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PT Screening > Neurology - Part 1 > Flashcards

Neurology - Part 1 Flashcards

1
Q

Somatosensory Pathway

A

Spinal Cord to Brain (Afferent)

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2
Q

Motor Pathway

A

Brain to Spinal Cord (Efferent)

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3
Q

Subgroups of Neuromuscular Conditions

A
  • Non-progressive disorders of the CNS: Congenital or acquired in infancy/childhood (Autism, Epilepsy, Spina Bifida, Down’s Syndrome, Meningitis, Cerbral Palsy
  • Non-progressive disorder of CNS: Acquired in adolescence or adulthood (TBI, meningitis, CVA, concussion, asphyxia
  • Progressive disorders of the CNS (Alzheimer’s disease, MS, ALS, Parkinson’s)
  • Spinal Cord Injury (Trauma or Tumor)
  • Peripheral Cord Injury (Brachial plexus lesion, CTS, Tarsal Tunnel Syndrome)
  • Acute or Chronic Polyneuropathies (Diabetes, alcoholism, Guillain-Barre Syndrome)
  • Coma or near coma state
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4
Q

Who do you observe?

A

Providers, patients, etc.

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5
Q

What will you look for?

A
  • Having symptoms they haven’t told you or think they should tell you
  • How they respond to the conversation
  • Attitude
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6
Q

How do conversations contribute to clinical decision making?

A

Guide Priority List

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7
Q

What is cruical for pediatric observation?

A

How children interact with the environment

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8
Q

Who do you prioritize a global observation for?

A

EVERY PATIENT

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9
Q

Dysarthria

A

Speech difficulties from impaired motor control

  • Injury to tongue, palate, lips or pharaynx
  • Lesion of motor nerve PNS or CNS
  • Disease process of CNS
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9
Q

Dysarthria

A

Speech difficulties from impaired motor control

  • Injury to tongue, palate, lips or pharaynx
  • Lesion of motor nerve PNS or CNS
  • Disease process of CNS
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10
Q

Dysphonia

A

Difficulties in voice production volume, pitch, quality

  • May be due to inflammation or tumor or larynx
  • Vagus nerve damage to larynx
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11
Q

Dysphagia

A

Difficulties with swallowing

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12
Q

Aphasia

A

Cognitive, nerological disorder that results in diffculty or inability to produce or understand language

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13
Q

Receptive aphasia

A

Difficulty understanding

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14
Q

Expressive aphasia

A

Difficulty talking/expressing

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15
Q

Global aphasia

A

Both receptive and expressive

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16
Q

How can you test the ability to participate and react?

A
  • Understanding of questions
  • Word Comprehsnsion (one step command)
  • Repetition
  • Naming
  • Writing
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17
Q

Communication Assessment

A

Priority
- If diagnosis is known to cause communicarion problems
- Patient has diffuculty answering interview

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18
Q

What is cognition?

A

Conscious awareness of brain activity
-Includes attention, speed of processing, working memory, learning, adaptibility, problem solving

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19
Q

What is alertness?

A

State of active attention
Indluences by illness, medications, fatigue, emotions

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20
Q

Decordicate rigidity

A

Arms to core

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21
Q

Decerebrate rigidity

A

Arms back

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22
Q

Working memory

A

immediate recall and processing

23
Q

Short-term memory

A

Recent

24
Q

Long-term memory

A

Stored memories

25
Q

Anterograde amnesia

A

Difficulty recalling events that occur after the trauma

26
Q

Retrograde amnesia

A

Loss of memories from before the trauma

27
Q

Cognition Assessment

A

Priority
- Diasnosis is known cause of communication problems
- Patient has difficulty answering interview questions

28
Q

What if your patient has a psychological disorder?

A

-Normalize
-Address symptoms that may influence care
-Refer to the appropriate provider
-Provide resources available

29
Q

What if your patient has a psychological disorder?

A

-Normalize
-Address symptoms that may influence care
-Refer to the appropriate provider
-Provide resources available

30
Q

Emotional and Psychological Factors

A

Priority
-Informal assessment begins at interview/observation
-Variable to the degree it will interfere
-Chronic Pain
-Life altering conditions
-Depression screening questions

31
Q

What does the doral root carry?

A

Sensory Fibers

32
Q

What does the ventral root carry?

A

Motor Fibers

33
Q

What is distal to spinal nerve roots?

A

Branches -> Cords -> Divisions -> Trunks -> Roots

34
Q

Somatosensory Assessment

A

Priority
- Symptoms of nervous system involvement
- Those at risk for a condition that impairs distal extremity sensation
- Suspected nerve root level

35
Q

Upper Motor Neurons (UMN)

A
  • Affects spinal cord or brain
  • Traumatic or disease process
  • Common conditions: TBI, Stroke, SCI, MS
36
Q

Lower Motor Neurons (LMN)

A
  • Involves peripheral nerves
  • Traumatic nerve or disease process
  • Common conditons: Disc Bulge, Sciatica
37
Q

Spinal Nerve Root Testing

A

Priority
-Use when symptoms suggest nerve root pathology
-Differential between nerve root and peripheral nerve

38
Q

What is a reflex?

A
  • An action that is performed as a response to a stimulus and without conscious thought
  • Protects from harm
39
Q

Deep Tendon Reflexes (DTR)

A

Afferent nerve has direct connection with muscles spindle in target muscle

Quick stretch tendon (stretch reflex) stimulates muscle spindle

No specific DTR for each spinal level

40
Q

How are DTRs assessed?

A

Grading
0 = No reflex
1+ = minimal or depressed response
2+ normal response
3+ overly brisk response
4+ brisk response with clonus
(IF 1+ and 3+ are bilateral may not indicate pathology)

41
Q

Hypotonic DTRs

A
  • Injury or compression along the nerve pathway, including the nerve root
  • Prohibits transfer of the reflex message, either incoming or outgoing
  • If interruption of pathway, DTR will be diminished
  • If only one nerve root is involved, DTR might be present but diminished
42
Q

Hypertopic DTRs

A
  • CNS pathology
  • DTRs are influences by the descending motor pathways
  • Corticospinal tract messages tend to inhibit the synaptix response
  • Any point superior to the tract may inhibit modulation
43
Q

When should you perform a Deep Tendon Reflex Assessment?

A

Symptoms of CNS or PNS dysfunction

Suspected disease of CNS

44
Q

What is required for coordinated, volitional movement?

A

Adequate joint ROM

Strength

Intact neural pathway

Adequate cognitive processing to carry out the motion

45
Q

Role of Cerebellum

A

Movement synergies – does not cause movement but influences quality

Maintenance of upright posture

Maintenance of muscle tone

Receives sensory input from spinal cord and brain

46
Q

Types of Cerebellar Dysfunction

A
  • Ataxia
  • Dysdiadocokinesia
  • Intention Tremor
  • Postural Tremor
  • Hypotonia
  • Dysarthria
  • Deviations in eye control
47
Q

Ataxia

A

Without coordination; lack smooth trajectory and fine motor

Ex: Not normal heel to toe; odd rocking of foot

48
Q

Dysdiadochokinesia

A

Inability to produce rapid alternating movement

49
Q

Intention Tremor

A

Tremor increases as the limb reaches the target

50
Q

Postural Tremor

A

Induced by intentionally maintained head or trunk posture or holding a limb in front of body

51
Q

Hypotonia

A

Overall decrease in resting muscle tone

52
Q

Dysarthria

A

Poor word formation because inability to coordinate muscles and structures of speech

53
Q

Deviations in eye control

A

Lack of smooth pursuit, saccades, delayed initiation of eye movement

54
Q

Coordination Testing - Priority

A

Known or suspected lesions in CNS that may affect cerebellar function

Observed uncoordinated movement or gait abnormalities

Difficulty manipulating small objects

55
Q

Upper Motor Neuron Conditions: POTENTIAL FINDINGS

A
  • Cognitive Deficits
  • Weakness
  • Balance Deficits
  • Coordination Deficits
  • “Global” Somatosensory deficits (spinothalamic and/or posterior columns)
  • CN Involvement
  • Hypo or Hypotonia (spasticity)
  • Hyperreflexia
  • +UMN testing
  • Clonus
  • Babinski and/or Hoffman
56
Q

Lower Motor Neuron Conditions: POTENTIAL FINDINGS

A
  • Pain and/or numbness and tingling along nerve distribution
  • Weakness
  • Hypotonia
  • Pattern “Somatosensory deficits” (along peripheral N or dermatome)
  • Hyporeflexia
  • Negative UMN testing

PT Screening (21 decks)

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