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NMS IV test 1 Flashcards

1
Q

What are the functions of the posterior column

A

vibration, conscious proprioception, 2 point and light touch

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2
Q

What are the functions of the lateral spinothalamic tract

A

pain and temp (crosses at level)

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3
Q

What are the functions of the vestibular system

A

balance and spatial orientation

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4
Q

What are the functions of the cerebellar system

A

motor control coordinating voluntary movements

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5
Q

What are the functions of the Motor system - corticospinal tract

A

Carries motor and crosses in the brain stem

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6
Q

What are some characteristics of confusional states

A

Decreased level of consciousness, often reversible example head injury

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7
Q

What are some characteristics of dementias

A

Cognitive function and intellectual decline often irreversible example hemmorage or stroke

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8
Q

What would the patient complain of with a brain lesion

A

Mental status changes, HA, seizures, ICP visual compalaints

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9
Q

What would the patient complain of with a brainstem lesion

A

Crainial nerve deficitis

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10
Q

What would the patient complain of with a Pyramidal system lesion

A

uncoordinated voluntary actions

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11
Q

What would the patient complain of with an extrapyramidal system lesion

A

alterations in involuntary movements (athetosis, resting tumor, tics, dystonia)

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12
Q

What would the patient complain of with a cerebelllar lesion

A

uncoordinated motor movements; gait stance

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13
Q

What would the patient complain of with a spinal cord lesion

A

dissocation of sensory loss there may be LMN deficits if anterior horn or nerve root is also involved

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14
Q

What would the pt complain of with a peripheral NS lesion

A

dermatomal distrubution complaints, NTW

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15
Q

What neuro exam findind would be present with a brain lesion

A

mental status changes, motor/sensory deficits CONTRALATERAL to side of lesion (neuro signs/sx are dependent on where the lesion is located)

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16
Q

What neuro exam finding would be present with a brainstem lesion

A

CN deficits are usually IPSILATERAL, and motor/sensory deficits are CONTRALATERAL to the lesion (classical cross pattern)

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17
Q

What neuro exam finding would be present with an extrapyramidal lesion

A

resting tremors, chorea, athetosis, tics

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18
Q

What neuro exam finding would be present with a cerebellar lesion

A

ataxia and intention tremor Deficits are IPSILATERAL to the lesion past pointing, dysmentria

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19
Q

What neuro exam finding would be present with a spinal cord lesion

A

UMN signs, motor/sensory deficits IPSILATERAL to the lesion, pain/temp CONTRALATERAL to the lesion

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20
Q

What neuro exam finding would be present with a peripheral NS lesion

A

LMN signs flacid weakness, atrophy, fasculations hyporeflexia in dermatomal or plexus pattern

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21
Q

What are the 4 types of Aphasia

A

Brocca’s (poor speaking/caveman speech); Wernicke’s (poor comprehension), Conductive (pt has intact comprehension but can’t explain what they understood), Global (poor speaking and comprehension)

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22
Q

Anomia

A

inability to use or recognize names

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23
Q

Confabulations

A

the attempt to fill in memory gaps with false recollections

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24
Q

Dysarthria

A

disturbance of articulation

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25
Dysphonia
inability/dysfunction of phonation; hoarseness
26
Dysmetria
disturbance of movement towards a target
27
Dysesthesia
disturbance of sensation
28
Paresthesia
sensation of tingling, pricking of numbmess
29
Ataxia (cerebella)
staggering, clumsy, drunken; seen in cerebellar disease, alcohol intoxication, and MS
30
Ataxia (Sensory)
Slappin foot gait, tabetic; commonly seen in posterior column diseases, tabes dorsalis, polyneuropathy
31
Ataxia (vestibular dysfunction)
broad based, festinating gait (parkinsons) Swining gait (hemiplegic/stroke)
32
Apraxia
inability to perform previously learned task
33
Agnosia
inability to recognize common stimuli (objects, colors, sound, etc.)
34
Astereognosis
inability to identify an object by touch
35
Agraphesthesia
inability to identify a number written on the hand
36
Agraphia
inability to write
37
Alexia
inability to read
38
Dystonia
abnormal movements resulting in sustained abnormal postures
39
Athetosis
slow, writhing movements
40
Chorea
involuntary and unpredictable rapid irrregular muscle jerks
41
What are the different types of tremors
Resting (basal ganglia) Intention (cerebellar), chorea, athetosis, distonia
42
Myoclonus
sudden rapid twitchlike muscle contractions
43
Characteristics of UMN lesion
Mild/late atrophy, clonus, hyperreflexial, absent abdominal reflex, spastic muscle tone, EMG/NCV normal
44
Characteristics of LMN lesion
Atrophy, fasiculations, hyporeflexia, abdomainal reflex is normal, flaccid muscle tone, EMG/NCV positive for fibrillations
45
Dominant cerebral hemisphere vs. non-dominant
Language center is usually in dominate hemisphere
46
Papilledema
swelling of optic nerve
47
Optic atrophy
atrophy to optic nerve
48
Paralysis vs. paresis
paralysis = total loss of voluntarty motor control; Paresis = a partial loss of voluntary motor control
49
clonus
series of reflex contractions of a muscle which has been suddenly stretched
50
Hypotonia vs. hypertonia
Hypo = reduced resistance to PROM, flaccidity Hyper=ridiged usually d/t extrapryamidal lesion
51
Scotoma
Irregular visual field deficit
52
Know the visal field defects based on the location of the lesion
See diagram in notes
53
Signs of meningeal irritation
kernigs/brudzinski signs, nuchal ridigity, spinal ridigity
54
Hemiplegic gait
Swinging gait; commonly seen in strokes
55
Scissor gate
Spastic (sue to spasticity of adductor mm) seen in cerebal palsy and myelopathy
56
steppage gait
equine or foot drop gait; seen in L5 radiculopathy or peroneal nerve disease or weakness of tibialis anterior
57
Apraxic gaint
Magnet gait due to diffuse cerebral damage seen in alzheimers, huntingtons, and hydrocephalus
58
Waddling gait
seen in weak gluteus muscles and muscular distrophy; trendelenburg may be +
59
festinating gain
shuffling gait short steps hard to start and stop seen in parkinsons
60
Know and understand all aspects of the neuro exam discussed in class
Interview, mental status exam, posture/gait/station, coordination, cranial nerve exam, motor sensory and reflexes provocative test, ancillary studies
61
Know your DDX's
Where is the lesion, What type of lesion (destruction, compression, circulatory) What is the pt age?..
62
Bells palsy
Dysfunction of cranial nerve VII
63
Trigeminal neuralgia
disorder of CN V and causes stabbing or electric shock like pain in the face
64
Ocular palsys
CN VI causes double vision
65
Know the crainal nerve patterns
review on own
66
Accustic Neuroma (cerebellopontine angle tumor)
Slow growing tumor on CN VII causes problems with balance and hearing
67
Chronic alcoholic encephalopathy
Wernickes encephalopathy and Korsadoffs dementia
68
Wernickes encephalopathy
B1/thiamine deficiency seen in chronic alcoholics and severe malnutrition;usually reversible;sx = confusional states, opthalmoplegia, ataxia; tx= abstinence, IV injections of B1, detox
69
Korsakoffs dementia
A contuination of wernickes encephalopathy, seen in chroninc alcoholics;IRREVERSIBLE; affects the temporal lobe; causes amnestic dementia (can't form new memories)
70
Acute confusional states caused by alcohol withdrawl
hallucinations begin ~ 48 hours after stoping; may get seizures (poor prognosis); Delirum Tremens begin 3-5 days post and last up to 72 hours (15% risk of mortality)
71
Meningitis
Viral or Bacterial causes flu-like sx stiggneck petechia body rash seizures and confusional states LOC possible Assume bacterial until proven otherwise
72
1st degree concussion
mild nol LOC (dazed or stunned) PTA< 30 min
73
2nd degree concussion
LOC < 5 min; PTA 30 min to 24 hours
74
3rd degree concussion
LOC > 5 min; PTA > 24 hours
75
second impact syndrome
A person who has sustained 1 minor head injury has a 4 fold increase in risk of having second concussive injury ; second impact triggers a rapidly declining sequella w/I seconds to min
76
Boxers dementia (pugliestica dementia)
dementia caused by multiple concusions
77
Epidural hematoma/hemorrhages
MC results from a lateral skull fx; lacerates middle meningeal A; Most rapid bleed (minutes to hours); medical emergancy
78
Subdural hematoma
Following trauma can be acute (min to hours) subacute(days-wks) or chronic (wks to mos); most commonly presents as a slower bleed venous bleeding; usually not associated with skull fractures; elderyl are more susceptible
79
intercerebral hemorrhages
coup/cotntracoup injuries; typically located at the frontal/occipital lobes; SX= altered LOC, HA, signs of meningeal irritation, may have focal brain signs
80
Subarachnoid hemorrhages
Most occur spontaneously and are d/t congenitally abnormal blood vessels in circle of willis resultin in a rupture into the subarachnoid space; SX= severe rapid HA, altered LOC, meningeal irriatation and nausea and vomiting
81
What are some red flags for serious and immediate emergency referral
"I need my very special head protection" signs of open head injury/skull fx, glasgow coma scale
82
What is the glasgow coma scale
scores level of consciousness on a 3 to 15 point scale can be used as an outcome marker
83
What are some signs of dementioa
loss of memory, disorientation, loss of judgement, loss of abstrect thinking, loss of ability to calculate
84
What are some causes of dementia
Alzheimer's, multi-infarct dementia, trauma, hydrocephalus, metabolic (B123 deficiency), infections, drugs/toxins, brain tumors, parkinsons, herediarty
85
Multi-infarct dementia
vascula dementia from multiple tiny strokes over time; associated with hypertension and diabetes

NMS 4 (3 decks)

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