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Physical Dx Final > Neuruo > Flashcards

Neuruo Flashcards

(124 cards)

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1
Q

CNS

A

Brain (stem and cerebellum) and spinal cord

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2
Q

PNS

A

cranial nerves, spinal and peripheral nerves

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3
Q

Frontal lobe

A

motor cortex, reasoning memory, speaking, emotions

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4
Q

Parietal lobe

A

sensory cortex, reading, understanding spacial relationships

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5
Q

Occipital

A

vision

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6
Q

Cerebellum

A

balance, coordination, fine muscle control

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7
Q

brain stem

A

breathing, bp, HR, swallowing, body temp, digestion

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8
Q

Temporal lobe

A

understanding language, behavior, memory hearing

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9
Q

Spinal vertebrae

A

cervical- 7
Thoracic- 12
Lumbar- 5
Sacral- 5

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10
Q

Sensory pathways

A

Spinothalamic tract

Posterior column

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11
Q

Spinothalamic tract

A

crude touch, pain, temp

travel from periphery to spinal cord and cross to contralateral side BEFORE continuing to brain

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12
Q

Posterior column

A

vibration, proprioception, fine touch

Travel from periphery to spinal cord and stay on the SAME SIDE until reaching the brain stem, then cross

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13
Q

Motor pathway

A

UMN originate in pre-central gyrus (primary motor) and crosses contra-lateral in the medulla
Axons descend to synapse with anterior horn of LMN in PNS

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14
Q

Ataxic

A

gait that lacks normal coordination

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15
Q

Gait that lacks coordination and stability is due to

A

cerebellar disease, loss of positions sense or intoxication

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16
Q

Steppage gait

A

patient drags foot or lifts them high, then foot slaps floor; due to tibialis anterior and toe extensor weakness; LMN/peripheral nerve injury

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17
Q

Spastic Hemiparesis

A

drag toe, circle leg stiffly outward and forward (circumduction), or lean trunk to contralateral side to clear affected leg during walking; affected arm is flexed, immobile and held close to the side, with elbow, wrists and interphalangeal joints flexed;
affected leg extensors are spastic, ankles are plantar flexed and inverted

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18
Q

When do you see spastic hemiparesis

A

stroke

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19
Q

Steppage gait is seen with

A

LMN/peripheral nerve injury

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20
Q

Scissors gait

A

patients advance each leg slowly and thigh tend to cross; stiff gait and short steps

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21
Q

May look like they’re walking through water

A

Scissors gait

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22
Q

Scissors gait is seen with

A

spinal cord disease and spasticity disorders (cerebral palsy)

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23
Q

Sensory ataxia

A

unsteady gait and wide based stance; throw feet forward and outward, first bring down heel then toes with DOUBLE TAP; watch ground; usually have assistive device

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24
Q

Sensory ataxia gait is due to

A

Loss of proprioception (polyneuropathy, posterior column damage)

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25
Parkinsonian Gait
Stooped posture with head, arm hip and knee flexion; shuffling, short steps; slow to start; decreased arm swing and stiff turns
26
Parkinsonian gait
due to basal ganglia abnormalities (Parkinson's disease)
27
Coordination requires
motor cerebellar vestibular sensory
28
Romberg Test
position sense; stand with feet together, eyes closed; abnormal = unable to maintain upright posture
29
(+) Romberg could mean
dorsal column disease (can do with eyes open but not closed); cerebellar ataxia (can't balance w/ or w/o eyes open)
30
Pronator drift
standing with eyes closed, elevate arms to shoulder level with palms up; firmly tap on arm and patient should bring arm back up; Abrnomal = unable to keep arms at should heigh and/or arm probates/drifts down
31
Cause of pronator drift
UMN lesion = possible stroke
32
heel to shin test
Place heel at opposite knee, slide down leg then back up; should be able to keep contact with opposite leg
33
(+) heel to shin test
``` cerebellar disease (hell overshoots need, or foot oscillates side to side); Position sense absent (heel lifts too high) ```
34
(+) Finger-to-nose test
intentional tremor- multiple sclerosis
35
(+) Rapid alternating movement
cerebellar disease: slow, clumsy, irregular movement = dysdiadochokinesis
36
Dysdiadochokinesis
slow, clumsy, irregular movements
37
A&O x 4
person, place, time, situation
38
Cranial nerves
``` I: olfactory II: Optic III: Oculomotor IV: Trochlear V: Trigeminal VI: Abducens VII: Facial VIII: Acoustic IX: Glossopharyngeal X: Vagus XI: Spinal XII: Hypoglossal ```
39
Olfactory (CN I)
Function: smell Test: smell familiar scent Abnormal: anosmia (head trauma, parkinson disease)
40
Optic (CN II)
Function: Vision Test: visual field, acuity, funuscopic, pupillary light reflex Abnormal: visual field defect secondary to retinal emboli, optic neuritis, pituitary tumor, stroke
41
Oculomotor (CN III)
Function: eye movement Test: EOM's, pupillary light reflex Abnormal: vertical and horizontal diplopia; ptosis = CN III palsy
42
Trochlear (CN IV)
Functioin: Superior oblique, downward and internal rotation of eye Test: EOM's Abnormal: vertical diplopia
43
Trigeminal (V)
Function: Motor- temporal, masseter and lateral pterygoids Sensory: 3 divisions Test: clench jaw and lateral jaw movement , check facial expression Abnormal: trigeminal neuralgia
44
Abducens (VI)
Function: lateral rectus, lateral deviation of the eye Test: EOM's Abnormal: Horizontal diplopia, esotropia
45
Facial (VII)
Function: motor- facial movements; sensory: taste anterior tongue Test: funny faces Abnormal: peripheral- bell's palsy (entire one side) central- cerebral infarct (spares forehead)
46
Acoustic (VIII)
Function: hearing and balance Test: gross hearing, gait Abnormal: disequilibrium, vertigo, nystagmus
47
Glossopharyngeal (IX)
Funciton: motor: pharynx, Sensory: posterior tongue Test: gag reflex Abnormal: no gag reflex, loss of taste to posterior 1/3 of tongue
48
Vagus (X)
Motor: palate, pharynx, larynx Sensory: pharynx, larynx Cardiac, thorax and abdomen Test: palate elevation, quality of "ah" and uvula midline Abnormal: hoarseness, dyspnea, dysarthria, loss of gag reflex
49
Spinal (XI)
Function: SCM and trap Test: shoulder shrug and head rotation Abnormal: trap weakness, atrophy and fasciculations = scapular winging
50
Scapular winging is indicative of
Spinal nerve problem
51
Hypoglossal (XII)
Funciton: tongue movement Test: wag tongue Abnormal: central lesion = tongue deviates away Peripheral lesion = tongue deviates to weak side
52
Anesthesia
absence of touch sensation
53
Hypoesthesia
Decreased sensation to touch
54
Hyperesthesia
Increases sensitivity to touch
55
Allodynia
pain elicited from non-painful stimulus
56
Analgesia
absence of pain sensation
57
Hypoalgesia
decrease in pain awareness
58
Hyperalgesia
Increased sensitivity to pain
59
Lateral upper arm dermatome
C5
60
Radial forearm and thumb
C6
61
Middle Finger
C7
62
Ring and little finger
C8
63
Ulnar forearm
T1
64
Nipple line
T4
65
Umbilicus
T10
66
Inguinal region
L1
67
Anterior/proximal thigh
L3
68
Knee/medial skin
L4
69
Lateral shin, dorsal foot to great toe
L5
70
Lateral and plantar foot
S1
71
Stereognosis
ask patient to shut eyes and recognize familiar object in hand
72
Graphesthesia
number identification in hand
73
Normal two-point discrimination
<5 mm on finger bads
74
Static tremor
seen at rest; Parkinson disease (pill-rolling tremor)
75
Postural tremor
seen when affected area maintains posture (Hyperthyroid, anxiety, fatigue, benign essential)
76
Intention tremor
absent at rest, appear with movement; Multiple sclerosis
77
Pin-rolling tremor
Parkinson's
78
Tic
brief, repetitive, twitching
79
What disorders are seen with Tics
tourette syndrome, medications
80
Dystonia
Twisted posture of large body parts
81
Dystonia is associated with
meds, spasmodic torticollis
82
Dyskinesias
bizarre, rhythmic, repetitive movement
83
Dyskinesias associated with
parkinson disease, psychoses, meds
84
Akathisia
inability to sit still; due to meds (antipsychotics, compazine)
85
Chorea
brief, jerky, rapid, unpredictable movements; associated with Huntington disease, rheumatic fever
86
Athetosis
slow, twisting, writhing movement; cerebral palsy
87
Hypotonia/flaccidity of muscles
central and peripheral causes
88
Spasticity of muscles
increased muscle tone, velocity dependent; central corticospinal tract disease
89
Rigidity
increased resistance throughout ROM; Cog-wheel rigidity-- Parkinson's disease
90
Muscle Strength Grading
``` 0- no muscle contraction 1- visible contraction, no movement 2- joint motion, but not against gravity 3- movement against gravity only 4- movement with some resistance 5- full strength with full resistance ```
91
Shoulder Abduction
C5, axillary nerve
92
Elbow flexion
C5, C6; musculocutaneous
93
Elbow extension
C6, C7; radial
94
Wrist extension
C6, C7; radial
95
Wrist felxion
C7, C8; median
96
Finger abduction
C8, T1; ulnar
97
Thumb opposition
C8, T1; median
98
Test for Radial nerve
make fist
99
Test for ulnar nerve
spread fingers against resistance
100
Test for median nerve
okay sign
101
Hip flexion
L2,3; femoral
102
Hip extension
L4, 5; gluteal
103
Knee extension
L3,4; femoral
104
Knee flexion
L5, S1; sciatic
105
Ankle dorsiflexion
L4, 5; peroneal
106
Ankle plantar flexion
S1; plantar
107
Reflex scales
``` 0- no response +1- diminished +2- normal +3- increased +4- hyperactive, associated with clonus ```
108
Hypoactive DTR
diminished or absent | disease of spinal nerve roots or peripheral nerves (LMN)
109
Hyperactive DTR
brisk and can be associated with clonus; CNS lesions along descending corticospinal tract (UMN)
110
LMN findings
hypoactive weakness atrophy fasciculations
111
UMN findings
Hyperactive weakness spasticity positive babinski
112
Biceps DTR tests
C5,6
113
Brachioradialis DTR tests
C5,6
114
Triceps DTR tests
C6, 7
115
Patella DTR tests
L4
116
Achilles DTR tests
S1
117
Clonus
forced dorsiflexion of foot; evaluate for rhythmic oscillations; can be normal if bilateral; if abnormal, check at wrist
118
Abnormal clonus is due to
UMN disease
119
Babinski sign
L5, S1 Normal for toes to flex Abnormal: great toe extends and other toes fan out (CNS lesion affecting cotricospinal tract)
120
Superficial abdominal reflex
draw towards belly button from each quadrant; Normal: muscle contracts toward umbilicus Abnormal: central and peripheral pathologies
121
Cremasteric Reflex
stroke proximal medial thigh; normal: ipsilateral testicle to rise Abnormal: UMN, LMN; L1,L2 nerve injury; ilioinguinal injury s/p hernia repair
122
Brudzinski
Flex patient's neck Normal = remain relaxed Abnormal: hip and knee flexion (meningeal sign)
123
Nuchal rigidity
Place hands beind patien's head and flex head toward chest; Normal: easy motion Abnormal: pain and resistance indicating potential meningeal irritation
124
Kernig sign
Flex patient's hip and knee, then straighten knee; Normal: may have tightness in hamstring Abnormal = pain pain and resistance indicating meningeal irritation

Physical Dx Final (4 decks)

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