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neuro nml Flashcards

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1
Q

which lobe is responsible for behavior, judgment, motor planning, and some language

A

frontal lobe

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2
Q

which lobe is responsible for sensory processing

A

parietal lobe

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3
Q

which lobe is responsible for auditory processing, memory, some language (werknicke’s area)

A

temporal lobe

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4
Q

which lobe is responsible for visual processing, visuospatial processing

A

occipital lobe

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5
Q

which lobe is responsible for relaying visual, auditory, and sensation but not motor pathways

A

thalamus

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6
Q

which structures are part of the brainstem

A
  • midbrain
  • pons
  • medulla
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7
Q

which structure’s function is coordination of voluntary movements, balance, and equilibrium

A

cerebellum

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8
Q

where does the spinal cord end

A

T12-L1

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9
Q

injury to the spinal cord above what level is not compatible with life

A

above C5

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10
Q

diseases of the spinal cord are called

A

myelopathies

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11
Q

transmission of motor information form CNS are done via what 3 structures

A
  1. corticospinal tracts
  2. extrapyramidal tracts
  3. cerebellar tracts
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12
Q

transmission of sensory information to the CNS are done via

A
  1. spinothalamic tracts
  2. posterior columns
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13
Q

corticospinal tract is responsible for what type of movement

A

voluntary motor movement

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14
Q

spinothalamic tracts carry what information

A

light touch, pain, temperature, and pressure

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15
Q

posterior columns carry what information

A
  • vibration
  • proprioception
  • discriminative touch
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16
Q

what conditions are characterized by increased tone (spasticity), “stiff man” gait, elevated reflexes, proprioceptive changes, and positive romberg sign

A

myelopathies

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17
Q

what is the principle component of the neuromuscular junction exam

A

checking for strength of certain muscles and for fatigability

*diseases affecting the NMJ are characterized by proximal weakness and fatigability that is improved with rest

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18
Q

components of peripheral neuropathy exam

A
  1. light touch
  2. pin prick
  3. vibration
  4. proprioception
  5. muscle strength
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19
Q

the lumbosacral plexus consists of what nerve roots

A

L3-S1

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20
Q

what are plexopathies

A

characterized by

  • loss of reflexes
  • widely distributed weakness
  • multifocal numbness with or without pain
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21
Q

what are most plexopathies caused by

A
  • compression
  • infiltration
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22
Q

diseases of the nerve root are called

A

radiculopathies

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23
Q

the cervical roots C5-8 innervate what

A

upper extremities

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24
Q

which nerve roots are responsible for biceps reflexes

A
  • C5
  • C6
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25
which nerve roots are responsible for triceps reflex
* C7 * C8
26
which nerve roots are responsible for patellar reflex
* L3 * L4
27
which nerve roots are responsible for achilles reflex
* S1 * S2
28
components of brief mental status examination
"JOMAC" 1. Judgement 2. Orientation 3. Memory 4. Affect 5. Cognition
29
Optic nerve examination
1. visual acuity 2. visual fields: assess 4 fields of gaze (superior, inferior, lateral, medial) 3. funduscopic exam
30
oculomotor nerve examination
1. pupillary responses: direct and consensual 2. eyelid elevation: ptosis 3. EOMS 1. CN III: inferior oblique, superior/inferior/medial rectus 2. CN IV: superior oblique 3. CN VI: lateral rectus
31
trigeminal nerve examination
1. facial sensation 1. 3 divisions: light touch 2. corneal reflexes 1. CN V: afferent limb 2. CN VII: efferent limb 3. muscles of mastication 1. temporalis and masseter
32
facial nerve examination
1. muscles of facial expression 2. taste
33
Vestibulocochlear examination
1. gross hearing 2. weber and rinne test 1. sensineural vs conductive hearing loss
34
glosspharyngeal and vagus nerve examination
1. palate elevation: check for symmetry 2. gag reflex
35
spinal accessory nerve examination
* sternocleidomastoid * trapeizius
36
hypoglossal nerve examination
* assess for tongue in midline * tongue movement side to side
37
pronator drift: function and technique
* detect a subtle contralateral upper motor neuron lesion (weakness secondary to CVA) 1. stand with arms extended outward and **palms up** for 20-30 seconds with eyes closed 1. watch for pronation of arm and drift downward
38
Romberg test: function
* tests position sense (dorsal column and in some measure sensation in the feet)
39
Romberg test: technique
1. pt stands with feet together with eyes open and then closed for 20-30 seconds 2. loss of balance = positive test \*\*check Romberg before gait testing to avoid a fall
40
what dermatome contains the thumb
C6
41
what dermatome contains the middle fingers
C7
42
what dermatome contains the fifth digit
C8
43
what dermatome contains the nipple line
T4
44
what dermatome contains the umbilicus
T10
45
what dermatome contains the anterior thigh
L3
46
what dermatome contains the anterior shin
L4
47
what dermatome contains the top of foot
L5
48
what dermatome contains the bottom of foot
S1
49
technique for vibration, primary sensory testing
* place tuning fork on bony prominence and as what is felt and when it stops
50
technique for proprioception, primary sensory testing
1. hold sides of digit 2. assess by moving thumb up and down and ask direction 3. repeat with great toe
51
technique for two point discrimination, cortical sensory
1. move two pins closer together until patient can only appreciate one point * normals * fingertips: 2 mm * toes: 3-8 mm * palms: 8-12 mm * back: 40-60 mm
52
technique for graphesthesia, cortical sensory
1. draw a number (0-9 oriented to patient) on palm and dorsum of foot, ask patient to identify
53
technique for stereognosis, cortical sensory
1. ask patient to identify common object placed in hand
54
technique for tactile localization (extinction or "double simultaneous stimulation"), cortical sensory
1. simultaneously touch two seperate sites on opposite sides of the body and ask what was felt
55
"reflex dance"
* 1,2 ..achilles reflex (S1, S2) * 3, 4 ... patellar reflex (L3, 4) * 5, 6.. biceps reflex (C5, 6) * 7, 8... triceps reflex (C7, 8)
56
scale used to rate reflex responses
* **0-4** * 0: no response * +1: dimininished * **+2: normal** * +3: increased * +4: hyperactive, associated with clonus
57
clonus
* consistent with upper motor neuron disease * rhythmic oscillations between plantar and dorsiflexion
58
what is the biceps reflex
* tap biceps tendon to elicit forearm flexion
59
brachioradialis relfex exam
* C5,6 1. tap tendon/radius about 1-2 inches above the wrist to elicit forearm flexion and supination
60
triceps reflex exam
* C7-C8 1. tap triceps tendon to elicit forearm extension
61
patellar reflex exam
* L3-L4 1. tap patellar tendon to elicit knee extension
62
achilles reflex exam
* S1-S2 1. tap achilles to elicit plantar flexion
63
babinski reflex
1. stroke the lateral aspect of the plantar aspect of the foot upwards then across the ball of the foot * abnormal response: dorsiflexion of the great toe and fanning of the other toes
64
cerebellar examination: finger to nose
1. alternately touch examiner's finger, then thier own nose \*\*best for picking up dysmetria 1. plan b: arms at sides, alternately touch nose with one finger
65
cerebellar examination: heel to shin
1. lying down 2. slide heel of one foot down shin of other leg slowly and smoothly 3. repeat one more time 4. switch legs
66
cerebellar examination: rapid alternating movements
* look for speed and coordination while assessing 1. rapid pronation and supination of forearms 2. touching fingertips to thumb 3. tapping the feet
67
what is dysdiadochokinesia
inability to do rapid alternating movements 1. slow, but regular: cerebral dysfunction 2. fast but irregular: cerebellar dysfunction
68
cerebellar examination: gait
1. heel walk: also checks L5 2. toe walk: also checks S1 3. heel-to-toe (slight swaying is normal)
69
kernig's sign: function and technique
* assess meningeal irritation 1. patient supine 2. flex hip and knee 3. then attempt to straighten the leg 1. +LBP: positive sign
70
Brudzinski's sign: function and technique
1. patient supine 2. place hands behind patient's neck and attempt to flex the neck toward the chest 3. involuntary flexion of hips and knees is (+) sign suggesting meningeal irritation
71
what neurological tests do you do when the patient is standing
* Romberg * gait * stand on one foot and hop; switch * finger to nose * RAMs
72
what neurological tests do you do when the patient is sitting
* ophthalmic exam * cranial nerve exam * DTR of UE * Motor exam of UE and LE * DTR of LE * vibration at ankles * graphesthesia * temperature (warm/cold)

Physical Diagnosis (16 decks)

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