
- It is heavily innervated by serotoninergic neurons from substantia nigra?