Neuro - Bates Flashcards
(115 cards)
1
Q
What 4 regions make up the brain?
A
cerebrum, diencephalon, brainstem, cerebellum
2
Q
A vast network of interconnecting nerve cells in the brain are known as ___.
A
neurons
3
Q
___ are single long fibers that conduct impulses to other parts of the nervous system.
A
Axons
4
Q
___ matter consists of aggregations of neuronal cell bodies. Rims the surfaces of the cerebral hemispheres, forming the cerebral cortex.
A
Grey
5
Q
___ matter consists of neuronal axons that are coated w/myelin. The myelin sheaths allow nerve impulses to travel more rapidly.
A
White
6
Q
The ___ ___ affects movement.
A
basal ganglia
7
Q
The ___ maintain homeostasis and regulates temp, HR, and B/P, as well as emotional behaviors such as anger and sexual drive.
A
hypothalamus
8
Q
Hormones secretes in the hypothalamus act directly on the ___ ___.
A
pituitary gland
9
Q
The ___ lies at the base of the brain and coordinates all movement and helps maintain the body upright in space.
A
cerebellum
10
Q
The spinal cord is divided into segments: C1-C8 = \_\_\_ T1-T12 = \_\_\_ L1-L5 = \_\_\_ S1-S5 = \_\_\_ and coccygeal
A
cervical
thoracic
lumbar
sacral
11
Q
The ___ nervous system regulates muscle movements and response to the sensations of touch and pain.
A
somatic
12
Q
The ___ nervous system connects to internal organs and generates autonomic reflex responses.
A
autonomic
13
Q
The ___ nervous system, mobilized organs and their functions during times of stress and arousal.
A
sympathetic
14
Q
The ___ nervous system conserves energy and resources during times of rest and relaxation.
A
parasympathetic
15
Q
CN I is known as ___. Its function is ?
A
olfactory, sense of smell
16
Q
CN II is known as ___. Its function is ?
A
optic, vision and visual acuity
17
Q
CN III is ___. Its function is ?
A
oculomotor, pupillary constriction, pupillary reaction to light, opening the eye, accommodation and convergence, and most extraocular movements
18
Q
CN IV is ___. Its function is ?
A
trochlear, downward, internal rotation of the eye
19
Q
CN V is ___. It’s function is ?
A
trigeminal, jaw clenching and lateral jaw movement, cottonball to forehead, cheeks, and chin, difference between sharp or dull touch
20
Q
CN VI is ___. Its function is ?
A
abducens, lateral deviation of the eye
21
Q
CN VII is ___. Its function is ?
A
facial, facial expression, raising eyebrows, puff out cheeks, smile, frown, whistle
22
Q
CN VIII is ___. Its function is ?
A
acoustic, hearing and balance
23
Q
CN IX is ___. Its function is ?
A
glossopharyngeal, swallowing and gag reflex (pharynx)
24
Q
CN X is ___. Its function is ?
A
vagus, raises palate by saying “ahhh” (pharynx and larynx)
25
CN XI is ___. Its function is ?
spinal accessory, shoulder and neck movement (sternomastoid and upper portion of trapezius)
26
CN XII is ___. Its function is ?
hypoglossal, extend tongue and push tongue against cheeks
27
```
Sensory = ___ fibers
Motor = ___ fibers
```
afferent
| efferent
28
What 3 motor pathways impinge on the anterior horn cells? A lesion in any of these areas will affect ___ or reflex activity
the corticospinal tract, basal ganglia system, and the cerebellar system, movement
29
The ___ tract aka ___, mediates voluntary movement and integrate skills, complicated, or delicate movements by stimulating selected muscular actions and inhibiting others. Carry impulses that inhibit muscle tone. Fibers cross to the ___/contralateral side.
corticospinal, pyramidal, opposite
30
The ___ ___ system includes motor pathways that help to maintain muscle tone and to control body movements, especially gross automatic movements such as walking.
basal ganglia
31
The ___ system receives both sensory and motor input and coordinates motor activity, maintains equilibrium, and helps to control posture.
cerebellar
32
When upper motor neuron systems are damaged ABOVE the crossover of its tracts in the medulla, motor impairment develops on the ___ side. When there is damage BELOW the crossover, motor impairment occurs on the ___ side.
opposite/contralateral, same/ipsilateral
33
Damage to the basal ganglia system produces changes in what?
muscle tone and disturbances in posture and gait, a slowness or lack of spontaneois and automatic movements and various involuntary movements.
34
Cerebellar damage impairs what?
coordination, gait, and equilibrium, and decreases muscle tone as well
35
The ___ tract arises in free nerve endings in the skin that register pain, temp, and crude touch.
spinothalamic
36
The ___ ___ system transmit the sensations of vibration, proprioception, kinesthesia, pressure, and fine touch.
posterior column
37
At the ___ level, general quality of sensation is perceived (pain, cold, pleasant, unpleasant), but fine distinctions are not made.
thalamic
38
A lesion in the ___ ___ may not impair the perception of pain, touch, and position, but does impair finer discrimination.
sensory cortex
39
___ and ___ ___ are often preserved despite partial damage to the cord.
crude, light touch
40
Loss of position and vibration sense, w/preservation of other sensations, points to disease of the ___ ___.
posterior column
41
Loss of all sensations from the waist down, together w/paralysis and hyperactive reflexes in the legs, indicates transection of the ___ ___.
spinal cord
42
A ___ is the band of skin innervated by the sensory root of a single spinal nerve.
dermatome
43
A ___ is an involuntary stereotypical response.
reflex
44
2 of the most common symptoms in neuro disorders include ___ and ___.
h/a and dizziness
45
___ always warrant careful assessment.
H/A
46
Migraine, tension, cluster, and chronic dly headaches are known as ___ headaches.
primary
47
___ headaches arise from underlying structural, systemic, or infectious causes and my be life-threatening
Secondary
48
What type of h/a often presents as "the worse h/a of my life"?
subarachnoid hemorrhage
49
Severe h/a and stiff neck accompany ___.
meningitis
50
Dull h/a, increased by coughing and sneezing, esp in same location, occurs in ___ ___.
mass lesions
51
___ h/a is often preceded by an aura.
Migraine
52
What does POUND stand for?
```
Pulsatile or throbbing
One-day duration
Unilateral
Nausea/vomiting
Disabling or intensity causing interruption of dly activity
```
53
Feeling light-headed, weak in the legs, or about to faint points to ___.
syncope
54
___ is unsteady and off-balance.
disequilibrium
55
___ is a spinning sensation w/in the pt or of the surroundings.
Vertigo
56
double vision = ___
difficulty forming words = ___
problems w/gait or balance = ___
These 3 are suspicious for ___ or ___.
diplopia
dysarthria
ataxia
TIA, stroke
57
___ weakness occurs in the shoulder or hip girdle and effects movements like combing hair, reaching up to a shelf, getting up out of a chair, or climbing a high step.
Proximal
58
___ weakness occurs in the hands or feet and effects opening a jar or using scissors or a screwdriver
Distal
59
Burning pain in the hands/feet like pins and needles occurs in ___ ___.
diabetic neuropathy
60
Common causes of acute symptomatic seizures include ?
head trauma, alcohol, cocaine, withdrawal from alcohol, benzo's, and barbiturates, metabolic insults from low or high glucose, calcium, or sodium, acute stroke, meningitis, or enchephalitis
61
A ___ is a rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups and is the most common movement disorder.
tremor
62
Low-freq unilateral resting tremor, rigidity, and bradykinesia typify what disorder?
Parkinson's
63
An unpleasant sensation in the legs, esp at night, that gets worse during rest and improves w/activity is known as what?
RLS
64
___ is a neurologic deficit caused by cerebrovascular ischemia (87%) or hemorrhage (13%).
Stroke
65
___ ___ is an infarction of CNS tissue that may be symptomatic or silent.
Ischemic stroke
66
A ___ is a transient episode of neurological dysfunction caused by focal, brain, spinal cord, or retinal ischemia, w/out acute infarction.
TIA
67
ABCDD is used as a scoring system for stroke and stands for ?
```
Age > 60 yrs
B/P > 140/90
Clinical features of focal weakness or impaired speech
Duration up to or more than 60 mins
Diabetes
```
68
Stroke prevalence is highest in what ethnic group?
African American
69
Midlife risk factors for stoke include ?
autoimmune collagen vascular dis, hx of preeclampsia, gest diabetes, PIH
70
Stroke outcomes markedly improve if therapy is given w/in ___ hrs of onset of sympt.
3
71
Most common cause of ischemic sympt is occlusion of what artery, which causes field cuts and contralateral hemiparesis and sensory deficits.
middle cerebral artery
72
Occlusion of what artery often produces aphasia?
left middle cerebral artery
73
Occlusion of what artery produces neglect or inattention to the opposite side of the body.
right middle cerebral artery
74
What are the stroke attack warning signs?
sudden numbness or weakness of the face, arm, or leg
sudden confusion, trouble speaking or understanding
sudden trouble seeing in one or both eyes
sudden trouble walking, dizziness, or loss of balance or coordination
sudden severe h/a
75
Modifiable risk factors for ischemic stroke are ?
HTN, smoking, hyperlipidemia, diab, excess wt, lack of exercise, heavy alcohol use
76
For prevention of hemorrhagic stroke, optimal control of what is essential?
B/P
77
The most common type of peripheral diabetic neuropathy is what? It is slowly progressive and asympt in up to 50% of pts, increasing risk of foot injury and amputation. Maintaing HgA1C at or below ___ reduces the odds of onset of neuropathy by 60%.
distal symmetric sensorimotor polyneuropathy. 7.4%
78
___ is an acute confusional state marked by sudden onset, fluctuating course, inattention, and at times, changes in LOC.
Delirium
79
___ involves age-related changes in cognition from mild cognitive impairment and Alzheimer disease. The MMSE is the best test for this.
Dementia
80
___ is more common in ind w/significant medical conditions and involves screening w/2 questions: "Have you been feeling down, depress, or hopeless?" and "Have you felt litter interest or pleasure in doing things?"
Depression
81
What are the 5 things you want to assess for neuro function?
```
mental status, speech, and language
cranial nerves
the motor system
the sensory system
reflexes
```
82
___ is known as a difference of > 0.4mm in the diameter of one pupil.
Aniscoria
83
What 3 CN test the 6 cardinal directions of gaze w/either the star or an H?
III, IV, and VI
84
___ is an involuntary jerking movement of the eyes w/quick and slow components.
Nystagmus
85
___ is drooping of the upper eyelids
Ptosis
86
The palate fails to rise w/a bilat lesion of CN ___.
X
87
In a ___ ___ ___, the protruded tongue deviates transiently in a direction away from the side of the cortical lesion, toward the side of weakness.
unilateral cortical lesion
88
___ ___ refers to a loss of muscle bulk or wasting. When looking for this, pay particular attn to the hands, shoulder, and thighs.
Muscle atrophy
89
___ is an increase in bulk w/proportionate strength.
Hypertrophy
90
When a normal muscle w/an intact nerve supply is relaxed voluntarily, it maintains a slight residual tension known as ___ __. This can be assessed best by feeling the muscle's resistance to passive stretch.
muscle tone
91
```
Impaired strength = ___
Absence of strength = ___
Weakness of one-half of body = ___
Paralysis of one-half of body = ___
Paralysis of the legs = ___
Paralysis of all 4 limbs = ___
```
```
paresis (weakness)
plegia (paralysis)
hemiparesis
hemiplegia
paraplegia
quadriplegia
```
92
A muscle is strongest when ___ and weakest when ___.
shortest, longest
93
Muscle strength is graded on a 0-5 scales w/0 being what and 5 being what?
```
0 = no muscular contraction detected
5 = active movement against full resistance w/out evident fatigue (normal muscle strength)
```
94
Look for weak opposition of the thumb in median nerve disorders such as what?
carpal tunnel syndrome
95
The motor system tests for ?
Cerebellar system tests for ?
Vestibular system tests for ?
Sensory system tests for ?
muscle strength
rhythmic movement and steady posture
balance and coordination of eye, head, and body
position sense
96
When assessing the gait, what 6 things should you have the pt do?
walk across the room
walk heel-to-toe in a straight line
walk on the toes, then the heels for balance (plantar flexion and dorsiflexion)
hop in place
do a shallow knee bend on one leg, then the other
rise from a sitting position and step up on a sturdy stool
97
What test is used as a test of position sense? Have the pt stand w/feet together and eyes open and then close both eyes for 30-60 secs w/out support. Normally only minimal swaying occurs.
The Romberg test
98
When testing for ___ ___, have the pt stand for 20-30 secs w/both arms straight forward, palms up, and eyes closed.
pronator drift
99
What 4 things do you test to evaluate the sensory system?
pain and temp
position and vibration
light touch
discriminative sensations
100
Absence of touch = ___
Decreased sensitivity = ___
Increased sensitivity = ___
anesthesia
hypesthesia
hyperesthesa
101
___ refers to the ability to identify an object by feeling it. Place a familiar object (coin, pencil, cottonball) in pt's hand and ask them to tell you what it is.
Sterognosis
102
When motor impairment, arthritis, or other conditions prevent the pt from manipulating an object well enough to identify it, test the ability to identify numbers w/what test?
Number identification/Graphesthesia
103
Using the 2 ends of an opened paper clip, touch a finger pad in 2 places simultaneously and alternate between 1 and 2. This is known as what?
Two-point discrimination
104
___ ___ is where you touch a point on the patient's skin, then ask the pt to open both eyes and point to the place touched.
Point localization
105
Test for ___ by simultaneously stimulate corresponding areas on both sides of the body. Ask where the pt feels your touch.
extinction
106
Scale for grading reflexes ranges from 0-4+, w/0 being what? 4+ being what? and 2+ being what?
no response
very brisk, hyperactive, w/clonus
average, normal
107
Tests for meningeal inflam or subarachnoid hemorrhage include ?
neck mobility/nuchal rigidity (have pt touch chin to chest)
brudzinski's (flex the neck, watch the hips and knees in reaction - normally should remain relaxed and motionless)
Kernig's (flex pt's leg at both hip and knee, then straighten the knee - pain behind knee during full extension is +)
108
Dorsiflexion of the big toe from a stroke on the lateral aspect of the sole from the heel to the ball of the foot is known as a + ___ and indicates a NSC lesion in the corticospinal tract.
Babinski
109
Pain radiating into the ipsilateral leg upon a straight raise of the leg is known as a + ___-___ test and is usually caused from what 2 things?
straight-leg, sciatica, herniated disc
110
What are the 2 cardinal "Don'ts" if you have a stuporous or comatose pt?
Don't dilate the pupils
| Don't flex the neck if there is any question of trauma to the head or neck.
111
In the level of ___, the pt opens the eyes, looks at you, and responds fully and appropriately to stimuli.
alertness
112
A ___ pt appears drowsy but opens the eyes and looks at you, responds to questions, and then falls asleep.
lethargic
113
A pt in an ___ state opens the eyes and looks at you but responds slowly and is somewhat confused.
obtunded
114
A ___ pt arouses from sleep only after painful stimuli. Verbal responses are slow or even absent.
stuporous
115
A ___ pt remains unarousable w/eyes closed, even upon repeated painful stimuli.
comatose
