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Flashcards in Neuro Deck (103):
1

Most part of the neuro exam are objective/subjective?

Subjective

2

Testing of the neuro system is predicated on what?

Normal function of cognition, AND other organ systems

3

What are the "special" senses?

Sight
Hearing
Smell
Taste

4

What are somato sensory fibers?

Senses for pain, cold etc

5

True or false: right and left are divisions of the neuro system?

True

6

What is the opposite of supratentorial?

Posterior fossa

7

What are the three embryonic divisions of the brain?

Prosencephalon
Mesencephalon
Rhombencephalon

8

What cranial nerves are associated with the parasympathetic system?

III, VII, Ix, and X

9

What are the sacral levels of the para symp division?

S2, 3, 4

10

What spinal levels comprise the sympathetic nervous system?

T1-L2

11

How do you name spinal cord tracts?

From the origin of the signs, to its terminus

12

What is the other name for the afferent signals?

Spinothalamic

13

What is the other name for the efferent signals?

Corticospinal tracts

14

True or false: mood and physical appearance are not part of the mental status assessment

False

15

What does obtunded mean?

Obtundation refers to less than full alertness (altered level of consciousness), typically as a result of a medical condition or trauma.

16

What are the components of AVPU?

Alert
Verbally responsive
responds to Pain
U = unresponsive

17

What are the three major components of the Glasgow coma scale?

Eye opening
motor response
Verbal response

18

What is the mini cog recall test?

Repeat 3 words back after some time

19

When is a Folstein's mini-mental status exam performed?

During a full H & P

20

What is praxis?

Knowing how to use an object appropriately

21

How do you check for CN 1 dysfunction?

Have pt occlude nostril, and identify scents

22

How do you check for CN II dysfunction?

Visual acuity
Fundoscopic
Confrontation by fields

23

What are muscles are you testing with eye movements?

III, IV, and IV (oculomotor, trochclear, and abducens)

24

What is the innervation of the lateral recti?

LR6 (CN VI)

25

What is the innervation of the superior oblique muscle?

SO4 (CN 4)

26

What is the innervation of the majority of the eye muscles?

CN III

27

What CN that innervates the eye, also supplies parasympathetic function?

CN III

28

Internal torsion of the eye = what CN?

IV

29

Lateral eye movement = which CN?

VI

30

Lateral deviation of the eye = what muscle?

Lateral rectus

31

medial deviation of the eye = what muscle?

Medial rectus

32

Up and out movement of the eye = what muscle?

Superior oblique

33

Up and in movement = what eye muscle?

Inferior oblique

34

Down and out = what eye muscle?

Inferior rectus

35

Down and in = what eye muscle?

Superior oblique

36

Straight up eye movement = what eye muscle (s)?

Superior rectus and inferior oblique

37

Straight down eye movement = what eye muscle (s)?

Inferior rectus and superior oblique

38

PERRLA = which CN?

III

39

What does the swinging flashlight test look for?

Marcus gun pupil (afferent vs efferent defect)

40

Accommodation tests which eye muscle?

Ciliary muscles

41

What are the three spots to test for the three division of the trigeminal nerve?

Forehead
Maxillary region
Mandibular region

42

What are the muscles that are innervated by the trigeminal nerve?

The four muscles of mastication (the masseter, the temporal and the medial and lateral pterygoids. The other four muscles are the tensor veli palatini, the mylohyoid, the anterior belly of the digastric and the tensor tympani.

43

What are the four muscles of mastication?

Masseter
Temporal
Medial and lateral pterygoids

44

Besides the muscles of mastication, what other muscles does the trigeminal nerve supply motor function to?

Tensor veli palatini
Mylohyoid
Anterior digastric
Tensor tympani

45

What does CN VII supply sensory innervation to?

anterior 2/3 of the tongue

46

What supplies the motor innervation to all of the facial muscles?

CN 7

47

How can you distinguish between stroke and Bell's palsy?

unlike Bell's palsy, a stroke will usually let patients control the upper part of their faces. A person with a stroke will usually have some wrinkling of their forehead--**Bell's Palsy will NOT**

48

What does CN VIII do?

hearing and balance

49

How do you test CN VIII?

Whisper tests
Weber/rinne
Dix-hallpike

50

What supplies tast innervation to the posterior 1/3 of the tongue?

CN IX

51

What is the muscle that receives innervation from CN IX?

Posterior pharyngeal muscle

52

What supplies parasympathetic fibers to the parotid gland?

Parotid

53

How do you test for CN IX?

Gag reflex
Say "ahh"

54

Damage to the recurrent vagus nerve produces what?

Hoarseness of the voice

55

What is the motor supply to the posterior part of the tongue, pharynx, larynx?

CN X

56

What does CN XI innervate?

SCM
Trap

57

What does CN XII innervate?

Motor to the tongue

58

In a central lesion, the tongue will deviate toward or away from the side of the lesion?

Away

59

In a peripheral lesion, the tongue will deviate toward or away from the side of the lesion?

Toward

60

How do you test for CN XII?

Push tongue towards each cheek

61

What are the tests for motor function of the upper extremities?

1. Shoulder ab/adduction
2. Elbow flex/extend
3. Wrist extend/felx
4. Finger flexe/xtend

62

What are the tests for motor function of the lower extremities?

1. Hip flexion/extension
2. Knee flexion/extension
3. Ankle flexion

63

What is the nerve root for dorsiflexion of the ankle?

L4-5

64

What is the nerve root for plantarflexion of the ankle?

S1

65

What is the nerve root for inversion of the ankle?

L5

66

What is the nerve root for eversion of the ankle?

L5

67

What is the nerve root for dorsiflexion of the great toe?

L5

68

What is the nerve root for planterflexion of the great toe?

S1

69

Review muscle grading in the clin med foot lecture

***

70

Paresis = what?

Weakness

71

Plegia or paralysis = ?

Cannot move

72

What is the bulk examination for muscles?

Palpate for atrophy

73

Upper motor neuron lesions = ?

Spasticity/hypertonia

74

Biceps reflex = what Cervical nerve level?

C5

75

Triceps reflex = what Cervical nerve level?

C7

76

Brachioradialis reflex = what Cervical nerve level?

C6

77

Patellar reflex = what Cervical nerve level?

L3-L4

78

Calcaneal tendon reflex = what Cervical nerve level?

S1

79

What is 4/4 reflex called?

Clonus

80

What is clonus?

Rhythmic series of muscle contractions induced by stretching the tendon

81

What is the babinski sign? Who is this normal in? How do you describe it in a note?

Foot thing
Normal for infants
Upgoing or downgoing

82

What are primary sensory modalities? What does this test?

Light touch, pain, temp etc

Tests afferent pathways

83

What are secondary modalities?

Point localization, extinction, two point discrimination test

84

Vit B12 deficiency affects which sensory modality?

Primary

85

Where are the primary sensory modalities housed?

Posterior dorsal columns

86

How do you test for Primary modalities?

Vibrating tuning fork

87

What is stereognosis?

the ability to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information

88

Superficial pain fibers are of what type? Superficial touch?

Superficial pain = small
Superficial touch = semi-myelinated

89

How do you test for proprioception?

Close eyes, move their limb for them. Ask them which way it was moved

90

What is Graphesthesia? What does this test?

the ability to recognize writing on the skin purely by the sensation of touch

Tests secondary

91

What is cerebellar testing?

Assessment of coordination

92

Is cerebellar specific/sensitive?

Sensitive, but not specific

93

How do you assess cerebellar? How many tests do you need?

Rapid alternating movement
Gait/balance

Need one test in each of four areas

94

What is the result of a normal cerebellar test?

Diadochokinesia

95

What is the result of a ABnormal cerebellar test?

Dysdiadochokinesia

96

What are the "point to point" movements of the cerebellar test?

Finger to nose
FNF
H2S

97

What does the Romberg test, test for?

Proprioception (NOT cerebellar)

98

Look up forward and retropulsion in Parkinsons

***

99

What is tandem gait?

Heel-toe walking

100

What is the cerebellar gait?

Wide gait, swaying trunk,
fall toward side of lesion

101

Which side is affected in pronator drift (the affected or unaffected side)

Affected

102

What is Brudzinski's sign?

With pt supine, passive flexion of the neck causes involuntary flexion of the hips

103

What is Kernig's sign?

With pt supine, hip and knee flexed, attempt to passively extend the knee in painful and cannot be done