Ch. 1 - Neuro assessment and exam Flashcards Preview

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Flashcards in Ch. 1 - Neuro assessment and exam Deck (15)
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1

Confabulation

Severe disorientation and memory disturbance causing pt to make up stories to provide a convincing answer to questions; seen in alcoholism (Korsakoff's psychosis) or anterior hypothalamic lesions

2

Mutism

Pt is alert but makes NO ATTEMPT to speak; lesions to medial aspects of both frontal lobes (e.g. vasospasm s/p SAH)

3

Phalilalia

repetition of a particular syllable; can be seen in Parkinson's

4

Brain death exam

lack of pupillary response to light
lack of corneal reflex to stimulation
lack of oculocephalic reflex
failure of vestibulo-ocular testing
failure of gag or cough reflex
no motor response in face or muscles or CN in response to pain stimuli
failure of respiratory movements off ventilator and after PaCO2 has risen to 50 mmHg
tests need to be repeated after 30 min and by at least 2 doctors

5

What is the most important neurological sign indicating major intracranial pathology?

DROWSINESS

6

4 main speech disorders

Mutism, Aphonia, Dysarthria, Dysphasia

7

Aphonia

Pt able to speak but UNABLE TO PRODUCE any volume of sound 2/2 disturbance of vocal cords or larynx; if pt can cough then it is hysterical

8

Dysarthria

Impaired coordination of lips, palate, tongue, larynx 2/2 extrapyramidal, brainstem, or cerebellar lesions

9

Spastic vs. ataxic dysarthria

Spastic - 2/2 bilateral UMN dx (pseudobulbar palsy, motor neuron dx, or brainstem tumors)
Ataxic - incoordination of muscles of speech (staccato or scanning speech) 2/2 cerebellopontine angle tumors, cerebellar lesions, MS, and phenytoin toxicity

10

Expressive dysphasia

Pt can understand speech but cannot FORMULATE their own speech; 2/2 lesion in Broca's area or left posterior temporoparietal region

11

Receptive dysphasia

Cannot UNDERSTAND spoken or written speech; 2/2 lesion in Wernicke's area

12

Alexia

Inability to understand written speech; alexia with agraphia (inability to write) is 2/2 lesion in let angular gyrus

13

'Clasp knife' spasticity

Resistance is most pronounced when movement is first made; sign of UMN lesion

14

'Lead pipe' rigidity

Equal resistance to all movements; characteristic of lesion in extrapyramidal system

15

'Cog wheel' rigidity

Alternating jerky resistance to movement; degenerative lesions of extrapyramidal system (esp. Parkinson's dx)