neuro basics

Question 1

dorsal column in SC carries what?

where does it cross?

Answer 1

dorsal column/ medial leminiscal carries

1. proprioception
2. fine touch
3. vibration

crosses in medulla

Question 2

anterolateral system carries what?

where does it cross

Answer 2

anterolateral = spinothalamic
so it crosses immediately in spine

carries:

1. pain
2. temp
3. crude touch

Question 3

spinocerebellar carries what?

Answer 3

carries proprioception from GTO and muscles to cerebellum

Question 4

lateral corticospinal tract

Answer 4

motor tracts. only about 90% cross in medulla

10% never cross

Question 5

A nerve fibers

Answer 5

large, myelinated & fast conducting

Question 6

alpha- A nerve fibers

Answer 6

proprioception & somatic motor (voluntary muscle)

Question 7

beta-A nerve fibers

Answer 7

touch

pressure

Question 8

gamma- A nerve fibers

Answer 8

motor & muscle spindle

Question 9

delta- A nerve fibers

Answer 9

pain
temperature
touch

think spinothalamic fibers

Question 10

glasgow coma scale
3 elements
score ranges; do u want high or low

Answer 10

3 elements:

1. eye opening; spontaneous -> none
2. motor response -> follows commands -> abnormal response -> none
3. verbal response: oriented -> inappropriate -> none

score ranges from 3-15. want higher score

Question 11

glasgow coma scale- scores

Answer 11

3-8 = severe brain injury
9-12 = moderate
13-15 = minor brain injury

Question 12

ranchos los amigos levels of cognitive functioning (LOCF)

levels I-III

Answer 12

level I: no response
level II: generalized response- inconsistent and non-specific to stimuli
level III: localized response- inconsistent but specific to stimuli

Question 13

ranchos los amigos levels of cognitive functioning

levels IV-VI

Answer 13

level IV: confused/ agitated
level V: confused/ inappropriate - can respond to simple tasks
level VI: confused/ appropriate - requires external cues

Question 14

ranchos los amigos levels of cognitive functioning

levels VII - VIII

Answer 14

level VII: automatic appropriate - judgement remains impaired
Level VIII: purposeful appropriate - appropriate but not perfect (especially in stressful situations)

Question 15

classic signs of right brain lesions (6)

Answer 15

right brain lesions

1. quick and impulsive
2. poor safety awareness (poor judgement)
3. left sided neglect
4. poor spatial/ eye-hand coordination** perceptual deficits are associated with non-dominant brain lesions
5. irritability & short attention span
6. cannot retain information/ difficulty learning individual steps

Question 16

classic signs of LEFT brain lesions (6)

Answer 16

left brain lesions** usually dominant side

1. Aphasia
2. apraxia
3. difficulty starting and sequencing tasks
4. easily frustrated & high levels of anxiety
5. cautious and slow
6. perseveration

Question 17

2 tests for CNS infection or meningitis

Answer 17

1. Kernigs sign:
   supine with hip and knee flexed to chest; attempt to extend knee
   (+) increased pain
2. Brudzinski’s sign
   supine, flex neck to chest
   (+) both hips and knees flex “drawing up”

Question 18

why do we use isokinetic training post stroke

Answer 18

improves timing deficits and velocity control of movement

Question 19

working with pts with Left sided stroke (3)

Answer 19

1. develop appropriate communication base; words, gestures or pantomime
2. give frequent feedback
3. do not underestimate ability to learn

Question 20

working with pts with R sided stroke (6)

Answer 20

1. use verbal cues, demonstrations or gestures
2. frequent feedback focused on slowing down and controlling movement
3. focus on safety as pt is probably impulsive
4. avoid environmental (spatial) clutter
5. do not OVERestimate ability to learn

Question 21

word for pure motor stroke & where it occurs

Answer 21

lacunar = pure motor stroke

occurs with internal capsule lesion (posterior limb)