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This document provides medical mnemonics and summaries of various neurological conditions and clinical features:
1. It begins with mnemonics to remember aspects of neurological examinations and signs of various conditions such as Alzheimer's disease, normal pressure hydrocephalus, and multiple sclerosis.
2. Further sections summarize differential diagnoses, diagnostic criteria, clinical features and treatments for other neurological disorders and diseases including peripheral neuropathy, dementia, stroke, neurofibromatosis, and more.
3. Throughout there are explanations of anatomical structures and pathways in the nervous system, along with causes of clinical presentations like visual changes, vertigo, and others.
This document provides medical mnemonics and summaries of various neurological conditions and clinical features:
1. It begins with mnemonics to remember aspects of neurological examinations and signs of various conditions such as Alzheimer's disease, normal pressure hydrocephalus, and multiple sclerosis.
2. Further sections summarize differential diagnoses, diagnostic criteria, clinical features and treatments for other neurological disorders and diseases including peripheral neuropathy, dementia, stroke, neurofibromatosis, and more.
3. Throughout there are explanations of anatomical structures and pathways in the nervous system, along with causes of clinical presentations like visual changes, vertigo, and others.
This document provides medical mnemonics and summaries of various neurological conditions and clinical features:
1. It begins with mnemonics to remember aspects of neurological examinations and signs of various conditions such as Alzheimer's disease, normal pressure hydrocephalus, and multiple sclerosis.
2. Further sections summarize differential diagnoses, diagnostic criteria, clinical features and treatments for other neurological disorders and diseases including peripheral neuropathy, dementia, stroke, neurofibromatosis, and more.
3. Throughout there are explanations of anatomical structures and pathways in the nervous system, along with causes of clinical presentations like visual changes, vertigo, and others.
Run-over Small Children": Tone Power Reflexes Sensation Co-ordination/ Clonus Alzheimer's disease: progressive phases AC!: Amnesic phase (forgetting keys, leaving cooker on) ehavioural problems (antisocial, wandering) Cortical phase (incontinence, falls) !ecerebrate phase (return of primitive reflexes) "ydrocephalus: Normal pressure hydrocephalus !!x !"s: #et: urinary incontinence #obbly: gait abnormality #acky: dementia, memory problems Cere$ellar signs P%NAR!'S: Past pointing %ntention tremor Nystagmus Ataxia Rebound !ysdiadokinesia Slurred speech #$ote: %f you haven"t done &bs yet, a 'inard"s is for listening to a baby"s heart on mother"s abdomen( Multiple sclerosis: signs and symptoms %NS&'AR: %ntention tremor Nystagmus Slurred speech &thoff"s phenomenon 'hermitte"s sign Ataxia Rebound Conscious change: causes A(%)& T%PS: Alcohol (ncephalopathy %nfection )pioid &remia Trauma %nsulin Psychosis Syncope !ecreased level o* consciousness: meta$olic causes M(TA)'%C: Ma)or end organs (liver, kidney) (ndocrine/ (lectrolytes Toxins Acid ase disorders )xygenation 'ung ('*, pneumonia) %nfection/ %nflammatory/ %atrogenic Calcium Peripheral neuropathy: di**erential STA+'AN!: Sarcoid Thyroid Amyloid +uillian-+arre 'ead Alcohol Nutritional !rugs/ !iabetes !ementia: treata$le causes !(M(NT%A: !rug toxicity (motional (depression, anxiety, &,-, etc.) Metabolic (electrolytes, liver d/, kidney d/, ,&'-) (yes/ (ars (peripheral sensory restrictions) Nutrition (vitamin, iron deficiencies/ N'0 #Normal 'ressure 0ydrocephalus( Tumors/ Trauma (including chronic subdural hematoma) %nfection (meningitis, encephalitis, pneumonia, syphilis) Arteriosclerosis and other vascular disease #hipple's disease: *eatures ,*or neurologists- A #"%PP'(S !))M: Arthralgias #hipplei (organism) "ypothalamic involvement %ntestinal involvement/ %ntestinal biopsy re1uired P23 positive macrophages P,4 positivity 'ymphadenopathy (xtrapyramidal involvement Septran treat with !ementia )cular abnormalities (vertical ga/e palsy) )culomasticatory myorhythmia Myoclonus Congenital myopathy: *eatures !R(AMS: !ominantly inherited, mostly Reflexes decreased (n/ymes normal Apathetic floppy baby Milestones delayed Chorea: common causes St. /%T&S'S !ANC(: Sydenhams /ascular %ncreased 4+,"s (polycythemia) Toxins: ,&, 5g, 0g &remia S6* Senile chorea !rugs A'62 syndrome Neurodegenerative conditions: 0-, neuroacanthocytosis, -4'62 Conception related: pregnancy, &,'"s (ndocrine: hyperthyroidism, hypo-, hyperglycemia Status epilepticus: treatment "Thank +oodness All Cerebral ursts !issipate": Thiamine +lucose Ativan Cerebyx arbiturate !iprivan alint's syndrome S))T: Simultagnosia )ptic ataxia )cular apraxia Tunnel vision /isual loss: persistent $ilateral sudden onset visual loss di**erential 0')P: 0unctional 'eber"s hereditary neuropathy )ccipital infarctions Pituitary apoplexy Perinaud's syndrome: clinical *eatures P(R%NA&!'S: Pseudo 7th nerve palsy/ Penial region (yelid Retraction %nternuclear ophthalmoplegia Nystagmus Accomodation reflex present &pward ga/e palsy !efective convergence/ !ecerebrate rigidity Skew deviation enidict's syndrome: site a**ected enidict"s test for sugar gives red precipitate. 3imilarly, enidict"s syndrome affects rednucleus. Stro1e: $asic 2or1 up 8he '"s: Pump Pipes Plasma Neuro*i$romatosis: diagnostic criteria R)'AN!): Relative (9st degree) )sseous fibromas 'isch nodules in eyes Axillary freckling Neurofibromas !ime si/e cafe au lait spots )ptic gliomas Proximal myopathy: di**erential P(AC" P)!S: Polymyositis (ndocrine: hyper, hypothyroidism, ,ushing"s syndrome, acromegaly Alcohol Carcinoma "%: infection Periodic hypokalemic paralysis )steomalacia !rugs: steroids, statins Sarcoidosis !ementia: reversi$le dementia causes !(M(NT%A: !rugs/ !epression (lderly Multi-infarct/ Medication (nvironmental Nutritional Toxins %schemia Alcohol Stro1e: young patient's li1ely causes ; ,"s: Cocaine Consanguinity #familial such as neurofibromatosis and von 0ippel-6indau( Cancer Cardiogenic embol hyperCoagulation C$3 infection #eg: 0%: conditions( Congenital arterial lesion (ncephalitis: di**erential "('S 'AT%N AM(R%CAN: "erpesviridae (nteroviridae (esp. 'olio) Slow viruses (esp. <,, prions) Syphilis 'egionella/ 'yme disease/ 'ymphocytic meningoencephalitis Aspergillus Toxoplasmosis %ntracranial pressure Neisseria meningitidis Arboviridae Measles/ Mumps/ Mycobacterium tuberculosis/ Mucor (. coli Rabies/ Rubella %diopathic Cryptococcus/ Candida Abscess Neoplasm/ Neurocysticercosis = $eurocysticercosis should be assumed with recent 6atin 2merican immigrant patient unless proven otherwise. "ead trauma: rapid neuro exam = 9> '"s: Psychological (mental) status Pupils: si/e, symmetry, reaction Paired ocular movememts Papilloedema Pressure (+', increased %,') Pulse and rate Paralysis, Paresis Pyramidal signs Pin prick sensory response Pee (incontinent) Patellar relex (and others) Ptosis = 4eevaluate patient every ? hrs. Neuro*i$romatosis: diagnositic criteria 3type456 CA0( SP)T: Cafe-au-lait spots Axillary, inguinal freckling 0ibroma (ye: lisch nodules Skeletal (bowing leg, etc) Pedigree/ Positive family history )ptic Tumor (glioma) Pupillary dilatation 3persistent6: causes 7AM: 7rd nerve palsy Anti-muscarinic eye drops (eg to facilitate fundoscopy) Myotonic pupil (0olmes 2die pupil): most commonly in young women, with absent/delayed reaction to light and convergence, and of no pathological significance. )cular $o$$ing vs. dipping "reakfast is *ast, !inner is slow, both go do2n": obbing is *ast. !ipping is slo2. %n both, the initial movement is do2n. "untington's: chromosome8 involvement "&NT 9 !AT(: "&NTington"s on chromosome 9, with cau!AT( nucleus involvement. Pin4point pupil causes Pin-Point Pupils are due to oPioids and Pontine Pathology a$ins1i and 'MN signs: conditions exhi$iting them "! MASTS": !iabetes Motor neuron disease Ataxia (friedrichs) Subacute combined degeneration of cord Tabo paresis Syringobulbia Peripheral neuropathies: di**erential !AN+ T"(RAP%ST: !iabetes Amyloid Nutritional (eg +9> deficiency) +uillain-+arre Toxic (eg amiodarone) "eriditary (ndocrine Recurring (9@A of B-+) Alcohol Pb (lead) %diopathic Sarcoid Thyroid !ementia: some common causes !(M(NT%A: !iabetes (thanol Medication (nvironmental (eg ,& poisoning) Nutritional Trauma %nfection Al/heimer"s /ertigo: di**erential /)M%TS: /estibulitis )totoxic drugs Meniere"s disease %n)ury Tumor Spin (benign positional vertigo) Ramsay4"unt syndrome: cause and common *eature "Ramsay "unt": = *tiology: Reactivated "erpes /oster = ,omplication: Reduced "earing Stro1e ris1 *actors "(A!S: "ypertension/ "yperlipidemia (lderly Atrial fib !iabetes mellitus/ !rugs (cocaine) Smoking/ Sex (male) Multiple sclerosis 3MS6: epidemiology MS is a feminine title (Ms.) and is female predominant. Neuropathy: diagnosis con*irmation N(uropathy: Nerve conduction velocity (lectromyography attle sign attl(: ehind (ar Par1inson's disease: signs and symptoms SMART: Shuffling gait Mask-like facies Akinesia Rigidity Tremor Alzheimer's disease: common characteristics A':"(%M(R'S: Anterograde amnesia is usually first sign 'ife expectancy increase shows more cases in recent years :apped (loss of) acetylcholinergic neurons "ereditary disease (ntire hippocampus becomes affected %dentified by neurofibrillary tangles Mutation in amyloid genes associated w/ disease (ntorhinal areas degenerate first Retrograde amnesia ultimaltely develops Senile pla1ues are formed at synapse Thalamic $oundaries "% "%T PP' (people)": = -irections are in alphabetical order: 2nterior: %nterventricular Coramen %nferior: "ypothalamic nuclei (plane connecting them) 6ateral: %nternal capsule (posterior limb) 5edial: Third ventricle 'osterior: free Pole of Pulvinar 3uperior: 'ateral ventricle = 'osterior has > '"s. A**erent vs. e**erent neurons Afferent D Arrive (fferent D (xit Spinal cord: a**erent vs. e**erent neurons ",onfusing because they both sound the SAM(": SensoryDAfferent MotorD(fferent !ysphasia: roca's vs. #ernic1e's causing expressive vs. receptive (#AR(: roca"s area: (xpressive dysphasia. #ernicke"s Area: R(ceptive dysphasia A'S: symptoms A'S: Anterior horn neuron loss 'ower motor dominant effects Spino-cortical tract (cortico-spinal tract) Meningitis: site o* T meningitis attac1 T meningitis attacks The ase of the brain Cere$ellar deep nuclei "0at +irls (at !oritos": = Crom medial to lateral: 0astigial +lobose (mboliform !entate Cere$ellar peduncles: a**erent vs e**erent S(MA: Superior cerebellar peduncle (fferent (fibres) Middle cerebellar peduncle Afferent (fibres) +eniculate $odies: paired to respective colliculi S'%M: Superior colliculi: 'ateral geniculate body. %nferior colliculi: Medial geniculate body. Cere$ellar damage signs !AN%S": !ysdiadochokinesis Ataxia Nystagmus %ntention tremor Slurred speech "ypotonia Cere$ellar *unctional areas 2natomical shape/location of cerebellar areas is a key to their function and related tract. = /ermis ; Spinocerebellar ; Axial e1uilibrium. /ermis: right down the axis of cerebellum, and vertically segmented like a spinal column. = 0locculonodular lo$e ; /esti$ulocerebellar ; (ar, eye, body coordination. 0locculonodular lo$e: flares out to the edges, )ust like ears. = "emispheres o* cere$ellum ; Cere$rocerebellar ; Peripheral coordination. "emispheres: around periphery of cerebellum, and tract to cere$ral hemispheres. Auditory path2ay: mandatory stops "Come %n My aritone": Cochlear nucleus %nferior colliculus Medial geniculate nucleus rodmann"s E9 (cortex) )livary nuclei: ear vs. eye roles Superior )livary nucleus: S)und locali/ation. = %nferior olivary nucleus is therefore the one for sight #tactile, proprioception also(. +eniculocalcarine tract 'ower bank of calcarine sulcus is the 'ingual gyrus: it receives input from 'ower retinal 1uadrants. 8herefore, ,uneus is the &pper bank of calcarine sulcus: it receives input from &pper retinal 1uadrants. = 4emember: lower retinal 1uadrants represent superior visual field 1uadrants and viceversa. asal ganglia: !5 vs. !< connections -5 has 5 connection (3triatum-B'i/3$pr). -< has <connections (3triatum-B'e-B'i/3$pr). Meninges: layers in order PA!: Piamater Arachnoid !ura Coronal section o* $rain: structures "%n (xtreme Conditions (at People"s +uts %nstead of Their "earts": = Crom insula to midline: %nsula (xtreme capsule Claustrum (xternal capsule Putamen +lobis pallidus %nternal capsule Thalamus "ypothalamus Cranial nerves: sensory8 motor or $oth ,5=>?s style- "Some Say Marilyn Monroe ut My rother Says ridget ardot Mmm, MmmF": = Crom % to G%%: Sensory Sensory Motor Motor oth Motor oth Sensory oth oth Motor Motor Cranial nerves ")ne )ctopus )ffered Two Toddlers And 0ive /irgins +reat /alium And "ash": )lfactory )ptic )culomotor Trochlear Trigeminal Abducens 0acial /@estibulocochlear +lossopharyngeal /agus Accesory "ypoglossal Cranial nerves ,*or those 2ith a vegeta$le *etish- ")h )h )h To Touch And 0eel /ery +reen /egetables, Ah "eavenF": )lfactory )ptic )culomotor Trochlear Trigeminal Abducens 0acial /estibulocochlear +lossopharyngeal /agus Accesory "ypoglossal ThirstA2ater $alance control centre: location in hypothalamus "Hou loo1 up (supra...optic) at the clouds, to check if it"s going to rain (water)": 8herefore, water balance is in supraoptic nucleus. +eniculate $odies: medial vs. lateral system "'ateralD'ight. MedialDMusic.": 6ateral geniculate body is for visual system. 5edial geniculate is for auditory system. Cranial nerves ")ld )pticians )perate To Try Adding 0ortune And +etting /egas Another "otelF": = %n order from 9 to 9>: )lfactory )ptic )cculomotor Trochlear Trigeminal Abducens 0acial Auditory +lossopharyngeal /agus Accessory "ypoglossal Cranial nerves ,*or political Americans- ")ur )val )ffice Tomorrow Teeters As 0lorida Adds +eorge /ersus Al"s "andcounts": )lfactory )ptic )culomotor Trochlear Trigeminal Abducent 0acial Acoustic +lossopharyngeal /agus Accessory "ypoglossal Auditory path2ay ""ungry +irls B(ate) Nothing To S'%M Themselves": "air cells spiral +anglion cranial nerve B cochlear Nuclei Trape/oid body (decussation of ventral nuclei) Superior olivary nucleus 'ateral leminiscus %nferior colliculus Medial geniculate body Transverse temporal gyrus Spinothalamic tracts: *unction o* lateral vs. ventral "'umbago is conveyed by the 'ateral tract": 6umbago is lower back pain. 8herefore lateral tract conveys pain, so by default, ventral tract conveys light touch. +eniculate $odies: medial vs. lateral system MA'(: MedialDAuditory. 'ateralD(ye. 5edial geniculate body is for auditory system, lateral geniculate body is for visual system. ,an expand to MA'(S to remember 'ateralD(yeDSuperior colliculus (thus medial is inferior colliculus by default). Pur1inCe cells in cere$ellum are inhi$itory to deep nuclei 3hape of a purkin)e cell in dimensions is same as a policeman"s hand saying "3top". 8herefore, purkin)e cells are inhibitory. !ysphagia vs. dysphasia -ysphaSia is for Speech -yspha+ia is for your +ut #swallowing(. "ypothalamus: *eeding vs. satiety center "3tim the lat, get *at": = 3timulating lateral increases hunger. "3tim the ven, get thin": = 3timulating ventromedial increases satiety. Argyll4Ro$ertson Pupil *eatures 2rgyll 4obertson 'upil (24') 4ead it from front to back: it is ARP, standing for Accomodation Reflex Present. 4ead it from back to front: it is PRA, standing for Pupillary Reflex Absent. Cere$ellar deep nuclei "'adies !emand (xceptional +enerosity 0rom Men": = 8he E nuclei, from lateral to medial: #'ateral( !entate (mboliform +lobose 0astigial #Medial( !orsal; a**erent8 /entral; e**erent and their *unctions "5y friend !A/( got 1ic1ed in the $ehind and screamed": !orsal/Afferent component is the sensation o* pain coming from the rear. /entral/(fferent component is the motor action o* screaming (which is done at *rontof body). Cranial nerves ,*or those under stress- ")h )nce )ne Takes The Anatomy 0inal A +ood /acation Seems "eavenly": )lfactory )ptic )cculomotor Trochlear Trigeminal Abducens 0acial Auditory +lossopharyngeal /agus Spinal root of the accessory "ypoglossal Cere$ellar damage signs !AS"%N+: !ysdiadochokinesia Ataxia Speech "ypotonia %ntention tremor Nystagmus +ait "ypothalamus: general *unctions "TA'( of the hypothalamus": Temperature Appetite 'ibido (motion Argyll4Ro$ertson Pupil *eatures 6ook at the math signs around the two parts of the name: A4R. 8he 2 has no sign in front, which in math means DA (D Accommodate). 8here is a subtract sign in front of the 4 (4 React). 8herefore, pupil can accommodate, but can"t react. Spinal cord: converting ventralA anteriorA motorA e**erent and dorsalA posteriorA sensoryA a**erent 2 limousine: 8he motor of limo is ventral and anterior on the car. 8he Aerial is sensory and on the dorsal and posterior of the limo. = $ote 9: "A" is Afferent, and also, in a limo, the aerial on the top of the trunk has a capital "A" shape. = $ote >: 2n aerial is a sensory thing: picks up radio waves. = $ote : %f picked a limo up in your hand, can only see motor on ventral, since dorsal is covered by the hood/bonnet. )ptic chiasma: 2hat it loo1s li1e i* you're a genetics star 8he optic chiasma looks the same as a chiasma in meiosis, making it easy to spot on the dissected brain. Parasympathetic vs. sympathetic *unction 3ympathetic nervous system: "0ight or 0light". 'arasympathetic nervous system: "Rest and !igest". Chemoreceptor trigger zone "Syringes "elp Men )n !rugs": Serotonin "istamine Muscarinic )pioids !opamine Cere$ellar damage symptoms /AN%S"(!: /ertigo Ataxia Nystagmus %ntention tremor Slurred (or Staccato) speech (xagerrated broad based gait "ypotonic reflexes !ysdiadochokinesia. "ypothalamus: *eeding vs.satiety center "'ate night snac1": 'AT(ral is snac1ing #feeding( center. 8herefore, ventromedial is satiety center. Spinal tracts: simpli*ied geography < posterior: cross at the medulla. < lateral: ipsilateral (same side). < anterior: cross at the spinal level. = 3ee diagram. = $ote 9: -escending tracts on left of figure, ascending tracts on right. = $ote >: Cor ipsilaterals: one never crosses, one crosses at the level then doubles back farther up. 8he ipsilateral that crosses at the level (ventral spinocerebellar) is the ipsilateral closest to the > anterior ones, which also cross at the level. = 8ract names in each group: 'osterior >: lateral corticalspinal, dorsal columns. 6ateral >: dorsal spinocerebellar, ventral spinocerebellar. 2nterior >: ventral corticospinal, spinothalamic. Spinal tracts: +racilus vs. Cuneatus: origin *rom upper vs. lo2er lim$s +racilus is the name of a muscle in the legs, so Casciculus +racilus is for the lower limbs. +y default, Casciculus ,uneatus must be for upper limbs. Precentral vs. postcentral gyrus: motor vs. sensory <ust an extension of the rule that anterior D ventral D efferent D motor. 8he precentral gyrus is on the anterior side of the brain, so is therefore motor. ranchial arches: cranial nerve innervation %n 3ensory/5otor/+oth mnemonic "3ome 3ay 5arry 5oney ut 5y rother 3ays ig oobs 5atter 5ore", the "s also give rancial arch nerves in order: ut (,$ I): 9st arch rother (,$;): >nd arch ig (,$J): rd arch oobs (,$ 9@): Eth arch Temporal lo$e: location o* high vs. lo2 *reEuency recognition 8he $ass cle* looks like an ear. 8herefore, the $ass cle* #low fre1uency( is closer to the ear, and the treble clef #high fre1uency( is more medial. Cranial nerves: ol*actory and optic num$ers "Hou have t2o eyes and one nose": )ptic nerve is cranial nerve t2o. )l*actory nerve is cranial nerve one. = 2lternatively, note alphabetical order: o'factory, and oPtic. /entricle aperatures: converting the t2o nomenclature types Magendie foramen is the Medial aperture. 'uschka foramen is the 'ateral aperture. asal ganglia: indirect vs. direct path2ay 8he %ndirect pathway %nhibits. -irect pathway is hence the excitatory one. CS0 circulation: *unction o* choroid vs. arachnoid granules Choroid Creates ,3C. Arachnoid granules Absorb ,3C. +AA vs. +lu: the excitatory vs. inhi$itory transmitter in $rain 3eg in $asal ganglia6 !hen you +lue two things together, you add (D) those things together, therefore +lu is the excitatory one (D). B2+2 is therefore the negative one. Pituitary: 2hich hal* is the adenohypophysis 8he Anterior pituitary is the Adenohypophysis. roca's vs. #ernic1's area: e**ect o* damage to speech center "roca": your speech machinery is ro1en. = +roca is wanting to speak, but articulation doesn"t work, and very slow. "#er-nic1": "2ere" and "nic1" are both words of *nglish language, but together they are nonsensical. = !ernick is having good articulation, but saying words that don"t make sense together. 'o2er vs. upper motor neuron lesion e**ects 9. "ST)RM, a$y" >. "%n a 'o2er motor neuron lesion, everything goes !o2n: = 38&45 +aby tells you effects: Strength Tone )ther Reflexes Muscle mass a$inski"s sign = %n 6ower all things go down: strength, tone, reflexes, muscle mass, and the big toe down in plantar reflex (+abinski"s sign is big toe up: toe up D K5$6).
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