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Neurology Mnemonics

Peripheral nervous examination "Tall People


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).