Lecture 1 Flashcards
3 elements of consciousness
Arousal
alertness
awareness
structures required for level of consciousness
Reticular activating system= reticular formation, nucleus, tegmentum (midbrain), intralaminar nucleus of thalamus and dorsal thalamus
cerebral hemisphere
Orientation
to: person, place, time
Language
- expression
- comprehension
- repitition
- naming
Structures required for language
- expression = Brocas area
- comprehension = Wernicke’s area
- repetition= Acute fasciculus
- Naming = verbs/functor: frontal lobe; nouns = temporal-parietal lobe
structures for attn and concentration
- cognitive ideas = frontal-subcortical network
- visual-spatial attn = Non-dominant parietal lobe
Structures for memory
- encoding and consolidation of memory = hippocampus
- retrieval of memory = frontal-subcortical system
structures for semantic knowledge
temporal and parietal lobe
CN localization in brain
Midbrain = CN II, III, IV Pons = CN V, VI, VII, 1/2 of VIII Medulla = 1/2 of VIII, IX, X, XI, XII
CN III paralysis
cannot abduct or look up/down
also have ptosis of eyelid
CNIV paralysis
exotropia to R
CN VI paralysis
esotropia and no abduction
horizontal homonymous diplopia
CN VII paralysis : LMN vs UMN
LMN: ipsilateral facial paralysis with impaired forehead wrinkling
UMN: lower half of face is paralyzed, eye closure and forehead wrinkling preserved
Unilateral paralysis of CN IX and X
deviation of uvula to side of lesion
CN XIII paralysis
tongue deviation to side of lesion
hypotonia
decreased muscle tone
seen in LMN lesions, spinal shock and cerebellar lesions
hypertonia
increased, spasticity or rigidity
-seen in pyramidal lesions (spasticity); bilateral frontal lobe lesions (paratonia); extrapyramidal lesions (rigidity)
Upper Extremity muscle strength
- shoulder abduction = C5, C6
- Elbow flxn = C5, C6
- elbow extn = C5. C6 (radial nerve)
- finger spreading = C8, TI (ulnar nerve)
- thumb opposition = C8, TI (median nerve)
Lower extremity muscle strength
- hip flexion = L1, L2
- knee flexion = L5, S1, S2
- knee extn = L2, L3, L4
- Foot dorsiflexion = L4, L5
- Foot plantar flexion = S1, S2
DTR: Upper extremities
Biceps: C5, C6
Triceps: C7
Brachioradials: C6
DTR: Lower extremities
Patella: L4
Achilles: S1
Babinski reflex
(+) sign = dorsiflexion of big toe
Upper motor neuron lesion
Cerebeller sensory signs
dysmetria, dysdiodochokinesis, Romberg (coordination)
Gait and stance
