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Flashcards in Final Deck (80)
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1
Q

What are the functions of the posterior column?

A

Vibration, conscious proprioception, 2 point and light touch

2
Q

What are the functions of the lateral spinothalamic tract?

A

pain and temp (crosses at level)

3
Q

What are the functions of the vestibular system?

A

Balance and spatial coordination

4
Q

What are the functions of the cerebellar system?

A

Motor control coordinating voluntary movements.

5
Q

What are the functions of the Motor system - corticospinal tract?

A

Carries motor and crosses in the brain stem.

6
Q

What are some characteristics of the confusional states?

A

Decreased level of consciousness, often reversible example: head injury

7
Q

What are some characteristics of dementias?

A

Cognitive function and intellectual decline often irreversible. Example: Hemmorage or stroke.

8
Q

What would the patient complain of with a brain lesion?

A

Mental status changes, HA, seizures, ICP visual complaints.

9
Q

What would the patient complain of with a Pyramidal system lesion?

A

Uncoordinated voluntary actions

10
Q

What would the patient complain of with a brainstem lesion?

A

Cranial nerve deficits

11
Q

What would the patient complain of with a extrapyramidal system lesion?

A

Alterations in the involuntary movements (athetosis, resting tumor, tics, dystonia).

12
Q

What would the patient complain of with a cerebellar lesion?

A

Uncoordinated motor movements; gait, stance

13
Q

What would the patient complain of with a spinal cord lesion?

A

Dissociation of sensory loss, there may be LMN deficits if anterior horn or nerve root is also involved.

14
Q

What would the patient complain of with a peripheral NS lesion?

A

Dermatomal distribution complaints, NTW

15
Q

What neuro exam finding would be present with a brain lesion?

A

Mental status changes, motor/sensory deficits CONTRALATERAL to side of lesion (neuro signs/sx are dependent on where the lesion is located)

16
Q

What neuro exam finding would be present with a brainstem lesion?

A

CN deficits are usually ISPILATERAL, and motor/sensory deficits are CONTRALATERAL to the lesion (Classical cross pattern)

17
Q

What neuro exam finding would be present with a cerebellar lesion?

A

Ataxia and intention tremor deficits are IPSILATERAL to the lesion past pointing, dysmentria

18
Q

What neuro exam finding would be present with an extrapyramidal lesion?

A

Resting tremors, chorea, athetosis, tics.

19
Q

What neuro exam finding would be present with a spinal cord lesion?

A

UMN signs, motor/sensory deficits IPSILATERAL to the lesion, pain/temp CONTRALATERAL to the lesion.

20
Q

What neuro exam finding would be present with a peripheral NS lesion?

A

LMN signs, flacid weakness, atrophy, fasculations hyporeflexia in dermatomal or plexus pattern.

21
Q

What are the 4 types of Aphasia?

A
  • Brocca’s (poor speaking/caveman speech)
  • Wernicke’s (poor comprehension)
  • Conductive (pt has intact comprehension but can’t explain what they understand)
  • Global (poor speaking and comprehension)
22
Q

Anomia

A

Inability to use or recognize names

23
Q

Confabulations

A

The attempt to fill in memory gaps with false recollections.

24
Q

Dysarthria

A

Disturbance of articulation

25
Q

Dysphonia

A

Inability/dysfunction of phonation; hoarseness

26
Q

Dysmetria

A

Disturbance of the movement towards a target

27
Q

Dysesthesia

A

Disturbance of sensation

28
Q

Paresthesia

A

Sensation of tingling, pricking of numbness

29
Q

Ataxia (cerabella)

A

Staggering, clumsy, drunken; seen in cerebellar disease, alcohol intoxication, and MS

30
Q

Ataxia (Sensory)

A

Slapping foot gait, tabetic; commonly seen in posterior column diseases, tabes dorsalis, polyneuropathy

31
Q

Apraxia

A

Inability to perform previously learned task.

32
Q

Agnosia

A

Inability to recognize common stimuli (objects, colors, sounds, etc.)

33
Q

Astereognosis

A

Inability to identify an object by touch.

34
Q

Agraphesthesia

A

Inability to identify a number written on the hand

35
Q

Agraphia

A

Inability to write

36
Q

Alexia

A

Inability to read

37
Q

Dystonia

A

Abnormal movements resulting in sustained abnormal postures.

38
Q

Athetosis

A

Slow, writhing movements

39
Q

Chorea

A

Involuntary and unpredictable rapid irregular muscle jerks

40
Q

What are the different types of tremors?

A
  • Resting (Basal ganglia)
  • Intention (Cerebellar)
  • Chorea
  • Athetosis
  • Distonia
41
Q

Myoclonus

A

Sudden rapid twitchlike muscle contractions

42
Q

Characteristics of UMN lesion

A

Mild/late atrophy, clonus, hyperreflexia, absent abdominal reflex, spastic muscle tone, EMG/NCV normal.

43
Q

Characteristics of LMN lesion

A

Atrophy, fisiculations, hyporeflexia, abdominal reflex is normal, flaccid muscle tone, EMG/NCV positive for fibrillations.

44
Q

Dominant cerebral hemisphere vs. non-dominant

A

Language center is usually in dominant hemisphere.

45
Q

Papilledema

A

Swelling of optic nerve

46
Q

Optic atrophy

A

Atrophy of optic nerve

47
Q

Paralysis vs. paresis

A
Paralysis = total loss of voluntary motor control;
Paresis = a partial loss of voluntary motor control
48
Q

Clonus

A

Series of reflex contractions of a muscle which has been suddenly stretched

49
Q

Hypotonia vs. Hypertonia

A
Hypo = reduced resistance to PROM, flaccidity
Hyper = rigid usually d/t extrapyramidal lesion
50
Q

Scotoma

A

Irregular visual field deficit

51
Q

Signs of meningeal irritation

A

Kernigs/brudzinski signs, nuchal rigidity, spinal rigidity.

52
Q

Hemiplegic gait

A

Swinging gait; commonly seen in strokes

53
Q

Scissor gait

A

Spastic (due to spasticity of adductor mm); seen in cerbral palsy and myelopath

54
Q

Steppage gait

A

Equine or foot drop gain; seen in L5 radiculopathy or peroneal nerve disease or weakness of tibialis anterior.

55
Q

Apraxic Gait

A

Magnet gait due to diffuse cerebral damage; seen in alzheimers, huntingtons, and hydrocephalus.

56
Q

Waddling Gait

A

Seen in weak gluteus muscles and muscular distrophy; trendelenburg may be +

57
Q

Festinating Gait

A

Shuffling gait, short steps, hard to start and stop; seen in parkinsons

58
Q

Bells palsy

A

Dysfunction of cranial nerve VII

59
Q

Trigeminal Neuralgia

A

Disorder of CN V and causes stabbing or electric shock-like pain in the face.

60
Q

Ocular palsys

A

CN VI causes double vision

61
Q

Acoustic Neuroma (Cerebellopontine angle tumor)

A

Slow growing tumor on CN VII; causes problems with balance and hearing.

62
Q

Chronic alcoholic encephalopathy

A

Wernickes encephalopathy and Korsadoffs dementia

63
Q

Wernickes Encephalopathy

A

B1/thiamine deficiency seen in chronic alcoholics and severe malnutrition; usually reversible; sx = confusional states, ophtalmoplegia, ataxia; tx = abstinence, IV injections of B1, detox.

64
Q

Korsakoffs Dementia

A

A continuation of Wernickes Encephalopathy, seen in chronic alcoholics; IRREVERSIBLE; affects the temporal lobe; causes amnestic dementia (can’t form new memories)

65
Q

Acute confusional states caused by alcohol withdrawal.

A

Hallucinations being ~ 48 hours after stopping; may get seizures (poor prognosis); Delirium Tremens begin 3-5 days post and last up to 72 hours (15% risk of mortality)

66
Q

Meningitis

A

Viral or Bacterial causes flu-like sx: stiff neck, petechia, body rash, seizures and confusional states. LOC possible. Assume bacterial until proven otherwise.

67
Q

1st degree concussion

A

Mild no LOC (dazed or stunned ) PTA <30 mins

68
Q

2nd degree concussion

A

LOC < 5 min; PTA 30 minutes to 24 hours

69
Q

3rd degree concussion

A

LOC > 5 min; PTA > 24 hours

70
Q

Second impact syndrome

A

A person who has sustained 1 minor head injury has a 4 fold increase in risk of heaving a second concussive injury; second impact triggers a rapidly declining sequella w/ 1 seconds to minutes.

71
Q

Boxers dementia (Pugliestica dementia)

A

Dementia cause by multiple concussions.

72
Q

Epidural hematoma/hemorrhages

A

MC results from a lateral skull fx; lacerates middle meningeal A; Most rapid bleed (minutes to hours); medical emergency.

73
Q

Subdural hematoma

A

Following trauma can be acute (minutes to hours), subacute (days-weeks), or chronic (weeks to months); most commonly presents as a slower bleed venous bleeding; usually not associated with skull fractures; elderly are more susceptible.

74
Q

Intercerebral Hemorrhages

A

Coup/contracoup injuries; typically located at the frontal/occipital lobes; SX = altered LOC, HA, signs of meningeal irritation, may have focal brain signs.

75
Q

Subarachnoid Hemorrhages

A

Most occur spontaneously and are d/t congenitally abnormal blood vessels in circle of willis resulting in a rupture into the subarachnoid space; SX = severe rapid HA, altered LOC, meningeal irritation and nausea and vomiting.

76
Q

What are some red flags for serious and immediate emergency referral?

A

“I need my very special head protection” signs of open injury/skull fx, glasgow coma scale

77
Q

What is the glasgow coma scale?

A

Scores level of consciousness on a 3 to 15 point scale; can be used as an outcome marker.

78
Q

What are some signs of dementia?

A

Loss of memory, disorientation, loss of judgment, loss of abstract thinking, loss of ability to calculate.

79
Q

What are some causes of dementia?

A

Alzheimer’s, multi-infarct dementia, trauma, hydrocephalus, metabolic (B12) deficiency, infections, drugs/toxins, brain tumors, parkinsons, hereditary.

80
Q

Multi-infarct dementia

A

Vascular dementia from multiple tiny strokes over time; associated with hypertension and diabetes.