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Summer 2025 - AL, AT, WJ > Neuro Rehab I Lecture 1 - Neuro Overview > Flashcards

Neuro Rehab I Lecture 1 - Neuro Overview Flashcards

(72 cards)

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1
Q

capgras delusion

A

recurrent belief that a person has been replaced by an imposter; reported with lesions in the right hemisphere

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2
Q

stiffperson syndrome

A

diffuse stiffness without weakness or numbness; autoimmune syndrome

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3
Q

prosopagnosia

A

inability to recognize faces of familiar people; usually right hemispheric lesions

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4
Q

History & Neuro Exam –> ??? –> Localize lesion & formulate syndrome –> ??? + ??? + ??? —> diagnosis

A

History & Neuro Exam –> Interpretation of symptoms and signs –> Localize lesion & formulate syndrome –> Anatomic diagnosis + mode of onset and course + appropriate lab tests —> diagnosis

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5
Q

______ ________ is essential to diagnosis

A

good history

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6
Q

HPI stands for

A

History of Present Illness

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7
Q

Name some common neurologic complaints. Try for 3.

A
  • Disordered mentation, attention, memory, behavior
  • Language and communication disturbances
  • Excessive daytime sleepiness, insomnia, fatigue
  • Visual disturbances (vision loss, diplopia)
  • Weakness, numbness, other sensory alterations, balance problems
  • Sphincter disturbances (urinary or fecal incontinence, inability to void)
  • Erectile or ejaculatory dysfunction
  • Sudden (paroxysmal) behavioral changes (seizures, loss of consciousness)
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8
Q

Weakness can mean? (4)

A

-fatigue
-imbalance
-apathy
-pain
(there’s more)

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9
Q

7 parts of a Neurologic Exam

A

I. Mental Status & Language
II. Cranial Nerves
III. Motor
IV. Sensation
V. Reflexes
VI. Coordination
VII. Gait

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10
Q

Mental Status deals with:

A

-levels of consciousness
-orientation
-memory
-judgement
-abstraction
-praxis
-components of language

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11
Q

4 levels of consciousness

A

Alert; Lethargy; Stupor; Coma

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12
Q

alert definition

A

awake and interactive

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13
Q

lethargy definition

A

Appears asleep, but may be aroused with stimulation to interact with environment

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14
Q

stupor definition

A

Arouses briefly to vigorous stimuli, but not to the point of being interactive

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15
Q

coma definition

A

Unresponsive to external stimuli

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16
Q

dysarthria is (2)

A

slurred speech
motor disorder affecting the muscles of articulation

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17
Q

aphasia is

A

impairment of language production or comprehension

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18
Q

Name some components of language

A

-spontaneous speech
-naming
-comprehension
-repetition
-reading
-writing

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19
Q

dyguesia means

A

altered taste

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20
Q

Common pathologies of CN I

A

Symptomatic: post-viral, head trauma
Usually asymptomatic: Alzheimer’s, Parkinson’s

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21
Q

CN III innervates what muscles?

A

Levators of the eyelid,
superior rectus (SR),
inferior rectus (IR),
medial rectus (MR),
inferior oblique (IO) muscles of the eye,
pupillary constrictors (parasympathetic)

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22
Q

CN IV innervates

A

superior oblique (SO) muscle

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23
Q

CN VI innervates

A

lateral rectus (LR) muscle

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24
Q

CN V exam (3 things)

A

Corneal reflex, strength of jaw, facial
sensation

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25
Corneal Reflex tests which two CN
CN V and VII
26
CN VII exam
show teeth, wrinkle forehead, close eyes tight
27
CN VIII Exam (4)
* Hearing to finger rubs, tuning fork * Eye movements, nystagmus, smooth pursuit * Head thrust * Dix-Hall Pike
28
CN IX responsible for what 3 things
– Sensation/taste from posterior 1/3 tongue, back of the throat – Motor nerve elevates pharynx, contributes to gag – Parasympathetics to parotid
29
Motor Exam components
Bulk Tone Power Fatiguability Fasciculations
30
flaccidity definition
little resistance to passive movement
31
rigidity definition
steady muscular tension that is equal in degree in opposing muscle groups
32
spasticity definition
sustained increase in tension of a muscle when it is passively lengthened (speed dependent)
33
UMN signs
-stiffness, spasticity -weakness in pyramidal pattern -hyperreflexia
34
LMN signs
-weakness, atrophy, fasciculations -no sensory involvement -no pain -hypoactive reflexes
35
Reflex rating scale normal = clonus =
– 0 absent – 1+ present but diminished – 2+ normal – 3+ increased, spread – 4+ clonus
36
Spinal levels of the 5 DTRs
Biceps C5, C6 Brachioradialis C6 Triceps C7 Patella L4 Achilles S1
37
Clonus definition
Series of rhythmic involuntary muscle contractions induced by sudden passive stretching of a muscle
38
What is one of the earliest signs of dorsal column disease?
a positive Romberg sign
39
Where should the Romberg sign be included in the neuro exam?
the sensory OR coordination exam
40
* Lateral spinothalamic tract: ______ & _____ * Ventral spinothalamic tract: ______ ______ * Dorsal columns --medial lemniscus: ____________ and _______________
* Lateral spinothalamic tract: pain and temperature * Ventral spinothalamic tract: light touch * Dorsal columns --medial lemniscus: vibration and proprioception
41
The coordination exam tests the function of what 3 structures?
cerebellum, basal ganglia, related connections
42
how do coordination disorders manifest? (5)
imbalance incoordination ataxia dysdiadochokinesia abnormal movements
43
station definition
Attitude or manner of standing, including posture
44
3 types of diagnostic tests in Neurology
-lumbar puncture -neuroimaging -neurophysiology
45
Lumbar punctures can diagnose: (4)
– Inflammatory and infectious conditions – Subarachnoid hemorrhage – Pseudotumor cerebri (idiopathic intracranial hypertension): high opening pressure – Cancer involving meninges
46
Norms for: * Measure pressure: * Cell count, differential: * Protein: * Glucose:
* Measure pressure: normal 80-200 mm H20 * Cell count, differential: normal <5 WBC (white blood cells) * Protein: normal 15-45 * Glucose: normal 40-80
47
Lumbar puncture complications:
– Post-LP headache (positional) – bleeding – infection – back pain – Rare: herniation, nerve injury
48
Advantages of CT scan
quick and readily available; emergency diagnosis; there for people contraindicated to MRI
49
disadvantages of CT
radiation exposure; poor visualization of brainstem
50
What is hyperdense on CT?
Calcium, Bone, Blood
51
MRI advantages (3)
-no radiation exposure -much higher resolution, better clarity -unmarred by bony artifact
52
MRI Disadvantages
-some contraindications (pacemakers) -cannot assess bone -long acquisition time
53
All MRIs are done (with/without) contrast
Trick question: they can be done either way
54
______ combined with ___ ___________ allows for visualization of the subarachnoid space
myelography combined with CT scanning *usually you just do an MRI instead of this*
55
Conventional Angiography deals with the injection of dye where?
into the cranial arteries via catheterization from femoral artery; allows you to visualize occlusions, aneurysms, vascular malformations
56
SPECT stands for
Single-photon emission computed tomography
57
EEG measures: and used to evaluate: (5)
: brain electrical activity through scalp electrodes : seizures, brain death, encephalopathy, dementia, coma
58
Evoked potentials are a recording of .....
electrical activity in central sensory pathways produced by VEP, BAEP, SSEP stimulation
59
Visual (VEP)
alternating checkerboard pattern
60
Auditory (BAEP)
auditory clicks through earphones
61
sensory (SSEP)
electrical stimuli applied to peripheral nerves
62
Name 4 uses of Evoked Potentials
* Multiple sclerosis: identify subclinical demyelination * Brainstem lesions (BAEP) * Acoustic neuroma (BAEP) * Spinal cord injury (SSEP)
63
Electromyography (EMG) definition
Insertion of a small needle into individual muscles and recording of motor unit potentials at rest and with activity
64
Nerve Conduction Velocity (NCV) definition
Electrical stimulation over nerves with recording of sensory and motor nerve potentials and velocities
65
On an EMG & NCV: axonal neuropathies show: (2) demyelinating neuropathies show:
axonal neuropathies show: dec. amplitudes on NCV, abnormal spontaneous activity on EMG demyelinating neuropathies show: slowed conduction
66
On an EMG & NCV: myopathies show: (3)
normal NCV small duration low amplitude potentials
67
On an EMG & NCV: myasthenia gravis shows:
abnormalities on repetitive nerve stimulation
68
Basic Workup - Hemibody
MRI brain (w/o vs w/ and w/o)
69
Basic Workup – Spinal Cord
* MRI Spine (+/- Brain) * Rheum * B12, Vit E, Copper, HIV * +/- CSF
70
Basic workup – Nerve/Root
* EMG/NCV * Labs * +/- MRI Spine * +/- CSF
71
Basic Workup - Muscle
* EMG/NCV * CK * Rheum
72
Review the case studies at the end of this lecture!!!
Good job!

Summer 2025 - AL, AT, WJ (7 decks)

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