Neurology 1.3 Flashcards Preview

NMSK-B I > Neurology 1.3 > Flashcards

Flashcards in Neurology 1.3 Deck (56)
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1
Q

What is the significance of a careful history during a neurological exam?

A

hx can be used to get most of the necessary information in localizing a lesion which gives rise to a neurologic complaint

2
Q

In a neurological exam, how is mental status evaluated?

A

alert, oriented to person, place, time ( patient gives a cogent medical history)

3
Q

In a neurological exam, how is speech evaluated?

A

fluent, normal syntax, comprehension, repetition

4
Q

In a neurological exam, how are cranial nerves evaluated?

A

visual fields, extra ocular movements, fundoscopic exam, facial symmetry and facial sensation, and hearing is normal

5
Q

In a neurological exam, how are motor nerves evaluated?

A

mass, tone and strength of muscles (compare bilaterally)

6
Q

In a neurological exam, how are sensory nerves evaluated?

A

light touch, pin prick and double simultaneous stimulation

7
Q

In a neurological exam, how is gait evaluated?

A

stepping, toe-heel walking, turning; be observant

8
Q

In a neurological exam, how is cerebellar function evaluated?

A

finger nose finger, heal shin, no involuntary movements

9
Q

In a neurological exam, how are reflexes evaluated?

A

upper and lower extremities, toes planter bilaterally

10
Q

In a neurological exam, how is cerebrovascular function evaluated?

A

carotid, orbital or cranial bruits

11
Q

In a neurological exam, how is musculoskeletal function evaluated?

A

range of motion axial and appendicular structures, normal Osteopathic exam

12
Q

Which neurological exam requires the most patient cooperation?

A

sensory nerve function

13
Q

What is the goal directed behavior of executive functioning in testing mental status?

A

complex set of activities (involves, volition, planning, purpose, action, and effective performance). Activities of daily living affected.

14
Q

What is praxis?

A

(idiomotor apraxia; can’t do a simple task when asked, but can do it involuntarily); tested during mental status exam

15
Q

What is Gerstmann Syndrome and how is it tested?

A

left posterior hemispheric lesion;

1) R-L confusion (touch left shoulder, etc.)
2) Finger agnosia (inability to recognize fingers, pinky? Index/)
3) Agraphia (inability to write; couldn’t write name)
4) Acalculia (inability to calculate 2=+1=, 4+2=?)

16
Q

Which domains are affected in Gerstmann Syndrome?

A

1) visuospatial (r-l confusion, fingers)
2) praxis (can’t write name)
3) calculation (dyscalculia)

17
Q

Which domains are unaffected in Gerstmann Syndrome?

A

1) level of consciousnes
2) memory
3) mood
4) thought content

18
Q

What is the Montreal Cognitive Assessment test?

A

MoCA; test short term memory, visual spatia, repetition of words, executive functioning, attention, concentration, working memory, orientation

19
Q

What is CN I?

A

olfactory nerve; important test in early CNS degenerative disorder assesment

20
Q

What is CN II?

A

optic nerve; visual fields and acuity, also tested with fundoscopic exam

21
Q

What is inspected in a fundoscopic exam?

A

1) disc margins
2) venous pulsations
3) retinal vessels
4) retina
5) macula

22
Q

What is anisocoria?

A

asymmetric pupils; pupillary defect in CN III

23
Q

What is CN III?

A

oculomotor; anisocoria, Horner’s syndrome

24
Q

Which nerves are being tested with eye movements?

A

CN III, IV, VI; ptosis, EOM, nystagmus

25
Q

What is Internuclear Opthalmoplegia?

A

INO; produced by lesion of medial longitudinal fasciculus which connects CN VI with CN III

26
Q

How is Internuclear Opthalmoplegia tested?

A

impaired adduction on affected side with nystagmus in the other abducting eye

27
Q

What is CN IV?

A

trochlear nerve

28
Q

What is CN V?

A

trigeminal nerve; facial sensation and mastication muscles

29
Q

What is CN VI?

A

abducens nerve

30
Q

What is CN VII?

A

facial nerve; controls facial muscles; lesion is usually peripheral; Bell’s Palsy

31
Q

What is Bell’s Palsy?

A

peripheral weakness or paralysis of one side of the face causing facial droop; CN VII

32
Q

What is CN VIII?

A

vestibulocochlear nerve; hearing, balance

33
Q

Which nerves test palatal movement?

A

CN IX, X; “say ahh”, gag reflex

34
Q

Which nerves test dysarthria?

A

CN VII, IX, X, XII; articulation errors and voice quality

35
Q

Which nerves test head rotation and shoulder elevation?

A

CN XI (sternocleidomastoid and trapezius)

36
Q

What is CN IX?

A

glossopharyngeal nerve

37
Q

What is CN X?

A

vagus nerve

38
Q

What is CN XI?

A

spinal accessory nerve; head rotation and shoulder elevation

39
Q

What is CN XII?

A

hypoglossal nerve; tongue weakness

40
Q

What is monoparesis?

A

weakness of a single limb

41
Q

What is hemiparesis?

A

weakness of one side of the body

42
Q

What is paraparesis?

A

weakness of both lower extremities

43
Q

What is quadraparesis?

A

weakness of all four limbs

44
Q

What is plegia?

A

complete or nearly complete paralysis of the involved limbs

45
Q

What is diplegia?

A

applied mainly to bilateral facial paralysis

46
Q

What is spasticity?

A

clasp knife (give and catch) requires additional force; part of muscle tone

47
Q

What is rigidity?

A

increased resistance throughout range of motion; part of muscle tone

48
Q

What is rapid alternating movements?

A

hands on thighs and rapidly supinate; pronate hands for 10 seconds

49
Q

What is dysdiadochokinesis?

A

inability to perform rapid alternating movements slow or irregular; movement disorder

50
Q

What is point to point movements?

A

index finger from axaminer’s to nose and back and forth

51
Q

What is dysmetria?

A

inability to perform point to point movements

52
Q

What is heel down shin?

A

side down from know to top of foot

53
Q

What is the Rhomberg test?

A

patient stands still, feet together, then ask patient to close eyes and extend arms; positive if significant and immediate loss of balance (be prepared to make a catch)

54
Q

What is the cerebrovascular evaluation?

A

auscultate for carotid, orbital and cranial bruits

55
Q

What is a false positive of a cerebrovascular test?

A

anemia
hypermetabolic state
pressing too hard with stethoscope

56
Q

What is a false negative of a cerebrovascular test?

A

total occlusion