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Flashcards in Neuro Deck (51):

What is the function of the frontal lobe?

voluntary muscle activation
emotions and judgements
Broca's area = motor aspects of speech


What is the function of the parital lobe?

integration of sensatinon
touch, proprioception, pain and temp from opposite side of body


What is the function of the temporal lobe?

primary auditory cortex = receives/processes auditory stimuli
associative auditory = processes auditory stimuli
Wernicke's = language comprehension


What is the function of the occipital lobe?

primary visual cortex = receives/processes visual stimuli
visual association = processes visual stimuli


What is the function of the hypothalamus?

integrates and controls functions of the autonomic NS and neuroendocrine system
**maintains body homeostasis


What is the function of the thalamus?

Aside from sense of smell, all other sensory processes involve a thalamic nucleus receiving a sensory signal which is then directed to the relevant cortical area.
The thalamus plays a role in controlling the motor systems of the brain which are responsible for voluntary bodily movement and coordination.


What does the sympathetic NS do?

prepares body for fight or flight, emergency responses; increases HR and BP, constricts peripheral blood vessels, and redistributes blood; inhibits peristalsis
Thoracolumbar division T1-L2


What does the parasympathetic NS do?

conserves and restores homeostasis; rest and digest; slows HR and reduces BP; increases peristalsis and glandular activity
Craniosacral division CN 3, 7, 10; S2-4


What signs/tests do you use for examination of CNS infection or meningeal irritation?

signs of global, not focal
-neck mobility
-Kernig's sign - 90/90 HS, bilat pain suggests meninitis
-Brudzinski's sign - flex neck causes flexion of hips/knees
-slowed mental function
-altered vital signs
-generalised weakness


What do you examine for increased intracranial pressure secondary to cranial edema and brain herniation?

Altered level of consciousness
Altered vital signs
Pupillary changes
Papilledema at entrance to eye
Progressive impairment of motor function
Seizure activity


What is homonymous hemianopsia?

loss of half of visual field in each eye, contralateral to cerebral lesion


What is somatognosia?

patient can't identify body parts


What is visual spatial neglect?

unilateral neglect, ignores one side of body


What is anosognosia?

severe denial, neglect of lack of awareness of severity of conditions


What is agnosia?

inability to recognise familiar object with one sensory modality (ie sight), but can recognise same object with other sensory modality (ie. hearing)


What is apraxia?

inability to perform voluntary, learned movements in absence of loss of sensation, strength, coordination, attention or comprehension

Ideomotor - can't perform on command, but can do task on their own
Ideational - cannot perform task on command or on their own


What is aphasia? Types?

communication disorder

Nonfluent / expressive aphasia
Fluent / receptive aphasia


What is meningitis? And how do you treat it?

inflammation of membranes of the spinal cord or brain.
bacterial or viral
PT - supportive symptomatic Rx, bed positioning, PROM, skin care to prevent complications of immobility, safety measures if confusion present


What is encephalitis?

severe infection and inlammation of the brain
PT - supportive symptomatic therapy


What is a brain abcess?

infectious process in which there is a collection of pyogenic material in brain parenchyma.
PT - supportive symptomatic therapy


What is AIDS? S&S?

viral syndrome and severe depression of cell-mediated immunity
dementia complex
motor deficits - ataxia, weakness, tremor, loss of fine motor
peripheral neuropathy


List the types of spinal cord lesions and their characteristics

complete: bilat motor, bilat sensory loss

central: bilat motor, bilat pain and temp

Brown-sequard: ipsilat motor, ipsilat proprioception, contralat loss pain and temp

anterior: bilat motor loss, bilat pain/temp

posterior: bilat loss of proprioception, vibration, pressure

cauda equina


What types of nerve fibers are there? And what are the functions of each?

A fibers: large, myelinated, fast conducting
-Alpha proprioception, somatic motor
-Beta touch, pressure
-Gamma motor to motor spindles
-Delta pain temp touch

B fibers: small, myelinated, conduct less rapidly

C fibers: smallest, slowest, unmyelinated


What are levels of conciousness?

Alterness - appropriate response
Lethargy - appears drowsy, falls asleep quickly
Obtundation - can open eyes, responds slowly and confused, decreased interest in environment
Stupor - aroused from sleep from painful stimuli, verbal response slow/absent, minimal awareness
Coma - cannot be aroused, no response to stimuli


What is the Glasgow Coma Scale and how is it scored?

measures 3 elements of response - eye opening, motor response, verbal response

Severe scores 1-8
moderate 9-12
minor 13-15


What are the levels of Rancho Los Amigos?

1 - unresponsive
2- general
3 - local
4 - confused agitated
5 - confused inapp
6 - confused app
7 - auto inapp
8 - auto app, purposful
9 - assistance
10 - ind


What are the cranial nerves and what are their functions?

Olfactory - smell
Optic - vision
Oculomotor - move eyes, raise eyelids, regulate pupils
Trochlear - eye movements, proprioception
Trigeminal - sensations of head and face, chewing, muscle sense
Abducens - lateral eye movements
Facial - facial expressions, taste, secretion of saliva
Vestibulochochlear - balance, equilibrium, hearing
Glossopharyngeal - tast and other sensations of tongue, swallowing, saliva
Vagus - muscles for speech, swallowing, smooth muclse of viscera in abdo
Accessory - turning head, movement of shoulders, voice production
Hypoglossal - tongue movements


What is dyssenergia?

impaired ability to associate muscles together for complex movement


What is dysmetria?

impaired ability to judge the distance of range of movement


What is dysdiadochokiesia?

impaired ability to perform rapid alternating movements


What are the types of involuntary movements?

Tics - spasmodic contraction common in face, neck, shoulders

Chorea - quick twitches or dancing movements

athetosis - slow, irregular, twisting, writhing

tremor - continuous quivering movements, rhythmic oscillatory movement obs at rest

myoclonus - single, quick jerk


What are the sensory elements of balance?

visual - acuity, depth perception
somatosensory - proprioception, cutaneous sensation, trunk, feet, ankles
vestibular - changes in head position


What are the 6 recovery stages of a CVA?

1 - initial flaccidity, no voluntary movement
2 - emergence of spasticity, hyperreflexia, synergies
3 - voluntary movement possible, only in synergies, strong spasticity
4 - voluntary control in isolated joint movement
5 - increased voluntary control out of synergy, coordination deficits
6 - control and coordination near normal


What are characteristics of a left and right CVA lesion?

slow, cautious, hesitant, insecure
use words, gestures
do not underestimate ability to learn

impulsive, quick, indifferent, poor judgement
use verbal cues
visusospatial deficits, avoid clutter
focus on safety
do not overestimate ability


What is primary and secondary damage regarding a TBI?

diffuse axonal
focal injury
closed/open injury

hypoxic ischemic injury
swelling edema
electrolyte imbalance


Describe each ASIA scale level

A - complete, no motor or sensory function
B - incomplete, sensory but no motor
C - incomplete, motor preserved with > MMT 3
D - incomplete, motor >3 MMT
E - normal, motor and sensory normal


What is MS?

chrnoic progressive demyelinating disease of CNS
worsening symptoms with heat, hyperventilation, dehydration, fatigue
S&S = ataxic, spasticity, hyperreflexia, dysarthria, paraesthesia, vestibular involvement, fatigue


What is Parkinson's disease?

chronic progressive disease of CNS with degeneration of basal ganglia
S&S: rigidity, bradykinesia, resting tremor, impaired postrual reflexes


What is myasthenia gravis?

neuromuscular junction disorder, progressive muscular weakness and fatiguability on exertion
muscular strength worsens with continued contraction, improved with rest


What is epilepsy?

recurrent seizures


What are the types of peripheral nerve diseases?
Poly? Mono? Radic?

polyneuropathy - bilat symmetrical involvement

mononeuropathy - single nerve involvement

radiculopathy - involvement of nerve roots

clinical symptoms of LMN


What is trigeminal neuralgia?

CN V neuralgia

stabbing shooting pain following mandibular and maxillary divisions, one side of the face
exacerbated by stress, cold


What is Bell's palsy?

LMN lesion to CN VII (facial nerve)
unilateral paralysis
loss of control of salivation
acute onset, max severity in hours-days


What is Bulbar palsy?

weakness or paralysis of muscles innervaated by motor nuclei of lower brainstem (face, tongue, larynx, pharynx)


What is Guillain-Barre syndrome?

polyneuritis with progressive muscular weakness that develops rapidly
demyelination of cranial or peripheral nerves; LMN disease
sensory loss, paresthesia, pain, sensory loss less than motor loss
symmetrical distribution of motor loss
progresses from LE to UE, distal to proximal


What is ALS?

Degenerative disease affecting UMN and LMN
muscular weakness, early onset involves limbs progressing to whole body; atrophy, cramping, muscle fasiculations, twitching (LMN)
spasticity, hyperreflexia (UMN)
pain, cramping, postural stress syndrome, joint hypomobility


What is postpolio syndrome?

slowly progressive muscel weakness in patients with history of polio
abnormal fatigue
pain, myalgia
weakness and atrophy, asymmetrical


What are the anterior and posterior neurons of central gray matter?

anterior/ventral - efferent motor neurons

posterior/dorsal - afferent sensory neurons


What are the ascending and descending systems of the white matter in the spinal cord?

ascending (sensory)
-dorsal - proprioception, vibration, tactile
-spinothalamic - pain and temp, crude touch
-spinocerebellar - proprioception, voluntary movement control from touch and pressure receptors
- spinoreticular - deep and chronic pain

descending (motor)
-corticospinal - voluntary movement
-vestibulospinal - muscle tone, postural reflex
-rubrospinal - motor function
-reticulospinal - modifies transmission of sensation, pain


How do you measure spasticity with the Modified Ashworth Scale?

0 - no increase in muscle tone
1 - slight increase, minimal resistance at end ROM
1+ - slight increase in tone, minimal resistance through less than half of ROM
2 - more marked increase in tone, through most ROM, affected part easily moved
3 - considerable increased tone, passive movement difficult
4 - affected part rigid in flexion and extension


What is the differential diagnosis of UMN and LMN lesions?

UMN - hypertonia, spasticity, hyperreflexia, clonus, disuse atrohpy, impaired voluntary movement

LMN - hypotonia, hyporeflexia, neurogenic atrophy, strength altered along myotome