neurophys exam Flashcards
(127 cards)
1
Q
brown-sequard
A
lateral hemisection of the spinal cord
2
Q
muscle disease does not have reflex changes
A
right
3
Q
lacunar stroke
A
pure motor
4
Q
thalamic stoke
A
pure sensory
5
Q
lesion in the left lateral geniculate nuc
A
causes a right homonymous sectoranopia or incongruous right homonymous hemianopia
6
Q
lesion in the left temporal lobe
A
pie in the sky
7
Q
lesion in the parietal lobe
A
right homonymous defect denser inferiorly
8
Q
lesion in the upper bank of the left occipital lobe
A
right homonymous lower quadrantanopsia (maculat sparing)
9
Q
lesion in the lower bank of the left occipital lobe
A
right homonymous upper quandrantanopsia (macular sparing)
10
Q
lesions in the upper or lower banks of the occipital lobe respect the horizontal
A
but lesions in the temporal or parietal do not
11
Q
marcus gunn pupil
A
same as afferent pupillary defect
12
Q
accomodation is preserved but light reflex is impaired
A
Argyll Robertson pupils
13
Q
inability to look up and down
A
supranuc gaze palsy
14
Q
what to look for with nystagmus
A
pursuit (following finger) and saccadic movemnts (looking to a target finger); look for dysmetria and overshoot on returning to primary gaze
15
Q
SR
A
up and out
16
Q
IR
A
down and out
17
Q
SO
A
down and in
18
Q
IO
A
up and in
19
Q
LR
A
out
20
Q
MR
A
in
21
Q
how to look straight down
A
SO (down and in) and IR (down and out)
22
Q
how to look straight up
A
IO (up and in) and SR (up and out)
23
Q
what is neuralgia
A
pain, usually in the second or third division of the trigeminal nerve, wihtout sensory loss
24
Q
the motor trigeminal fibers travel with what division of the trigeminal nerve?
A
mandibular (V3)
25
jaw deviates toward the side of the weakness
of the motor of the trigeminal
26
what innervates the masseter muscle
trigeminal nerve, motor divison
27
what muscle do you test by raising your eyebrows
frontalis
28
what muscle do you test by closing your eyes
orbicularis oculi
29
what muscle puffs out the cheeks
buccinator
30
what muscle purses the lips tightly
orbicularis oris
31
Weber test
with sensorineural hearing loss, the Weber localizes to the good ear; with conudction deafness, it localizes to the bad ear
32
how to test the trapezius
shoulder srug against resistance
33
test the SCM
turn chin forcefully against resistance
34
hpoglossal nerve weakness
tongue deviates toward the affected side
35
tremor at rest
basal gang
36
tremor on maintaining posture
essential tremor
37
tremor on action
localizes to the cerebellum
38
where does hemoballismus (violent flinging of limbs) localize
subthalamic nuc
39
rigidity (which is different from spasticity) localizes where?
basal gang
40
grading strength
0- none; 1-flicker; 2-with gravity eliminated; 3-against gravity; 4-against gravity with resistance; 5-normal strength
41
what does pronator drift tell you
with subtle CST weakness, arm in the supinated position will pronate;
42
when does a brainstem lesion spare the face?
at pons or below
43
shoulder abduction first 90 degrees
supraspinatus; suprascap nerve; C5
44
shoulder abduction the second 90 deg
deltoid; axillary nerve; c5
45
shoulder adduction
latissimus dorsi (nerve to lat dors); pec major (dual innerv); both are C7
46
shoulder external rotation
infraspinatus; suprascap nerve; c5
47
shoulder internal rotation
subscapularis (subscapular nerve); also teres minor; these are all c5
48
elbow flexion when it is supinated
biceps (musculo-cutaneous nerve); roots C5 and C6
49
elbow fleixion when it is pronated
brachioradialis (radial nerve); roots C5, C6
50
elbow extenstion
triceps (radial nerve); c7
51
elbow supination
supinator (radial nerve); c6
52
elbow pronaton
pronator teres (median nerve); pronator quadratus (anterior interosseus branch of medial)
53
wrist flex
all forearm muscles (median); flexor carpi ulnaris (ulnar)
54
wrist extension
all extension muscles (radial); brachioradialis (radial); root is C6/7
55
finger flexion
flexor digitorum profundus (median and ulnar); C8 root
56
thumb abduction
abductor policis brevis- median nerve (T1)
57
finger extension
all extensors (radial nerve); c8 nerve root
58
finger abduction
interossei and abductor digitorum minimi (ulnar nerve); T1
59
Pinhcing movemnet
nerve root C8; long flexor of thumb, long flexor of index (both anterio interosseus nerve)
60
hip flex
iliopsoas (L2/3- direct nerve supply and femoral twigs)
61
knee extension
quadricpes (L2,3,4); femoral nerve
62
hip extenson
glutei (L4, L5), gluteal nerves
63
knee flex
hamstrings (L5, S1); tibial nerve, peroneal nerv; lateral head of biceps femoris
64
hip adduction
adductor group (L2, 3,4); obturator nerve
65
what are the hamstrings
any one of five tendons controlled by one of three muscles (semitendinous, semimembraneous, and biceps femoris)
66
what are the adductors of the hip?
adductor longus, brevis, magnus, minimus; pectineus; gracilis;
67
plantar flexion
tibial nerve; gastroc; tibialis posterior; S1, S2
68
inversion of the foot
tibialis anterior and tibialis posterior work together; tibial and peroneal nerves; L4
69
dorsiflex the foot
tibialis anterior, long extensors, peroneus tertius, extensor dig brevis; L4,L5
70
eversion of the foot
peronei longus and brevus; peroneal nerve; S1 nerve root
71
most freq involved roots in cervical spondylosis
C5 and C6
72
acute cervical disk lesion usually occurs at wht level
C7
73
what nerve gets injured with fracture of the humeral neck, dislocation of the humerus, or IM injections
axillary nerve
74
pancoast tumor of the lung ape involves which nerves
lower trunk of the brachial plexus
75
incorrect use of a crutch damages what nerve?
radial nerve in the axilla
76
fracture of the humerus hits what nerve
radial nerve in the spiral groove
77
what else besides midshaft fracture of the humerus hits the radial nerve in the spiral groove?
Saturday night palsy (when drunk)
78
trauma to the heel of the hand damages what?
deep branch of the ulnar nerve; no sensory loss in typical causes
79
sciatic nerve splits into
common peroneal (aka common fibular) and tibial nerve
80
which nerve is subject to trauma at the fibula neck
peroneal nerve
81
what is the saphenous nerve
cutaneous branch of the femoral nerve
82
what is subject to damage during varicose vein surgery
saphenous nerve
83
grading of tendon reflexes
0-absent; 1-hypoactive; 2-normal; 3-hyperactive but prob not pathological; 4- pathological increase with clonus
84
jaw jerk reflex
tests trigeminal nerve
85
biceps jerk
tests c5,c6
86
brachioradialis reflex- how to test
rest patient's arm on his lap; briskly tap the distal radius, looking for flex and supination of the forearm
87
what roots does brachioradialis DTR test
supinatory, C5/C6
88
triceps reflex- how do you do it?
with patient's arm flexed, tap the tricpes tendon, which lies just above the olecranon process
89
tricpes reflex tests which nerve root
C7
90
finger jerks are what nerve roots
C8, T1
91
knee jerk is what nerve roots
L3, L4
92
ankle jerk (achilles) is what nerve root?
S1
93
upper quadrants of abdomen are what dermatomes
T8, T9
94
lower quadrants of abdomen are what dermatome
T10, T11
95
cremasteric reflex
L1, L2; stoke medilal thigh with a pin and note contraction of cremasteric wth elevation of ipsilateral testical
96
anal wink reflex tests what nerve root
S5; stroke medial buttock and look for anal contraction
97
back of head is which dermatome
C2-3
98
subclavicular dermatome
transition from C4 to T2
99
thumb dermatome
C6
100
nipples dermatome
T4
101
waist dermatome
T10
102
groin dermatome
T1
103
Lateral border of foot dermatome
S1
104
medial aspect of leg
saphenous nerve
105
light touch
goes with pain and temp in the anterolateral system (spinothalamic tract)
106
anterior versus posterior brain
action versus perception
107
left vs right brain;
left is language and praxis; right is spatial representation, attention, and prosody
108
dorsal vs ventral
where vs what
109
aprosodias
right hemisphere
110
what is the papez circuit involved in?
memory
111
what is the papez circuit
hippocamp->fornix-->mamillary bodies-->ant thalamic nuc (via mammlothalamic tract)-->cingulate gyrus
112
papez circuit mnemonic
heman ate cat
113
right parietal lobe lesion
hemineglect, anosagnosia, extinction
114
praxis localizes where
left fronto-parietal circuit
115
alien hand syndrome
corticobasalar (i.e. involving the cerebral cortex and basal gang), degeneration or mesial frontal lesions
116
what happens in alien hand syndrome?
unintentional hand postures and apraxis
117
anterograde amnesia
can't lay down new memories; lesion in bilateral mesdial temporal lobe lesions (esp hippocampus)
118
hippocampus
consolidation of info from short term to long term memory and also spatial navigation
119
Anton's syndrome/blindsight lesion where
bilateral occipital lesions
120
Anton's syndrome
coritcal blindness with confabulation
121
Blindsight
intact visual responses despite cortical blindness
122
Balint's syndrome
lesion in the bilateral parieto-occipital regions
123
what are the symptoms of Balint's syndrome
optic ataxia (clumsy visually guided movements), ocular aprazia (unable to get eyes to look to the right place), simultagnosia (can't see the forest through the trees)
124
Gerstmann syndrome
left inferior parietal lesion
125
symptoms of Gerstmann syndrome
right/left confusion, finger agnosia, dysgraphia, dyscalculia
126
prosopagnosia localizes where
occipito-temporal lesions
127
pure alexia (aka alexia without agraphia) localizes where
left occipital and splenum of corpus callosum; can write but cannot read
