Neuro Flashcards
(157 cards)
1
Q
Frontal lobe
A
voluntary skeletal, behavioral, visceral functions
2
Q
Parietal
A
processing sensory data; proprioception
3
Q
Occipital
A
vision
4
Q
Temporal
A
Sound and integration of taste, smell, and balance
5
Q
Speech center is called
A
Wernicke
6
Q
Basal ganglia
A
refine motor movements
7
Q
Cerebellum
A
muscle tone, balance, posture; integration of voluntary movement
8
Q
Thalamus
A
pain and temperature
9
Q
Brainstem structures:
A
medulla oblongata, pons, midbrain, and diencephalon
10
Q
Two structures of diencephalon
A
thalamus; hypothalamus
11
Q
Pons
A
transmits information between the brainstem and cerebellum
12
Q
Medulla olbongata is the site where
A
descending corticospinal tracts decussate
13
Q
ascending spinal tracts
A
complex discrimination tasks
14
Q
posterior (dorsal) column spinal tracts
A
fine touch, 2-point discrimination, and proprioception
15
Q
Spinothalamic
A
light and crude touch; pressure, temp, and pain
16
Q
How long is the spinal cord
A
40-50 cm
17
Q
where does the spinal cord begin and end?
A
begins at foramen magnum and ends at L1 or L2
18
Q
The gray matter contains:
A
the nerve cell bodies associated with sensory pathways and the ANS
19
Q
The white matter of the spinal cord contains
A
the ascending and descending spinal tracts
20
Q
descending spinal tracts
A
brain to muscles; muscle tone, posture, and precise motor movements
21
Q
Corticospinal
A
skilled, delicate movements
22
Q
vestibulospinal
A
extensor muscles to contract during fall
23
Q
UMN
A
nerve cell bodies for the motor pathways; begin and end within the CNS
24
Q
UMN role
A
influencing, directing, and modifying spinal reflex arcs and circuits; can affect movement only through LMN
25
UMN injury causes
initial paralysis, followed by partial recovery
26
LMN
originate in anterior horn of spinal cord and extend to PNS; transmit signals directly to muscles
27
LMN injury
permanent paralysis
28
motor/efferent go to what horn
anterior
29
sensory/afferent go to what horn
posterior
30
how many pairs of spinal nerves?
31
31
The major portion of the brain growth occurs in the x year of life, along with myelinization of the brain and nervous system?
first
32
At birth the neurologic impulses are primarily handled by the?
brainstem and spinal cord
33
The following reflexes are present at birth
sucking, rooting, yawning, sneeze, hiccup, blink at bright light, and withdrawal from pain
34
Motor maturation proceeds in what direction
cephalocaudal
35
What change in pregnant patients leads to neurologic changes?
hypothalamic-pituitary neurohormonal changes
36
Do tendon reflexes increase or decrease in the elderly?
decreased
37
Three screening questions for fall risk?
have you fallen in the past year? Do you feel unsteady when standing or walking? Do you worry about falling?
38
Corneal reflex is associated with what CN?
V (trigeminal)
39
Palate and uvula movement is associated with what CN?
IX and X
40
Guttural speech sounds are associated with CN?
IX and X
41
Tongue movement is associated with CN?
XII
42
Lingual speech sounds are associated with CN?
XII
43
The loss of sense of small or an inability to discriminate odors called
anosmia
44
Anosmia is due to
trauma to the cribriform plate or an olfactory tract lesion
45
What's the first thing to lose function in the presence of increased intracranial pressure
sixth cranial nerve
46
Impaction of sixth cranial nerve can lead to what vision abnormality
absence of lateral (temporal) gaze
47
When UMN are affected what is paralyzed?
voluntary motor paralyzed, but emotional movements are spared
48
What is paralyzed in LMN?
all facial movements on the affected side are paralyzed
49
posterior tongue taste and nerve?
bitter and sour; 1/3; IX
50
anterior tongue taste and nerve?
sweet and salty; 2/3; VII
51
enhanced physiologic tremor is seen when?
hands are held extended, disappears when limb at rest
52
Potential cause of enhanced physiologic tremor
drug or alcohol withdrawal; hyperthyroidsm; hypoglycemia; toxicity
53
describe tremor of essential tremor
symmetric; worse with stress or fatigue; improved with alcohol
54
cause of essential tremor:
AD
55
Intentional tremor describe
seen during intentional movements; does not occur with rest
56
Cause of intentional tremor
cerebellar disorder like MS or alcohol abuse
57
Describe resting tremor
seen at rest; slow supination-pronation
58
Cause of resting tremor
PD
59
a positive romberg test indicates
cerebellar ataxia, vestibular dysfunction, sensory loss
60
For all the Romberg tests (standing on foot; bouncing on foot) what is the time frame?
5 seconds
61
Heel-toe walking is called?
tandem gait
62
the affected leg is stiff and extended with plantar flexion of the foot ; movement of the foot results from pelvic tilting upward on the involved side; the foot is dragged, often scraping the toe, or it is circled stiffly outward and forward; the affected arm remains flexed and adducted and does not swing
spastic hemiparesis
63
the patient uses short steps, dragging the ball of the foot across the floor; the legs are extended and the thighs tend to cross forward on each other at each step due to injury to the pyramidal system
spastic diplegia
64
the hip and knee are elevated excessively high to lift the plantar flexed foot off the ground; the foot is brought down to the floor with a slap; unable to walk on heels
steppage
65
the patient's feet are wide-based; staggering and lurching from side to side is often accompanied by swaying of the trunk
cerebellar gait
66
the patient's gait is wide-based; the feet are thrown forward and outward, bringing them down first on heels, then on toes; the patient watches the ground to guide his or her steps; positive romberg present
sensory ataxia
67
the patient limits the time of weight bearing on the affected leg to limit pain
ataxia
68
the patient's posture is stooped and the body is held rigid; steps are short and shuffling, with hesitation on starting and difficulty stopping
parkinsonian gait
69
loss of position of joints indicates?
peripheral neuropathy
70
polyneuropathy manifests in what distribution?
glove and stocking
71
manifestations of complete transverse lesion of the spinal cord
all sensation lost below the level of the lesion; pain/temp/touch sensation lost one or two dermatomes below lesion
72
partial spinal sensory syndrome aka
brown-sequard
73
partial spinal sensory syndrome manifestations
pain and temp sensation loss one or two dermatomes below the lesion on the opposite side of the body from the lesion; proprioceptive loss and motorparalysis occur on the lesion side of the body
74
familiar object test
sterognosis
75
touch two areas of body and ask how many and where test
extinction phenomenon
76
upper abdominal reflexes
T8, T9, T10
77
lower abdominal reflexes
T10, T11, T12
78
cremasteric reflxes
T12, L1, L2
79
Plantar reflxes
L5, S1, S2
80
biceps reflex
C5 C6
81
brachioradial reflex
C5 C6
82
triceps reflex
C6 C7 C8
83
patellar reflex
L2, L3, L4
84
Achilles reflex
S1 and S2
85
the babinski sign indicates a
pyramidal tract UMN disorder
86
Babinski sign is expected in children younger than
2 years old
87
With abdominal reflex do you stroke toward or away from umbilicus?
away
88
With abdominal reflex how does the abdomen respond?
slight movement of the umbilicus toward each area of stimulation, bilaterally equal
89
Diminished abdominal reflex seen in?
obese patients, stretched abdominal muscles (pregnancy); absent on side of corticospinal tract lesion
90
absent reflexes may indicate
neuropathy or LMN disorder
91
Hyperactive reflexes may indicate
UMN disorder
92
UMN muscle tone
increased tone, muscle spasticity, risk for contractures
93
LMN muscle tone
decreased tone, muscle flaccidity
94
UMN muscle atrophy
little or none, but decreased strength
95
LMN muscle atrophy
loss of muscle strength; muscle atrophy or wasting
96
UMN sensation
sensation loss may affect entire limb
97
LMN sensation
sensory loss follows the distribution of dermatome or peripheral nerves
98
UMN reflexes
hyperactive deep tendon and abdominal reflexes; + babinski
99
LMN reflexes
weak or absent deep tendon, plantar, and abdominal reflexes, negative plantar reflex, no pathologic reflexes
100
UMN fasiculations
none
101
LMN fasiculations
present
102
UMN motor effect
paralysis of voluntary movements
103
LMN motor effect
paralysis of muscles
104
uMN location of insult
damage above level of brainstem affects opposite side of body; damage below the brainstem affects the same side of body
105
LMN location of insult
damage affects muscle on same side of body
106
grade 0 reflex
no response
107
grade 1+ reflex
sluggish or diminished
108
grade 2+ reflex
active or expected response
109
grade 3+ reflex
more brisk than expected, slightly hyperactive
110
grade 4+ reflex
brisk, hyperactive, with intermittent or transient clonus
111
brachioradial reflex results in what action?
pronation
112
sustained clonus indicate?
UMN disease
113
diabetic foot exam filament?
5.07
114
monofilament should be applied for x time
1.5 seconds
115
how to test for nuchal rigidity?
with patient supine, slip hand under head and raise it, flexing neck. Try to make patient's chin touch sternum. Placing hand under shoulders and raising will help relax the neck. Pain and resistance is positive.
116
Brudzinski sign
involuntary flexion of the hips and knees when flexing the neck
117
Kernig sign
flexing the leg at the knee and hip when patient is supine, then attempting to straighten the leg. positive is present when the patient has pain in the lower back and resistance to straightening the leg at the knee.
118
jolt accentuation of HA
ask pt to move head horizontally at a rate of 2-3 rotations per second. Positive is increased HA over the baseline.
119
decorticate is associated with
corticospinal tracts injury above the brainstem
120
decerebrate is associated with injury to
the brainstem
121
coordinated sucking and swallowing is a function of the
cerebellum
122
hands are usually held in fists for first
3 months
123
Purposeful movements begin at about
2 months
124
taking objects with one hand at
6 months
125
transferring objects between hands at
7 months
126
purposefully releasing objects by
10 months
127
which reflex is present at birth?
patellar
128
achilles and brachioradial reflex appear at age
6 months
129
Ankle clonus in an infant?
one or two beats
130
positive babinski normal until
16-24 months
131
rooting reflex
touch corner of infant's mouth, when hungry will move head and open mouth on side of stimulation
132
rooting reflex disappears by
3-4 months
133
palmar grasp
touch palm of infant's hand from ulnar side, note strong grasp of finger
134
palmar grasp strongest between
1-2 months
135
palmar grasp disappears by
3 months
136
plantar grasp
touch plantar surface of infant's feet at base of toes; toes should curl downard
137
plantar grasp strong up to
8 months
138
moro
with infant supported in semisitting position, allow the head and trunk to drop back to 30 degree, observe symmetric abduction and extension of arms, fingers fan out and thumb and index finger form a C; the arms then adduct in an embracing motion followed by relaxed flexion; legs follow a similar pattern
139
moro diminishes by
3-4 and disapears by 6 months
140
placing reflex
hold infant upright under arms next to table or chair; touch the dorsal side of the foot to table/chair; observe flexion of the hips and knees and lifting of the foot as if stepping up on the table
141
stepping reflex
hold infant upright under arms and allow soles of feet to touch the surface; observe for alternate flexion and extension of the legs; simulating walking
142
Asymmetric tonic neck or "fencing"
with infant lying supine and relaxed, turn his or her head to one side so jaw is over shoulder; observe for extension of arm and leg on the side to which the head is turned and for flexion of the opposite arm and leg
143
asymmetric tonic neck or "fencing" diminishes by
3-4 months and disappears by six
144
what four baby reflexes are present at birth?
rooting, palmar grasp, plantar grasp, moro
145
placing is present by
4 days of age
146
stepping present by
birth to 8 weeks
147
asymmetric tonic neck or "fencing" present by
2-3 months
148
In a child, delaying in sitting or walking may be sign of
cerebellar disorder
149
the child beginning to walk has what type of gait?
wide-based
150
what type of taste is lost with aging?
salty
151
gait of advancing age
shorter steps with less lifting; shuffling; arms are more flexed and legs may be flexed at hips and knees
152
Screening test of balance, strength and cerebellar function
The Timed Up and GO Test
153
Timed Up and Go Test
stand up from chair without using arms; walk 10 feet to mark on floor, turn around, walk 10 feet, and sit down without using chair arms; assistive devices ok
154
How long does it take to complete Timed Up and Go test
10 seconds
155
Fall risk tool
Performance Oriented Mobility Assessment Tool AKA Tinetti Balance and Gait tool
156
are lower extremities or upper extremities reflexes diminished first in elderly
lower first
157
What reflexes may be absent in the elderly?
achilles and plantar
