Neuro Flashcards
(133 cards)
1
Q
Frontal Lobe for?
A
behavior, judgement
2
Q
Parietal Lobe for?
A
sensory processing
3
Q
Temporal Lobe for?
A
auditory processing, memory
4
Q
Occipital Lobe for?
A
visual/spatial processing
5
Q
Thalamus for?
A
relay visual, sound, sensation
NOT motor
6
Q
Basal Ganglia for?
A
automated movements
7
Q
Brainstem contains?
A
CNs, arousal, descending motor tracts, ascend sensory, respiratory
8
Q
Cerebellum does?
A
coordinates voluntary movement, balance
9
Q
Spinal cord ends where?
A
T12-L1
10
Q
Cord injury above C5 =
A
death
11
Q
Myelopathies are?
A
diseases of spinal cord
12
Q
Corticospinal Tract carries?
A
voluntary motor movement,
nerves from motor cortex CROSS to contra-lateral side of medulla
13
Q
Spinothalamic Tract carries?
A
carries light touch,
pain,
temp,
pressure
14
Q
Posterior Columns carry?
A
carry vibration,
proprioception,
discriminative touch
15
Q
Exam for CNS includes (4)?
A
1) gait
2) romberg
3) reflex
4) tone
16
Q
Myopathies are?
A
disease of mm
17
Q
PNS muscle exam includes? (3)
A
1) bulk
2) strength
3) tone
18
Q
Neuromuscular jxn diseases characterized by?
A
proximal weakness and fatigue,
improves w/ rest
19
Q
Neuromuscular jxn exam includes? (2)
A
1) strength
2) fatigue
20
Q
Peripheral neuropathies are?
A
diseases of peripheral nerves
(U) diffuse
21
Q
PNS nerve exam includes?
A
1) sharp/dull
2) vibration
3) proprioception
4) mm strength
22
Q
Brachial plexus located?
A
C5-C8
23
Q
Lumbosacral plexus located?
A
L3-S1
24
Q
Plexopathies characterized by? (3)
A
1) loss of reflex
2) widely distributed weakness
3) multifocal numbness (w/ or w/o pain)
25
Most plexopathies caused by?
compression or infiltration
26
PNS plexus exam includes? (3)
1) strength
2) motor
3) reflex
27
Radiculopathies are?
diseases of nerve root
| (U) localized
28
Radiculopathies U from?
compression or other mechanical
29
Cervical roots for UE located?
C5-8
30
Injury to roots causes?
1) lancinating dysesthetic pain (stabbing pain when touched)
2) focal weakness
3) reflex loss
31
Lumbsacral roots to LE located?
L3-S1
32
of spinal nerve pairs?
```
31
C=8
T=12
L=5
S=5
Coc=1
```
33
Location of reflex:
Biceps
Triceps
Patellar
Achilles
```
B = C5,6
T = C7,8
P = L3,4
A = S1,2
```
```
"reflex dance" to help remember:
1,2 achilles
3,4 patellar
5,6 biceps
7,8 triceps
```
34
Integrity of reflex dependent on what 3 things?
Afferent
Synaptic
Efferent neurons
35
Syncope?
brief LOC
36
JOMAC is?
```
mental status exam:
Judgement
Orientation
Memory
Affect
Cognitive
```
37
Pronator Drift tests for?
contralateral upper motor neuron lesion
38
Romberg test for?
balance
| eyes closed, feet tog
39
Thumb dermatome?
C6
40
Middle finger dermatome?
C7
41
5th digit dermatome?
C8
42
Nipple line dermatome?
T4
43
Umbilicus dermatome?
T10
44
Anterior thigh dermatome?
L3
45
Anterior shin dermatome?
L4
46
Top of foot dermatome?
L5
47
Bottom of foot dermatome?
S1
48
2 Point Test?
(cortical sensory)
fingertips: 2mm
toes: 3-8mm
palms: 8-12mm
back: 40-6o-mm
49
Stereognosis test?
(cortical sensory)
| identify object
50
Graphesthesia test?
(cortical sensory)
| draw letter in palm
51
Tactile Location test?
(cortical sensory)
| touch pt in two separate places, opp side of body
52
Finger-to-Nose exam for?
cerebellar disease
53
Finger-to-Nose exam for?
cerebellar disease
54
Heel-to-shin exam for?
cerebellar disease
55
Rapid alternating movement test?
pronate/supinate forearms
| for cerebellar disease
56
Dysdiadochokinesia is?
inability to do rapid alternating movements
57
Gait exams test for?
cerebellar disease
58
Kernig's Sign?
for meningeal irritation
pt supine, flex hip/knee, straighten leg
+ if low back pain
59
Dysphoric is?
unhappy
60
Obtundation is?
hard to arouse
slow/confused responses
decreased interest in surroundings
61
Stupor is?
unresponsiveness w/o painful stimuli
62
Dysarthria is?
problem w/ motor speech/articulation
63
Dysphonia is?
weak, breathy voice
64
Aphasia is?
impaired ability to speak, write
65
Expressive (Broca's) Aphasia?
comprehension intact
| speech disability
66
Receptive (Wernicke's) Aphasia?
comprehension not intact
| fluent, nonsensical speech
67
Global Aphasia?
combo of Expres/Recept
68
Apraxia is?
```
inability to perform a learned motor act:
don't understand command
don't remember command
motor ability is intact
(U) parietal lobe lesion
```
69
Agnosia is?
inability to recognize sensory (any kind) stimuli
| (U) large parieto-occipital-post temporal lesion
70
Accelerating levels of awareness? (4)
Alert ->
Vigilant ->
Hypomaniac ->
Manic
71
Decelerating levels of awareness? (8)
```
Alert ->
Relaxed ->
Lethargic ->
Somnolent ->
Obtunded ->
Stuporous ->
Comatose ->
Death
```
72
Coma is?
Localized to?
sustained LOC doesn't reverse w/ internal or external stim
impaired bilat thalamus
bilat hemispheric injury
midbrain or below injury
73
Lethargy (somnolence) is?
aroused w/ light stim
74
Delirum is?
hypervigilant w/ agitation and impaired attention
75
Confused is?
impaired attn, incoherent thougnt
76
Fugue is?
sudden abandonment of life to start new life w/o later memory of the fugue
77
Catatonia is?
psychomotor disturb in schizophrenia
78
Coma glasgow score of < 8 for >72 hrs means?
very poor prognosis
79
Coma Vigil/Alpha Coma?
Pt appears awake but still brain dead:
open eyes
cough, yawn
move extremities
80
Decorticate posturing?
extended legs, plantarflex
arms tight against chest w/ flexed wrists
from lesion in corticospinal tract: cortex to up midbrain
81
Decerebrate posturing?
legs and arms out straight, flexed feet/hands and neck
from damage to cortispinal tract at pons or upper medulla
82
Brain herniation etiology?
2º to ↑ ICP from trauma, lesions
83
Brain herniates where?
under falx
| thru tentorium or foramen mag
84
3rd Nerve Palsy presents?
unilateral, fixed, dilated pupil
| ptosis
85
3rd Nerve Palsy etiology?
uncal brain herniation,
| aneurysm compressing CN III
86
L 4th nerve Paralysis (paralytic strabismus) presents?
L eye can't look down while looking medially
87
L 6th nerve Paralysis (paralytic strabismus) presents?
looking forward, L eye esotropic (looks medially)
looking L, L eye look straight ahead
88
Pupils fixed at midposition (2-5mm) from?
midbrain lesion
89
Pinpoint and reactive pupils from?
pontine lesion
90
Unilateral fixed pupil dilation from?
CN III lesion
| uncal herniation
91
Bilateral fixed pupil dilation from?
central hernia
| hypoxia
92
Oculocephalic Reflex (Doll's Eyes) presents?
eyes open, rotate head side-side
eyes roll same direction as head instead of opp direction
93
Oculocephalic Reflex from?
midbrain or pons lesion
| CN III - VIII lesion
94
Vestibulocochlear Reflex presents?
head at 30º
cold water in ear causes fast nystagmus away from ear
normal response would be slow turn toward ear
95
Vestibulocochlear Reflex from?
brainstem lesion
| CN III - CN VI
96
Cheyne-Stoke respiration in coma?
apnea lasting 10 to 60 sec, followed by gradually increasing depth and frequency of respirations
from bihemispheric lesion
metabolic encephalopathy
97
Hyperventilation (Kussmaul's) respiration in coma?
metabolic acidosis
| herniation
98
Apneustic respiration in coma?
prolonged inspiration unrelieved by attempts to exhale
Pontine damage
99
Cluster respiration in coma?
early medullary damage
100
Ataxic (Biot's) respiration in coma?
quick, shallow inspirations followed by apnea
medullary damage
101
CN I deficit
hyposmia (decreased)
anosmia (absent)
olfactory groove meningioma
102
Pituitary Adenoma presents?
visual field defect and HA
103
Signs of pituitary hypersecretion?
↑ growth hormone ->acromegaly
↑ prolactin -> infertility
↑ ACTH -> cushings
104
CN VII: central lesion presents?
Contralateral paralysis of low face,
| spares forehead
105
CN VII: peripheral lesion presents?
Ipsilateral paralysis of entire side of face
106
Bell's palsy from?
low motor neuron lesion
107
Acoustic Neuroma?
benign growth on CN VIII ->
| sensory neural hearing loss
108
Glossopharyngeal Lesion?
CN IX lesion ->
deviation of palate AWAY from side of lesion
loss of gag reflex
109
Hypoglossal Lesion?
CN XII lesion ->
| tongue deviation TOWARD lesion
110
Cerebrovascular Accident (CVA) sxs? (5)
```
Acute weak/numb
Abrupt impaired consciousness
Worst HA of life
Aphasia (can't speak)
Dysarthria (slurred speech)
```
111
Upper Motor Neuron impairment sxs? (5)
1) Weakness in affected distribution
2) Spasticity
3) Hyperactive DTRs
4) Clonus
5) Babinski sign +
112
Lower Motor Neuron impariment sxs? (5)
1) Weakness in segmental distribution
2) Muscle atrophy
3) Flaccidity
4) Fasciculations (mm twitching w/o moving joint)
5) Reduced/absent DTRs
113
Up MN weakness present where?
below level of lesion
114
Unilat lesions above medulla present?
contralateral weakness
115
Unilat lesions below medulla present?
ipsilateral weakness
116
Up MN disease may result in damage to?
corticospinal tracts
117
Carpal tunnel synd what kind of MN defect?
lower MN
118
Ulnar Entrapment is?
3 sxs?
Ulnar nerve compression (low MN):
1) sensory loss 4th/5th digits
2) motor loss hypothenar (abd digiti minimi, 1st dorsal ineross)
3) pain 4th/5th digits and elbow
119
Resting Tremor?
prominent at rest
gone w/ movement
(Parkinson's)
120
Postural Tremor?
seen in head or extrem while maintaining posture
| hypothyroidism
121
Intention Tremor?
seen when reaching for target
| cerebellar dx, MS, old
122
Oral-Facial Dyskinesias
tics of face, jaw, tongue
123
Athetosis?
writhing, twisting mvmts
| slower than chorea
124
Myoclonus?
sudden, rapid jerks
| infections, stroke, anoxia
125
Spastic Hemiparesis?
a/w corticospinal disease: ONE SIDE
UE flexed
LE extended
drag foot around
126
Steppage Gait (foot drop)?
LMN disease:
drag foot,
high knee lift,
foot slap
127
Sensory ataxia (poor coordination)?
a/w loss of proprioception in legs and + Romberg:
unsteady, wide-based gait,
watch ground
128
Cerebellar ataxia?
a/w cerebellar dx:
staggering, wide-based gait,
turn difficulty,
can't stand w/ eyes closed
129
Parkinson's etiology?
degeneration of dopaminergic neurons in substantia nigra
130
Parkinson's sxs?
```
cog-wheel rigidity
pill-rolling resting tremor
masked facial expression
bradykinesia
30% dementia
```
131
Reflex scale?
```
0 = no response
+1 = diminished
+2 = normal
+3 = increased
+4 = hyperactive
```
132
Reinforcement techniques for obtaining reflexes?
| Jendrassik
```
UE = grit teeth
LE = grab fingers and pull in opp direction
```
133
Affect:
Blunted?
Flat?
Labile?
blunt = reduced
flat = absent
labile = abrupt ∆s
