Neuro Flashcards
(219 cards)
1
Q
What is the function of the Corpus Callosum?
A
Relays information from one side of the brain to the other.
2
Q
What functions are associated with the Parietal Lobe?
A
Associated with sensation of touch, kinesthesia, perception of vibration, and temperature. Receives information from other areas of the brain regarding hearing, vision, motor, sensory, and memory. Provides meaning for objects. Interprets language and words. Spatial and visual perception.
3
Q
What impairments are associated with the dominant hemisphere of the Parietal Lobe?
A
Agraphia, alexia, agnosia.
4
Q
What impairments are associated with the non-dominant hemisphere of the Parietal Lobe?
A
Dressing apraxia, constructional apraxia, anosognosia.
5
Q
What are some general impairments of the Parietal Lobe?
A
Contralateral sensory deficits, impaired language comprehension, impaired taste.
6
Q
What is the main function of the Occipital Lobe?
A
Main processing center for visual information, processes visual information regarding colors, light, and shapes. Judgment of distance, seeing in three dimensions.
7
Q
What are the impairments associated with the Occipital Lobe?
A
Homonymous Hemianopsia, impaired extraocular muscle movement and visual deficits, impaired color recognition, reading and writing impairment, cortical blindness with bilateral lobe involvement.
8
Q
What functions are associated with the Frontal Lobe?
A
Voluntary movement (primary motor cortex/precentral gyrus), intellect, orientation, Broca’s area (speech, concentration), personality, temper, judgment, reasoning, behavior, self-awareness, executive functions.
9
Q
What are the impairments associated with the Frontal Lobe?
A
Contralateral weakness, perseveration, inattention, personality changes, antisocial behavior, impaired concentration, apathy, Broca’s aphasia (expressive deficits), delayed or poor initiation, emotional lability.
10
Q
What functions are associated with the Temporal Lobe?
A
Primary auditory processing and olfaction, Wernicke’s area (ability to understand and produce meaningful speech, verbal and general memory, assist with understanding language), interpretation of other people’s emotions and reactions.
11
Q
What are the impairments associated with the Temporal Lobe?
A
Learning deficits, Wernicke’s aphasia (receptive deficits), antisocial, aggressive behaviors, difficulty with facial recognition, difficulty with memory, memory loss, inability to categorize objects.
12
Q
What is the role of the Hippocampus?
A
Responsible for the process of forming and storing new memories of personal history and other declarative memory. Important for learning language.
13
Q
What are the primary functions of the left brain?
A
Language, sequence and perform movements, understand language, produce written and spoken language, analytical, controlled, logical, rational, math calculations, express positive emotions (love and happiness), process verbally coded info in an organized, logical, and sequential manner.
14
Q
What are the primary functions of the right brain?
A
Nonverbal processing, process info in a holistic manner, artistic abilities, general concept comprehension, hand-eye coordination, spatial relationships, kinesthetic awareness, understand music, understand nonverbal communication, math reasoning, express negative emotions, body image awareness.
15
Q
What is the Basal Ganglia?
A
Grey matter masses located deep within the white matter of the cerebrum, responsible for voluntary movement, regulation of autonomic movement, posture, muscle tone, and control of motor responses. Dysfunction is associated with Parkinson’s Disease, Huntington’s Disease, Tourette’s Syndrome, Attention-Deficit Disorder, OCD, and many addictions.
16
Q
What is the Diencephalon?
A
Located under the cerebral hemispheres, contains the thalamus, hypothalamus, subthalamus, and epithalamus. It is where major motor and sensory tracts synapse and acts as an interactive site between the CNS and the endocrine system, complementing the limbic system.
17
Q
What is the function of the Amygdala?
A
Small, almond-shaped nucleus involved in emotional and social processing, fear and pleasure responses, arousal, processing of memory, and formation of emotional memories.
18
Q
What is the Thalamus?
A
Relay or processing station for the majority of information that goes to the cerebral cortex, coordinates sensory perception and movement with other parts of the brain. Receives information from cerebellum, basal ganglia, and all sensory pathways except the olfaction tract, then relays that information to the correct cortex. Damage can produce Thalamic Pain Syndrome.
19
Q
Where is the hypothalamus located?
A
Below the thalamus at the base of the diencephalon.
20
Q
What functions does the hypothalamus regulate?
A
Hunger, thirst, sexual behavior, sleep, body temperature, adrenal glands, and pituitary gland.
21
Q
What can lesions in the hypothalamus produce?
A
Obesity, sexual disinterest, poor temperature control, and diabetes insipidus.
22
Q
What is the role of the pons?
A
Assist with regulation of respiration rate and orientation of the head in relation to visual and auditory stimuli.
23
Q
Which cranial nerves originate from the pons?
A
Cranial Nerves V (5) to VII (8).
24
Q
What is the function of the brainstem?
A
Relay station sending messages between various parts of the body and the cerebral cortex.
25
What primitive functions are regulated by the brainstem?
Heart rate and respiratory rate.
26
Where is the reticular activating system found?
Within the midbrain, pons, medulla, and a portion of the thalamus.
27
What can severe damage to the brainstem result in?
"Brain death" due to loss of key functions.
28
Where do the majority of cranial nerves originate?
Within the brainstem.
29
What is the primary connection of the midbrain?
Connects the forebrain to the hindbrain.
30
What is the primary function of the cerebellum?
Fine tuning of movement and maintaining posture and balance.
31
What are the three lobes of the cerebellum?
* Anterior lobe
* Posterior lobe
* Flocculonodular lobe
32
What happens if one side of the cerebellum is damaged?
Produces ipsilateral impairment.
33
What deficits may lesions in the cerebellum produce?
* Ataxia
* Nystagmus
* Tremor
* Hypermetria
* Poor coordination
* Deficits in postural reflexes, balance, and equilibrium
34
What is the composition of the medulla oblongata?
White matter on the surface and grey matter in the interior.
35
What autonomic activities does the medulla oblongata influence?
Regulation of respiration and heart rate.
36
What reflex centers are found in the medulla?
Vomiting, coughing, and sneezing.
37
What type of impairment can damage to the motor tracts in the medulla produce?
Contralateral impairment.
38
Which cranial nerves originate from the medulla?
Cranial Nerves IX (9), X (10), XI (11), and XII (12).
39
What are the impairments associated with the Anterior Cerebral Artery (ACA)?
* Contralateral LE motor involvement
* Contralateral LE sensory involvement
* Loss of bowel and bladder control
* Loss of behavioral inhibition
* Significant mental changes
* Neglect
* Aphasia
* Apraxia
* Agraphia
* Perseveration
* Akinetic mutism, paraplegia, incontinence, abulic aphasia, and personality changes with significant bilateral involvement
## Footnote
The ACA supplies blood to the medial portions of the frontal lobes and the superior medial parietal lobes.
40
What are the impairments associated with the Posterior Cerebral Artery (PCA)?
* Contralateral pain and temperature sensory loss
* Contralateral hemiplegia (central area)
* Mild hemiparesis
* Ataxia, Athetosis, or Choreiform movement
* Quality of movement is impaired
* Thalamic Pain Syndrome
* Anomia
* Prosopagnosia with occipital infarct
* Hemiballisms
* Visual agnosia
* Homonymous Hemianopsia
* Memory impairment
* Alexia, Dyslexia
* Cortical blindness from bilateral involvement
## Footnote
The PCA supplies blood to the occipital lobe and the inferior part of the temporal lobe.
41
What are the impairments associated with the Middle Cerebral Artery (MCA)?
* Wernicke's, global, or Broca's aphasia in dominant hemisphere with bilateral occlusion
* Homonymous Hemianopsia
* Apraxia
* Flat affect with right hemisphere damage
* Contralateral weakness of face and UE with lesser involvement in the LE
* Contralateral sensory loss of face and UE with lesser involvement in the LE
* Impaired spatial relations
* Anosognosia in non-dominant hemisphere
* Impaired body schema
## Footnote
The MCA is the most common site for strokes and supplies a large portion of the lateral cerebral cortex.
42
What impairments are associated with the Vertebral-basilar Artery?
* Loss of consciousness
* Hemiplegia or tetraplegia
* Comatose or vegetative state
* Inability to speak
* Locked-in syndrome
* Vertigo
* Nystagmus
* Dysphagia
* Dysarthria
* Syncope
* Ataxia
## Footnote
The vertebral-basilar system supplies blood to the brainstem, cerebellum, and posterior part of the brain.
43
What are the symptoms of Wallenberg Syndrome?
* Ipsilateral facial pain and temperature impairment
* Ipsilateral ataxia, vertigo
* Contralateral pain and temperature impairment of the body
## Footnote
Wallenberg Syndrome results from a stroke in the lateral medulla oblongata, affecting the distribution of the vertebral and/or posterior inferior cerebellar arteries.
44
True or False: Contralateral weakness of face and upper extremity is more pronounced than lower extremity weakness in Middle Cerebral Artery (MCA) impairments.
True
## Footnote
The MCA primarily affects the lateral aspects of the brain, leading to more significant impacts on the face and arm.
45
Fill in the blank: The __________ artery is associated with conditions like locked-in syndrome and dysphagia.
[Vertebral-basilar Artery]
## Footnote
Locked-in syndrome occurs when there is damage to the pons, affecting the ability to move and speak while retaining cognitive function.
46
What are the signs and symptoms of meningitis?
Fever, headache, vomiting, complaints of a stiff and painful neck, nuchal rigidity, pain in lumbar area and posterior thigh.
## Footnote
Brudzinski's sign: Flexion of the neck facilitates flexion of the hips and knees. Kernig's sign: Pain with hip flexion combined with knee extension. Sensitivity to light.
47
What is the gold standard for diagnosing meningitis?
Lumbar Puncture.
48
What is the treatment for meningitis?
Antibiotic, antimicrobial, and steroids.
49
What does the Corticospinal Tract (Anterior) control?
Ipsilateral voluntary, discrete, and skilled movements.
50
What does the Corticospinal Tract (Lateral) control?
Contralateral voluntary fine movement.
51
What are the effects of damage to the Corticospinal tracts?
Positive Babinski sign, absent superficial abdominal reflexes, and cremasteric reflex.
52
What is the function of the Reticulospinal Tract?
Facilitation or inhibition of voluntary and reflex activity through the influence on alpha and gamma motor neurons.
53
What does the Rubrospinal Tract facilitate?
Motor input of gross postural tone, facilitating activity of flexor muscles, and inhibiting the activity of extensor muscles.
54
What is the role of the Tectospinal Tract?
Contralateral postural muscle tone associated with auditory/visual stimuli.
55
What does the Vestibulospinal Tract control?
Ipsilateral gross postural adjustments subsequent to head movements, facilitating activity of the extensor muscles, and inhibiting activity of the flexor muscles.
56
What are the consequences of damage to the Extrapyramidal tracts?
Significant paralysis, hypertonicity, exaggerated deep tendon reflexes, and clasp-knife reaction.
57
What do the Cuneocerebellar Tracts provide?
Ipsilateral subconscious proprioception of the neck and upper extremities.
58
What is the function of the Fasciculus Cuneatus?
Trunk, neck, and upper extremity proprioception, vibration, two-point discrimination, and graphesthesia.
59
What does the Fasciculus Gracilis do?
Trunk and lower extremity proprioception, two-point discrimination, vibration, and graphesthesia.
60
What is the role of the Spinocerebellar Tract?
Ipsilateral subconscious proprioception, tension in muscles, joint sense, and posture of the trunk and lower extremities.
61
What is the function of the Spino-olivary Tract?
Goes to the cerebellum and relays information from cutaneous and proprioception organs.
62
What does the Spinoreticular Tract influence?
Levels of consciousness.
63
What is the role of the Spinotectal Tract?
Provides afferent information for spinovisual reflexes and assists with movement of eyes and head towards a stimulus.
64
What does the Spinothalamic Tract (Anterior) sense?
Crude touch and pressure.
65
What does the Spinothalamic Tract (Lateral) sense?
Pain and temperature sensation.
66
What is Brown-Sequard's Syndrome?
Incomplete lesion that produces hemisection of the spinal cord.
67
What are the symptoms of Brown-Sequard's Syndrome?
Paralysis and loss of vibratory sense and position sense on the same side (ipsilateral) as the lesion, loss of pain and temperature sense on the opposite side (contralateral) of the lesion.
## Footnote
Damage to the Corticospinal tracts and dorsal column causes ipsilateral symptoms, while damage to the lateral Spinothalamic tract causes contralateral symptoms.
68
What is the Peripheral Nervous System (PNS)?
The PNS consists of autonomic neurons divided into sympathetic and parasympathetic nerves.
69
Where do sympathetic nerves originate?
Sympathetic nerves originate in the lateral horn of the thoracic spinal cord.
70
Where do parasympathetic nerves originate?
Parasympathetic nerves originate from the lateral grey matter of the sacral level of the spinal cord and from the brain.
71
What are A Fibers?
A Fibers are large, myelinated fibers with a high conduction rate.
72
What are B Fibers?
B Fibers are medium, myelinated fibers with a reasonably fast conduction rate; they are the preganglionic fibers of the ANS.
73
What are C Fibers?
C Fibers are small, poorly myelinated or unmyelinated fibers with a slowed conduction rate; they are the postganglionic fibers of the sympathetic system and exteroceptors for pain, temperature, and touch.
74
What are the types of cranial nerves based on function?
Cranial nerves can be classified as afferent (sensory) and efferent (motor).
75
What is the function of the Olfactory nerve (CN I)?
The Olfactory nerve is responsible for the sense of smell.
76
What is the function of the Optic nerve (CN II)?
The Optic nerve is responsible for vision.
77
What is the function of the Oculomotor nerve (CN III)?
The Oculomotor nerve controls voluntary motor functions of the eyeball and autonomic functions of the smooth muscle of the eyeball.
78
What is the function of the Trochlear nerve (CN IV)?
The Trochlear nerve controls the voluntary motor function of the superior oblique muscle of the eyeball.
79
What is the function of the Trigeminal nerve (CN V)?
The Trigeminal nerve is responsible for voluntary motor functions of the muscles of mastication and sensory functions for touch and pain in the face.
80
What is the function of the Abducens nerve (CN VI)?
The Abducens nerve controls the voluntary motor function of the lateral rectus muscle of the eyeball.
81
What is the function of the Facial nerve (CN VII)?
The Facial nerve controls voluntary motor functions of facial muscles and autonomic functions of lacrimal, submandibular, and sublingual glands.
82
What is the function of the Vestibulocochlear nerve (CN VIII)?
The Vestibulocochlear nerve is responsible for hearing and balance.
83
What is the function of the Glossopharyngeal nerve (CN IX)?
The Glossopharyngeal nerve has voluntary motor functions for select muscles of the pharynx and autonomic functions for the parotid gland.
84
What is the function of the Vagus nerve (CN X)?
The Vagus nerve controls voluntary motor functions of muscles of the palate, pharynx, and larynx, as well as autonomic functions for thoracic and abdominal viscera.
85
What is the function of the Accessory nerve (CN XI)?
The Accessory nerve controls voluntary motor functions of the sternocleidomastoid and trapezius muscles.
86
What is the function of the Hypoglossal nerve (CN XII)?
The Hypoglossal nerve controls voluntary motor functions of the muscles of the tongue.
87
What is a test for the Olfactory nerve (CN I)?
Identify familiar odors (e.g., chocolate, coffee).
88
What is a test for the Optic nerve (CN II)?
Test visual fields and visual acuity.
89
What is a test for the Oculomotor nerve (CN III)?
Test upward, downward, and medial gaze; reaction to light.
90
What is a test for the Trigeminal nerve (CN V)?
Test face sensation, clench teeth, and push down on chin to separate jaw.
91
What is a test for the Facial nerve (CN VII)?
Close eyes tight, smile and show teeth, whistle and puff cheeks.
92
What is a test for the Glossopharyngeal nerve (CN IX)?
Test ability to swallow and gag reflex.
93
What is a test for the Vagus nerve (CN X)?
Say 'Ahhh' and test gag reflex.
94
What is a test for the Accessory nerve (CN XI)?
Test resisted shoulder shrug.
95
What is a test for the Hypoglossal nerve (CN XII)?
Test tongue protrusion; if injured, tongue deviates toward injured side.
96
What is the spinal level for the Abdominal Reflex?
The spinal level is T8-L1.
97
How is the Abdominal Reflex stimulated?
Stroke briskly and lightly with a blunt object from each quadrant of the abdomen in a diagonal manner towards the belly button.
98
What is the response for the Abdominal Reflex?
Contraction of the abdominals and deviation of the belly button in the direction of the stimulus.
99
What is the spinal level for the Corneal 'Blink' Reflex?
The spinal level is Trigeminal and facial nerves.
100
How is the Corneal 'Blink' Reflex stimulated?
Ask the patient to look up and away from you. Stroke the cornea using a piece of cotton.
101
What is the response for the Corneal 'Blink' Reflex?
Both eyes will blink with contact to one eye.
102
What is the spinal level for the Cremasteric Reflex?
The spinal level is L1-L2.
103
How is the Cremasteric Reflex stimulated?
Scratch the skin of the upper medial thigh.
104
What is the response for the Cremasteric Reflex?
A brisk and brief elevation of the testicle on the ipsilateral side.
105
What is the spinal level for the Gag Reflex?
The spinal level is glossopharyngeal and vagus nerves.
106
How is the Gag Reflex stimulated?
The therapist lightly stimulates each side of the back of the throat and notes the reaction.
107
What is the response for the Gag Reflex?
A gag will occur post stimulation. May be absent in some percentage of the normal population.
108
What is the spinal level for the Plantar Reflex?
The spinal level is L5-S1.
109
How is the Plantar Reflex stimulated?
Stroke the lateral aspect of the sole of the foot with the blunt end of a reflex hammer from the heel to the ball of the foot and medially to the base of the great toe.
110
What is the response for the Plantar Reflex?
Flexion of the toes. This is called the Babinski reflex and it is an abnormal response that indicates CNS lesion.
111
What is Two-point Discrimination?
Using a two-point caliper on the skin, identify one or two points without visual input.
112
What does Vibration sensation involve?
Perceive vibration or pain through a tuning fork.
113
What does a Reflex Grading Scale of 0 indicate?
No Response: Always abnormal.
114
What does a Reflex Grading Scale of 1+ indicate?
Diminished/Depressed Response: May or may not be normal.
115
What does a Reflex Grading Scale of 2+ indicate?
Active normal Response: Normal.
116
What does a Reflex Grading Scale of 3+ indicate?
Brisk/Exaggerated Response: May or may not be normal.
117
What does a Reflex Grading Scale of 4+ indicate?
Very brisk/Hyperactive: Always abnormal.
118
What are the types of sensation?
Superficial: Temperature, Pain, Light touch; Deep: Proprioception, Kinesthesia, Vibration; Cortical: Bilateral simultaneous stimulation, Stereognosis, Two-point Discrimination, Barognosis, Localization of touch.
119
What is Barognosis?
Perceive the weight of different objects in the hand.
120
How is Deep Pain assessed?
Squeeze the forearm or calf muscle.
121
What is Graphesthesia?
Identify a number or letter drawn on the skin without visual input.
122
What is Kinesthesia?
Identify direction and extent of movement of a joint or body part.
123
What is Light Touch?
Perceive touch through light pressure or use of a cotton ball.
124
What is Localization in sensation?
Ability to identify the exact location of light touch on the body using a verbal response or gesturing.
125
What is Proprioception?
Identify a static position of an extremity or body part.
126
What is Stereognosis?
Identify an object without sight.
127
What is Superficial Pain?
Perceive noxious stimulus using a pen cap, paper clip end or pin.
128
How is Temperature sensation tested?
Perceive warm and cold test tubes.
129
What is Allodynia?
The sensation of pain in response to a stimulus that would not typically produce pain.
130
What is Analgesia?
The absence of pain while remaining conscious.
131
What is Anesthesia?
The absence of touch sensation.
132
What is Causalgia?
Constant, relentless, burning hyperesthesia and hyperalgesia that develops after a peripheral nerve injury.
133
What is Dysethesia?
Distortion of any of the senses, especially the sense of touch.
134
What is Hyperesthesia?
Heightened sensation.
135
What is Hyperpathia?
An extreme exaggerated response to pain.
136
What is Hypesthesia?
A diminished sensation to touch.
137
What is Neuralgia?
Severe and multiple shock-like pains that radiate from a specific nerve distribution.
138
What is Pallanesthesia?
Loss of vibration sensation.
139
What is Paresthesia?
Abnormal sensations such as tingling, pins and needles or burning sensations.
140
What happens with Peripheral Nerve Degeneration?
The voluntary muscles have an altered response to acetylcholine, with wasting of the sarcoplasm and loss of fibrils. This results in total loss of muscle over time with replacement by fibrous tissue.
141
What is Neurapraxia?
Mild form of injury where the axon, epineurium, perineurium, and endoneurium are all intact.
142
What are the symptoms of Neurapraxia?
Pain, minimal muscle atrophy, numbness or greater loss of motor and sensory function, diminished proprioception.
143
What is the recovery time for Neurapraxia?
Rapid and complete within 4-6 weeks.
144
What are the most common causes of Neurapraxia?
Pressure injuries.
145
What is Double Crush Syndrome?
Two separate lesions along the same nerve that create more severe symptoms.
146
What is Mononeuropathy?
Isolated nerve lesion associated with trauma and entrapment.
147
What is a Neuroma?
Abnormal growth of nerve cells associated with conditions like vasculitis, AIDS, and amyloidosis.
148
What is Peripheral Neuropathy?
Impairment or dysfunction of the peripheral nerves associated with diabetic peripheral neuropathy, trauma, and alcoholism.
149
What is Polyneuropathy?
Diffuse nerve dysfunction that is symmetrical and typically secondary to pathology and not trauma.
150
What conditions are associated with Polyneuropathy?
Guillain-Barre Syndrome, Peripheral Neuropathy, use of neurotoxic drugs, and HIV.
151
What is Wallerian Degeneration?
Degeneration that occurs distally, specifically to the myelin sheath and axon.
152
What is Axonotmesis?
A more severe grade of injury to a peripheral nerve. Reversible injury to damaged fibers since they maintain an anatomical relationship to each other.
153
What structures are preserved in Axonotmesis?
Endoneurium, epineurium, Schwann cells, and supporting structures.
154
What is a consequence of Axonotmesis?
Distal wallerian degeneration can happen.
155
What is the regeneration rate of a nerve after Axonotmesis?
The nerve can regenerate distal to the site of the lesion at a rate of 1 mm per day.
156
What is the recovery process for Axonotmesis?
Spontaneous recovery varies from spotty to no recovery. Surgery may be required for repair.
157
What are the common causes of Axonotmesis?
Traction, compression, and crush injuries are the most common.
158
What is Neurotmesis?
The most severe grade of injury to a peripheral nerve.
159
What components are damaged in Neurotmesis?
Axon, myelin, and connective tissue components are all damaged.
160
What is the nature of the injury in Neurotmesis?
Irreversible injury with no possibility of regeneration.
161
What are the symptoms of Neurotmesis?
Flaccid paralysis and wasting of muscles occur, total loss of sensation to area supplied by the nerve.
162
What is the recovery outlook for Neurotmesis?
No spontaneous recovery. With surgical reattachment, potential regenerating axons may grow at 1 mm per day.
163
What is Upper Motor Neuron Disease?
Lesions found in the descending motor tracts within the cerebral motor cortex, internal capsule, brainstem, or spinal cord.
164
Where are the damaged tracts located in Upper Motor Neuron Disease?
In the lateral white column of the spinal cord.
165
What are the symptoms of Upper Motor Neuron Disease?
Hyperactive reflexes, mild atrophy, absent fasciculations, and hypertonic tone.
166
What is Lower Motor Neuron Disease?
Lesions that affect nerves or their axons at or below the level of the brainstem.
167
What part of the spinal cord may be affected in Lower Motor Neuron Disease?
The ventral grey column of the spinal cord may also be affected.
168
What are the symptoms of Lower Motor Neuron Disease?
Diminished or absent reflexes, present atrophy, present fasciculations, and hypotonic to flaccid tone.
169
What is Athetosis?
A movement disorder that presents with slow, twisting, and writhing movements that are large in amplitude.
170
Where is Athetosis usually seen?
In the trunk, extremities, face, and tongue.
171
What happens when Athetosis movements are brief?
They can merge with chorea (choreoathetosis).
172
What happens when Athetosis movements are sustained?
They can merge with dystonia.
173
What is Chorea?
A form of hyperkinesis that presents with brief, irregular contractions that are rapid.
174
What are the characteristics of Chorea movements?
Sudden, random, and involuntary.
175
What is Ballism?
A form of chorea that includes choreic jerks of large amplitude.
176
What are the characteristics of Ballism?
It produces flailing movements of the limbs and is typically secondary to damage of the subthalamic nucleus.
177
What is Dystonia?
A syndrome of sustained muscle contractions that frequently causes twisting, abnormal postures, and repetitive movements.
178
What types of movements are associated with Dystonia?
All muscles can be affected, and the involuntary movements are often accentuated during volitional movement and can produce overflow.
179
What are Tics?
Sudden, brief, repetitive coordinated movements that usually occur at irregular intervals.
180
What are the types of Tics?
There are simple and complex tics that vary from myoclonic jerks to jumping movements that may include vocalization and repetition of other sounds.
181
What are Tremors?
Involuntary, rhythmic, oscillatory movements that are typically classified into three groups.
182
What are Resting Tremors?
Observable at rest and may or may not disappear with movement. May increase with mental stress.
## Footnote
Example: Pill-rolling tremor.
183
What are Postural Tremors?
Observable during a voluntary contraction to maintain a posture.
## Footnote
Example: Rapid tremor associated with hyperthyroidism, fatigue or anxiety, and benign essential tremor.
184
What are Intention (Kinetic) Tremors?
Tremors that are absent at rest but observable with activity and typically increase as the target approaches. These likely indicate a lesion of the cerebellum or its efferent pathways and are typically seen with multiple sclerosis.
185
What is Athenia?
Generalized weakness, typically secondary to cerebellar pathology.
186
What is Clasp-Knife Response?
A form of resistance seen during ROM of a hypertonic joint where there is greatest resistance at the initiation of range that lessens with movement through the ROM.
187
What is Cogwheel Rigidity?
A form of rigidity where resistance to movement has a physic quality to it.
188
What is Fasciculation?
A muscular twitch caused by random discharge of a lower motor neuron and its muscle fibers. Can be benign or suggest LMN disease.
189
What is Hemiballism?
An involuntary and violent movement of a large body part.
190
What is Lead Pipe Rigidity?
A form of rigidity where there is uniform and constant resistance to ROM, often associated with lesions of the basal ganglia.
191
What is Suspensory Strategy?
Used to lower the center of gravity during standing or ambulating in order to better control the center of gravity, often used when both mobility and stability are required during a task.
## Footnote
Example: knee flexion, crouching or squatting.
192
What are the symptoms of central nystagmus?
Bidirectional or unidirectional movement, no inhibition with fixation, mild vertigo, may be chronic.
193
What are the symptoms of peripheral nystagmus?
Unidirectional movement indicating the opposite direction of the lesion, will inhibit nystagmus and vertigo, significant vertigo, symptoms last minutes to weeks.
194
What are the etiologies of central lesions causing nystagmus?
Demyelination of nerves, vascular issues.
195
What are the etiologies of peripheral lesions causing nystagmus?
Ménière's disease, vascular disorders, trauma, toxicity, infection of the inner ear.
196
What does the Multi-Directional Reach Test assess?
Limits of stability anteriorly, posteriorly, and laterally to both sides.
197
What does the Romberg Test assess?
Balance and sensory ataxia; compensation through the visual system may occur with mild lesions.
198
What does the Short Physical Performance Battery assess?
Lower extremity performance and risk for falling; a score of <10 indicates mobility limitations.
199
What does the Timed Get Up and Go Test assess?
A person's level of mobility and balance.
200
What are the cut-off times for the Timed Get Up and Go Test?
Independent: ≤10 sec; >20 sec: limit for functional independence; >30 sec: high risk for a fall.
201
What does the Balance Evaluation Systems Test (BESTest) assess?
Six different underlying systems that may affect balance.
202
What does the Berg Balance Scale assess?
A patient's risk for falling; a score <45 indicates increased risk.
203
What does the Clinical Test of Sensory Interaction on Balance (CTSIB) assess?
Contributions of different sensory systems to a patient's balance.
204
What does the Dynamic Gait Index (DGI) assess?
Balance with varying gait tasks; a score <19 indicates increased risk for falls.
205
What does the Four Square Step Test assess?
A patient's ability to step in multiple directions; >15 seconds indicates increased risk for falls.
206
What does the Fregly-Graybiel Ataxia Test Battery assess?
Balance dysfunction; best suited for higher-level patients.
207
What does the Fugl-Meyer Sensorimotor Assessment of Balance Performance Battery assess?
Balance specifically for patients with hemiplegia.
208
What does the Fullerton Advanced Balance Scale assess?
Risk of falling; a score <26 indicates increased risk.
209
What does the Functional Gait Assessment assess?
Balance with varying gait tasks; a score <23 indicates increased risk for falls.
210
What does the Functional Reach Test assess?
Standing balance and risk of falling.
211
What are the age-related standards for the Functional Reach Test?
20-40 years: 14.5-17 inches; 41-69 years: 13.5-15 inches; 70-87 years: 10.5-13.5 inches.
212
What is the Tinetti Performance Oriented Mobility Assessment used for?
It is used to screen patients and identify if there is an increased risk for falling. A total score less than 19 indicates a high risk for a fall.
213
Where are the locations associated with Types of Fluent Aphasia?
They are located in the temporal lobe, Wernicke's area, or regions of the parietal lobe.
214
What is Wernicke's Aphasia?
It is characterized by a lesion in the posterior region of the superior temporal gyrus and is also known as receptive aphasia.
215
What are the impairments associated with Wernicke's Aphasia?
Impairments include writing, poor naming ability, and impaired comprehension (reading/auditory).
216
What is not impaired in Wernicke's Aphasia?
Good articulation and use of paraphasias; motor impairment is not typical.
217
What is Conduction Aphasia?
It is characterized by a lesion in the supramarginal gyrus and arcuate fasciculus.
218
What are the impairments associated with Conduction Aphasia?
Impairments include severe impairment with repetition, speech interrupted by word-finding difficulties, and writing.
219
What is not impaired in Conduction Aphasia?
Intact fluency and good comprehension; reading is also not impaired.
