25 - Neurological

Question 1

Central nervous system (CNS):

Answer 1

brain + spinal chord

Question 2

Frontal lobe

Answer 2

personality, behaviour, emotion, intellectual function. Contains brocas area + precentral gyrus (primary motor area)

Question 3

Parietal lobe

Answer 3

sensation. Contants postcentral gyrus (primary sensory area)

Question 4

Occipital lobe

Answer 4

visual reception

Question 5

Temporal Lobe

Answer 5

hearing, taste, smell. Contains Wenike’s area

Question 6

Cerebellum

Answer 6

motor coordination, equilibrium, balance

Question 7

Wenike’s area

Answer 7

associated with language comprehension

Question 8

Brocas area

Answer 8

mediates the motor speach

Question 9

Basal Ganglia

Answer 9

grey matter that initate/coordinates movement

Question 10

Thalamus

Answer 10

relay station. Sensory pathways form synapses on way to cerebral cortex

Question 11

Hypothalamus

Answer 11

Major respiratory center. Regulate temperature, heart rate, blood pressure, sleep, appitte

Question 12

Spinal Cord

Answer 12

mediates posture control, urination and pain responce

Question 13

Crossed representation

Answer 13

left cerebral cortex receives sensory info from and controls motor function to the right side of the body and vice versa.

Question 14

Spinothalamic tract

Answer 14

sensory fibers that transmit sensations of pain, temperature, touch.

Question 15

Posterior (dorsal) column

Answer 15

conduct sensation for localized touch (seriognosis), position and vibration, proprioception. Enter dorsal root medulla thallmus sensory cortex

Question 16

Corticospinal or pyramidal tract

Answer 16

voluntary puposfull movementment (like writing).

Question 17

Extrapyramidal tracts

Answer 17

muscle tone control of body movements like gross motor movements like walking

Question 18

Cerebellar system

Answer 18

coordinated movement, maintains posture

Question 19

Upper motor neurons

Answer 19

in CNS, Ex. Corticospinal, Extrapyramidal tracts, corticobulbar. Diseases use ALS, MS

Question 20

Lower motor neurons

Answer 20

in PNS, ex. Cranial nerves, spinal nerves of PNS. Diseases are spinal chord lesions, poliomucelitis, amyotrophic lateral sclerosis

Question 21

Nerve

Answer 21

bundles of fibers that exist outside of CNS

Question 22

Reflex

Answer 22

basic defense mechanisms of the nervous system, involuntary and offer quick reaction to potential harm

Question 23

Peripheral Nervous System

Answer 23

Outside of the CNS
Carries input to the CNS
Delivers output from the CNS

Question 24

Syncope

Answer 24

medical term for fainting or passing out.
sudden loss of strength and temportary loss of consciousness (fainting) caused by lack of cerebral blood flow like with low bp

Question 25

Vertigo

Answer 25

sensation of rotational spinning

Question 26

Screening neurological examination

Answer 26

screening on healthy patient

Question 27

Complete neurological examination

Answer 27

done on patient with neurological concerns

Question 28

Neurological recheck examination

Answer 28

done on patients with demonstrated neurological deficts who require periodic assessments

Question 29

Corneal Reflex

Answer 29

touch coreal area with bit of cotton and it should automatically close.

Question 30

Gait

Answer 30

normally smooth, rhythmic ad effortless with swinging arms. Step length is approx.. 30cms from heel to toe Cerebellar function Balance tests

Question 31

Tandem walking

Answer 31

patient walks in a straight line in a heel-to-toe manner. This decreases base of support and accentuates problems with coordination Cerebellar function Balance tests

Question 32

Rapid Alternating Movements

Answer 32

pat knee with both palms, then flip to the back on hands and pat with those. Repeat increasing speed. Or. touch thumb to each finger on same hand then reverse firsction Cerebellar function Coordination and skilled movements

Question 33

Finger-to-finger Test

Answer 33

with eyes open, ask patient to touch your finger than their own nose. Move your finger to a dif location Cerebellar function Coordination and skilled movements

Question 34

Finger-to-Nose Test

Answer 34

ask patient to close eyes, stretch out arms then touch nose with each index figner, alternating hanfs. Cerebellar function Coordination and skilled movements

Question 35

Heel-to-Shin Test

Answer 35

patient lies down, places heel on the opposite knee, run it down fthe shin from knee to ankle, switch legs. Cerebellar function Coordination and skilled movements

Question 36

Vibration

Answer 36

close eyes, hold tuning fork at base of joint finger/big toe and ask what they feel. If they feel that the nerve is in tact. Then move up the nerve. If the nerve is intact distally it’s also intact proximally. Posterior column tract

Question 37

Proprioception

Answer 37

with their eyes close you move their finger/toe up/down and ask which direction it’s moved Posterior column tract

Question 38

Stereognosis

Answer 38

patients ability to recognize objects by feeling their form, size, weight with eyes closed Posterior column tract Tactile discrimination

Question 39

Graphesthesia

Answer 39

ability to read a number by having it traced on the skin. Close eyes then use blunt instrument to trace letters on patients palm Posterior column tract Tactile discrimination

Question 40

Two-point discrimination

Answer 40

patients ability to distinguish two simultaneous pinpoints on skin. Apply two points of an open paper clip lightly to skin in ever-closing distances. Distances is most sentitive in fingertips and lest sensitive in upper arms/tight/back Posterior column tract Tactile discrimination

Question 41

Extinction

Answer 41

simultaneously touch both sides of the body at the same point. Ask patient to state how many sensations felt. Normally both sides are felt. Posterior column tract Tactile discrimination

Question 42

Point location

Answer 42

touch the skin and withdraw stimulus promptly. Tell the patient to point where they were touched. Posterior column tract Tactile discrimination

Question 43

Clonus

Answer 43

set of rapid, rhythmic contractions of the same muscle

Question 44

Hyper-reflexia

Answer 44

exaggerated reflex that occurs when the monosynaptic reflex arch is released from usually inhibiting influence of higher cortical levels.

Question 45

Hyporeflexia

Answer 45

reduced functioning of a reflex. Soemtimes reflex absent

Question 46

Biceps Reflex

Answer 46

but your thumb on bicepts tendon and stike your thumb. Normal: bicep contracts, forearm flex

Question 47

Triceps Reflex

Answer 47

strike tricepts tendon directly above elbow. Normal: forarm extension

Question 48

Brachioradialis Reflex

Answer 48

stike forarm aprox 2-3cm above radial styloid process. Normal: flexion of forearm and supination of palm (palm turns up)

Question 49

Patellar Reflex

Answer 49

stike tendion just below patella. Normal: extension of lower leg

Question 50

Achilles Reflex

Answer 50

strike achieles tendion. Normal: foot plantar flexes (push down) against your hand (you fordoflex the foot holding it up them the reflex)

Question 51

Reinforcement

Answer 51

technique to relax the muscles and enhance the response.

Question 52

Abdominal Reflex

Answer 52

lightly strike the abdomen on each side above and below the umbilicus and abdominal muscle will contract and umbilicus will deviate towards the side that’s beign tested. (doesn’t work for pregnancy/obsese)

Question 53

Cremasteric Reflex

Answer 53

lighght touch inner thigh and the testes will life up/contract. Causes the creamasteric muscle to contract.

Question 54

Plantar Reflex

Answer 54

end of reflex hammer and stoke foot from heel to ball of foot curing inwards at toe. Normal: the toe should flex Abnoraml is Babinski (dorsiflexion/extension of toe)

Question 55

Kernig's sign

Answer 55

raise on leg and flex at knee/hip. Ask them to straighten their leg. Normal: Discomfort behind knee. Abnormal: Pain in hamstring/resistance to extention is seen in meningeal irritation **also McMurry Test

Question 56

Dyskinesias

Answer 56

involuntary movement

Question 57

Glasgow coma scale

Answer 57

``` Assess the functional state of the brain Standardized assessment Numerical value Normal is 15 <7=coma ```

Question 58

fasciculation

Answer 58

Rapid, continuous twitching of resting muscle Fine: Occurs with lower motor neuron disease, associated with atrophy and weakness Coarse: Occurs with cold or fatigue

Question 59

paralysis

Answer 59

Decrease or loss of motor power Motor nerve or muscle fibre problems Acute causes: ex. trauma, spinal cord injury, CVA, Belly’s palsy > Hemiplegia - being paralyzed on one side of the body > Paraplegia - being paralyzed from the waist down > Quadriplegia - paralysis of arms and legs > Paresis - muscle movement has become weakened or impaired (mild/moderate) > Monoplegia - paralysis in one limb

Question 60

Tic

Answer 60

Involuntary, compulsive, repetitive twitching of a muscle group Neurological cause, tardive dyskinesias, Tourette’s syndrome, psychogenic cause

Question 61

myoclonus

Answer 61

Rapid, sudden jerk or a short series of jerks at fairly regular intervals Can be mild or severe (hiccup, seizures)

Question 62

Tremor

Answer 62

Involuntary contraction of opposing muscle groups Rhythmic, back and forth movement Disappear during sleep May be slow or fast

Question 63

Rest Tremor

Answer 63

when the muscle is relaxed, such as when the hands are resting on the lap. With this disorder, a person's hands, arms, or legs may shake even when they are at rest. Often, the tremor only affects the hand or fingers Coarse and slow Partly or completely disappears with voluntary movement Parkinsonism

Question 64

Intention tremor

Answer 64

a rhythmic, oscillatory, and high amplitude tremor during a directed and purposeful motor movement, worsening before reaching the endpoint. Worse with voluntary movement Occurs with cerebellar disease and MS Essential tremor (familial)- more common in older adults, benign

Question 65

Chorea

Answer 65

Sudden, rapid, jerky, purposeless movement involving limbs, trunk, or face Not rhythmic or repetitive More compulsive than a tic Huntington’s

Question 66

Athetosis

Answer 66

Slow, twisting, writhing, continuous movement Resembles a snake or worm Cerebral Palsy