Feb 252019

Neurology is the branch of medicine concerned with the study and treatment of disorders of the nervous system. The nervous system is a complex, sophisticated system that regulates and coordinates body activities. It has two major divisions: Central nervous system: the brain and spinal cord. Medicos Library has provided high standard Neurology Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Anatomy of hindbrain

  • The hindbrain comprises: – The myelencephalon (medulla oblongata and lower part of the fourth ventricle) – The metencephalon (pons, cerebellum and intermediate part of fourth ventricle), and – Isthmus rhombencephalon.
  • The medulla oblongata opens into the fourth ventricle.
  • The nucleus ambiguous gives rise to fibres of the accessory, vagus and glossopharyngeal nerves.
  • The locus caeruleus receives sensory fibres from the trigeminal nerve.
  • The three parts of the cerebellum include the vermis and the two hemispheres which are confluent.
  • The pyramids (spinothalamic tracts) are medial to the olives.
  • The median portion of the cerebellum is the vermis and the cerebellar hemispheres lie lateral to it.

Gross anatomy

  • Difficulties with task sequencing and executive skills
  • Expressive (Broca’s) aphasia: located on the posterior aspect of the frontal lobe, in the inferior frontal gyrus. Speech is non-fluent, laboured, and halting
  • disinhibition
  • perseveration
  • anosmia
  • primitive reflexes (positive grasp, pout and palmomental reflexes)
  • inability to generate a list
  • Changes in personality.

A unilateral parietal lobe lesion, left or right, causes:

  • contralateral hemihypesthesia
  • mild hemiparesis
  • parietal ataxia
  • homonymous hemianiopia
  • inferior quadrantanopia, and unilateral impairment of optokinetic nystagmus.

A left (usually dominant) parietal lesion causes the above signs in addition to sensory aphasia, Gerstmann syndrome (dysgraphia, dyscalculia, finger agnosia, left-right disorientation), bilateral apraxia and tactile agnosia.

A right (usually non-dominant) parietal lesion also causes left extinction phenomenon, left visual neglect, neglect of the left side of the body, anosognosia, impaired spatial processing and dressing apraxia.

Biparietal lesions result in markedly impaired orientation and spatial processing and ataxia.

Advice form Dr. Yousif Abdallah Hamad

How to use the notes to study for MRCP:

  • Initially, you need to skim through the notes at least twice to build up an idea about the syllabus of MRCP. Highlight any portion that is difficult so that you can concentrate on that during your revision.
  • Next proceed to the question banks. You can choose to do Passmedicine, onexamination or Pastest. I usually recommend students to do Passmedicine and the Pastest.
  • As you go through the questions make a super-revised notes of your own. Write down in one sentence what you learned from the question you just attempted.
  • If you get any question wrong or you get confused then return to the notes and re-read one more time before attempting the question again. And write down the point in red in you revision notes so that you can skim through it easily during your revision.
  • I have highlighted some points in yellow and green to help you concentrate on those points. As you go through passmedicine and pastest, you can highlight the points further to help in your revision.
  • During your revision before the main exam, only read the highlighted portions including those that you highlighted when practicing the question bank. And also read your super-revised notes that you made from the question banks.

I believe these method has worked for many students and will help you in your journey to be successful in MRCP part 1 and as well as build your basics for Part 2.

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