Neuro Flashcards
(119 cards)
1
Q
Afferent neurons
A
carry signals from the periphery to the CNS
2
Q
Efferent neurons
A
carry signals from CNS out to the periphery
3
Q
The lobes of the brain are commonly used for what during a physical exam?
A
landmarks
4
Q
Frontal lobe
A
emotional/behavioral, voluntary movements
5
Q
Temporal lobe
A
auditory
6
Q
Parietal lobe
A
sensation
7
Q
Wernicke’s area
A
responsible for comprehension of speech
8
Q
Broca’s area
A
responsible for production of speech
9
Q
Hypothalamus
A
central control center of the brain
responsible for vital signs
10
Q
Midbrain, pons and medulla
A
part of the brainstem and is the central core of the body
11
Q
Spinal cord
A
mediates reflexes
12
Q
Cranial nerve I type and name
A
sensory
olfactory
13
Q
Cranial nerve II
A
sensory
optic
14
Q
Cranial nerve III
A
mixed
occulomotor
15
Q
Cranial nerve IV
A
motor
trochlear
16
Q
Cranial nerve V
A
mixed
trigeminal
17
Q
Cranial nerve VI
A
motor
abducens
18
Q
Cranial nerve VII
A
mixed
facial
19
Q
Cranial nerve VIII
A
sensory
acoustic
20
Q
Cranial nerve IX
A
mixed
glossopharyngeal
21
Q
Cranial nerve X
A
mixed
vagus
22
Q
Cranial nerve XI
A
motor
spinal
23
Q
Cranial nerve XII
A
motor
hypoglossal
24
Q
Cranial nerve I assessment
A
have patient close eyes, occlude one nostril and have them smell something
25
Cranial nerve II assessment
Snellen
26
Cranial nerve III, IV, VI assessment
PERRLA and 6 cardinal gazes
27
Cranial nerve V assessment
palpate temporal and masseter muscles for mastication
| also have them close their eyes and touch cotton swab to face
28
Cranial nerve VII assessment
have patient smile, frown, close eyes, puff cheeks and then suck them back in
29
Cranial nerve VIII assessment
hearing acuity
30
Cranial nerve IX and X assessment
depress tongue with tongue blade and watch uvula contraction while patient says "ahh"
test gag reflex
31
Cranial nerve XI assessment
check sternomastoid and trapezius muscles for equal size and strength by having patient shrug against resistance
32
Cranial nerve XII assessment
inspect tongue; have them say "light", "tight" and "dynamite" and make sure speech is clear and distinct
33
The cerebellum is responsible for?
equilibrium
34
Aphasia
loss of ability to express or understand speech
35
Ataxia
lack of muscle control or coordination of voluntary movements; looks similar to being drunk
36
Decerebrate rigidity
result of midbrain lesion
exaggerated extensor posture
arms will be extended with wrists turned out
legs will be extended with feet internally rotated
head will be arched backwards
37
Decorticate rigidity
result of severe damage to the brain
exaggerated flexed posture
arms will be at the chest with hands clenched
legs and knees will be internally rotated and feet may cross
38
Dysphasia
deficiency in generation or understanding of speech
39
Dysphagia
difficulty swallowing
40
Hemiplegia
paralysis of one side of the body
41
Paraplegia
paralysis of legs or lower body
42
Tic
repetitive twitching that can usually be surpressed
43
Tremor
rhythmic involuntary movement of opposing muscle groups
44
Tension headache origin
musculoskeletal
45
Tension HA definition
mild-moderate HA that is a less disabling form of migraine
46
Tension HA location
bandlike; on both sides of the head, forehead or back of the head
47
Does a tension HA throb or pulse?
No
48
Tension HA duration
30 minutes to days
49
Tension HA quality
dull, aching, diffuse
50
Tension HA timing and triggers
situational, response to overwork or stress
| not worsened by physical activity
51
Migraine HA definition
genetically transmitted vascular origin
prodrome aura
2-3 times more common in women than men
52
Migraine HA location
can be unilateral or bilateral
| behind eyes, temple or forehead
53
Migraine HA character
throbbing
| pulsing
54
Migraine HA duration
rapid onset
| peaks 1-2 hours after and lasts 4-72 hours
55
Migraine HA timing and triggers
2/month that last 1-2 days
1 in 10 patients have one every week
triggered by hormones, foods, hunger
stress letdown, sleep deprivation
56
Cluster HA definition
Rare, intermittent
| excruciating, unilateral with autonomic symptoms
57
Cluster HA location
always unilateral
| behind eyes, temple, forehead or cheek
58
Cluster HA character
piercing, burning, continuous
59
Cluster HA duration
abrupt onset, peaks in minutes, lasts 45-90 minutes
60
Cluster HA quantity and severity
Severe
| can occur multiple times a day in clusters which can sometimes last weeks
61
Cluster HA timing
1-2/day
each lasts 0.5-2 hours
this will last for months and then patient will go into remission
62
Cluster HA triggers
alcohol, stress, daytime napping, wind/heat exposure
63
Acute vs chronic headache
acute headaches have been present for hours or days, are usually severe, and are seen in the ER
chronic headaches have been present for months or years, vary in severity and are often seen by PCP
64
What is the most important thing to ask when assessing a TBI?
Did the patient lose consciousness? For how long?
65
What is the most important question to ask as it relates to headaches?
Have you had any unusually frequent or severe headaches?
66
Objective vertigo
stationary objects in the environment are moving
67
Subjective vertigo
the person feels as if they are moving
68
Preictal phase
usually starts with an aura
69
Aura
a subjective sensation that definitively precedes a seizure; can be auditory, visual or motor
70
Ictal phase
actual seizure
71
Postictal phase
After seizure
72
What questions should be asked regarding the postictal phase?
Do you sleep? Do you have confusion, weakness, headache, or muscle aches?
73
What commonly occurs in patients who are in the ictal phase of a seizure?
Loss of control of bowel and/or bladder
74
What questions should be asked regarding seizures?
When did they start? How often do they occur? Do you have an aura? Where in the body do they occur? Do you have any associated signs? Are there are precipitating factors (discontinuing medication, fatigue, stress, hypoglycemia etc)?
75
What is the most important question that must be asked and addressed when it comes to tremors?
How do tremors affect the patient's ADLs?
76
Paresis
partial or incomplete paralysis
77
Paralysis
completenly absent movement
78
Expressive dysphasia is also known as?
Broca's
79
Broca's dysphasia?
patient understands/comprehends but cannot respond
80
Receptive dysphasia is also known as?
Wernicke
81
Wernicke dysphasia
they can respond but cannot understand or comprehend
82
Global dysphasia
combination of both expressive and receptive dysphasia
83
What is the most important thing to remember when assessing atrophy in the aging adult?
It may not be from a neurological deficit, it may just be related to advanced age
84
What is the correct order of the neurological exam?
```
mental status (ABCTs; A&O)
cranial nerves
motor nerves
sensory
reflexes
```
85
Appearance
body movements
dress
grooming
hygiene
86
Behavior
LOC
facial expressions
speech
mood and affect
87
Cognition
```
orientation
attention span
recent memory
remote memory
new learning
```
88
Thought processes
logical content
perceptions
suicidal ideations
89
What tests do we use to test muscle strength?
Hand grasp with push-pull
| Plantar flexion and dorsiflexion with resistance
90
What tests can we use to test cerebellar function?
Gait
Romberg
Rapid Alternating Movement
91
Gait test
watch patient walk 10-20 feet, turn and return to the starting point; have patient walk heel-toe in a straight line
normal gait is smooth and rhythmic
92
Romberg test
ask patient to stand up with feet together and arms at side; when stable, have patient close eyes and hold position for 20 seconds
93
Positive vs negative Romberg test
```
positive = excessive swaying present
negative = no swaying present
```
94
What are the various RAM tests?
```
Knee pat with hand flip
Thumb to finger
Finger to finger (patient to yours)
Finger to nose (patient touches their own nose after touching your finger)
Heel to shin
```
95
What RAM tests are included in the NIH stroke scale?
Finger to finger
Finger to nose
Heel to shin
96
Bicep reflex test process and what it tests
hold patient's forearm, place thumb over bicep tendon, hit with reflex hammer
C5 and C6
97
Tricep reflex test process and what it tests
suspend arm at bicep, strike directly above elbow at tricep tendon
C7 and C8
98
Brachioradialis relfex test process and what it tests
hold thumbs to suspend arms strike right above radial styloid process
C5 and C6
99
Quadricep reflex test process and what it tests
let lower legs dangle freely and strike right below knee cap
| L2 - L4
100
Achilles reflex test process and what it tests
knee flexed with hip externally rotated, hold foot in dorsiflexion and strike behind the foot at the heel
L5-S2
101
Reflex scale
```
4-point
4+ = very brisk
3+ = brisker than average
2+ = average
1+ = diminished
0 = none
```
102
What type of dysfunction is Parkinson's disease?
motor system dysfunction
103
Definition of Parkinson's disease?
defect of extrapyramidal tracts
104
What are the defining characteristics of Parkinson's disease?
```
tremors
rigidity
cogwheel rigidity in hands
stooped posture
short and shuffling gait
flat, staring, expressionless face
pill rolling maneuver with fingers
```
105
Which is more ominous; decerebrate or decorticate posturing?
decerebrate
106
Location of lesion in decerebrate vs decorticate rigidity
brain stem at midbrain or upper pons vs. lesion at or above brain stem
107
What does a positive babinski reflex indicate?
upper motor neuron lesion
108
Who has the responsibility of notifying family of status of a brain dead patient?
nurse
109
What must be checked when doing a neurological recheck?
LOC, motor function, pupillary response, vital signs, glasgow coma scale
110
Why do we perform a neuro recheck?
monitor those with established neurologic deficits
111
GCS definition
standardized objective assessment that defines the LOC of a person by using a numeric scale
112
What GCS score will a fully alert, healthy human have?
15
113
What GCS score reflects a coma?
7 or less
114
What is the leading cause of long term disability and the 3rd leading cause of death?
stroke
115
What are the most common symptoms of a stroke?
weakness in face or arms unilaterally, confusion, slurred speech, changes in vision, trouble walking, sudden and severe headache
116
TIA
ministroke
isn't permanent
usually caused by a spasm
117
What are the three main causes of stroke?
HTN
cigarette smoking
cardiac disorder
118
Modifiable risk factors for stroke
```
smoking
obesity
HTN
diabetes
heart disease
```
119
Nonmodifiable risk factors for stroke
```
age
family history
sex
race
prior stroke
```
