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PSP > Numbness And Tingling > Flashcards

Numbness And Tingling Flashcards

1
Q

FAST exam

A 
. For stroke 
. Face droops 
. Arm weakness
. Speech difficulty 
. Time
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2
Q

Parenthesia

A

. Distorted sensation, tingling

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3
Q

Anesthesia

A

. Loss of sensation

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4
Q

Hyperesthesia

A

. Too much sensation

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5
Q

Allodynia

A

. Pain w/ innocuous stimulus

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6
Q

What to ask for history numbness

A

. Duration
. Distribution
. Good neuro ROS
. Check for muscle weakness/atrophy, skin, pulses, edema

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7
Q

. Interrelationships of nervous system

A

. Receiving sensory stimuli from environment
. Identifying/ integrating adaptive processes for maintenance
. Integrating responses of CNS/Endocrine system
. Controlling cognitive/voluntary behavioral processes

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8
Q

Frontal lobe functions

A 
. Voluntary skeletal movement 
. Repetitive movement
. Working memory
. Judgement
. Behavior
. Broca’s area
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9
Q

Broca’s area

A

. Language production
. Aphasia: patient knows what they want to say but can’t formulate speech
. Stuttering

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10
Q

Parietal lobe functions

A

. Processes sensory data
. Assists w/ processing of tactile sensation
. Proprioception
. Complex purposeful motor movement

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11
Q

Occipital lobe functions

A

. Interpretation and perception of visual data

. Recognition of color, shapes, and faces

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12
Q

Temporal lobe functions

A

. Emotional responses/ memory
. Integration of taste and smell
. Interpretation of speech (wernicke’s)

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13
Q

Wernicke’s area

A

. Sup. Temporal gyrus
. Comprehension and understanding of written and spoken language
. Difficulty processing incoming speech in your head (receptive aphasia)

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14
Q

Upper motor neurons

A

. Originate in motor region of cerebral cortex or brain stem

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15
Q

Lower motor neurons

A

. Originate in grey columns of spinal cord, ant. Nerve roots or CN nuclei of brainstem

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16
Q

Upper motor nerve lesions symptoms

A

. Weakness
. Reflexes inc.
. Tone inc.

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17
Q

Lower motor neuron lesion symptoms

A 
. Weakness
. Atrophy
. Fasciculations 
. Reflexes dec. 
. Tone dec.
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18
Q

Things to ask for seizure history

A 
. Sequence of events 
. Symptoms 
. Aura
. LOC
. Muscle activity 
. Postictal state
. Assoc. events (time, sleep, stress, frequency) 
. Meds/drugs/alcohol
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19
Q

History to ask related to gait

A

. A lance/falls

. Leg strength

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20
Q

Questions to ask about weakness/paresthia

A

. Onset
. Character
. Assoc. symptoms
. Concurrent illness

21
Q

Big risk factors for CVA

A

. High cholesterol
. High bp
. DM

22
Q

Important things in family medical history when patient has numbness/tingling

A 
. Alcohol
. Hereditary disease
. Mental retardation
. Epilepsy/headaches
. Alzheimer’s disease
. Weakness/gait disorders 
. Medical/metabolic disorders
23
Q

CN III/IV/VI examination

A

. Inspect eyelids for symmetry
. Inspect pupils for size/equality
. Test consensual response/accommodation
. Test extraocular eye movements

24
Q

How to test CN V

A

. Test pain/sensation
. Corneal reflexes
. Motor: symmetry, palpate jaw for strength/tone in muscles

25
Q

How to test CN VII

A

. Motor: make faces for facial expression mm.

. Sensory: tongue for salt/sweet

26
Q

How to test VN IX

A

. Test tongue for sour/bitter

. Test gag reflex

27
Q

how to test CN X

A

. Inspect palate/uvula (say AHH to see rise)
. Swallowing
. Guttural speech sounds

28
Q

How to test CN XII

A

. Inspect tongue for atrophy/symmetry/tremor
. Test tongue strength
. Evaluate lingual sounds l, t, d, n

29
Q

Cerebellar function

A

. Coordination and fine motor skills
. Movements: thumb-finger, finger-nose, finger-nose-finger, heel chin
. Balance equilibrium: observe gait, rhomberg, stand on one foot
. Rapid alternating movements

30
Q

How many neurons are lost per minute in ischemia?

A

1.9 million neurons

. Brain ages 3.8 yrs

31
Q

Cortical sensory functions

A

. Higher order cortical discriminatory sensory functions
. Graphesthesia: number identification
. Sterognosis (identification of object by feeling it)
. Tactile extinction (simultaneous stimuli test by touching each side
. 2 point discrimination: test w/ caliper, 2 sterile needles
. Point location: identify area touched on them

32
Q

Primary sensory functions

A

. Superficial touch
. Superficial pain and temperature
. Deep pressure/vibration and joint position

33
Q

Examine all sensory function for ___

A 
. Symmetry and differences 
. Patient’s interpretation of sensation 
. Discrimination
. Location 
. Note impairment using dermatomal chart
34
Q

Superficial reflexes

A

. Upper/lower abdominal
. Cremasteric
. Plantar: babinski reflex (fanning of toes)

35
Q

Muscle stretch response

A

. Muscle initially stretched
. Afferent signals are sent to spinal cord
. Interneuron connects afferent and efferent fibers
. Efferent signals sent to mm. To cause contraction

36
Q

Grading of deep reflexes

A 
. 0: absent 
. 1: dec. but present 
. 2: normal 
. 3: hyperreflexsive, brisk and excessive 
. 4: hyperreflexsive, w/ clonus
37
Q

Deep reflexes

A 
. Biceps: C5
. Brachioradialis: C6
. Triceps: C7
. Patellar: L4 
. Achilles: S1
38
Q

Hemiplegia (Early)

A

. Half of body unresponsive
. Externally rotated high
. Flaccid arm

39
Q

Decorticate rigidity

A 
. Abnormal flexor response 
. Internally rotated thigh 
. Plantar flexed foot
. Flexed elbow 
. Adducted arm 
. Flexed wrist 
. Insult lesion close to cerebrum, before midbrain and red nucleus
40
Q

Decerebrate rigidity

A 
. Abnormal extensor response
. Plantar flexed foot 
. Flexed wrist 
. Pronated forearm 
. Extended elbow 
. Adducted arm 
. Lesion in red nucleus or below
41
Q

Mental status

A

. Assess alert and orientation

. Alert and oriented x3 (person, place, and time)

42
Q

Muscle bulk

A

. Atrophy: secondary to PNS disorders
. Hypertrophy: inc. in mm. Bulk w/ normal or inc. strength
. Pseudohypertrophy: inc. bulk w/ diminished strength

43
Q

Eye opening grading

A

. 1: wont’ open even to supraorbital pressure
. 2: open w/ pain from sternum/limb/supraorbital pressure
. 3: open to speech, nonspecific response, not necessarily to command
. 4: eyes open normally

44
Q

Verbal response grading

A

1: no verbalization
2: moans/groans, no speech
3: intelligible, no sustained sentences
4: converses but confused, disoriented
5: converses and is oriented

45
Q

GCS

A

. Glascow coma score
. Mild rating: 13-15
. Moderate: 9-12
. Severe: 8 or less, needs intubation

46
Q

Motor response grading

A

1: non response to any pain, limb remains flaccid
2: shoulder adducted and shoulder and forearm internally rotated, extended (decerebrate)
3: withdrawal response or assumption of hemiplegic posture (decorticate)
4: arm withdrawals to pain, shoulder abducts
5: obeys commands
6: can localize pain

47
Q

Pronator drift

A

. Stan 20-30 sec w/ eyes closed
. Arms held out straight w/ palms up
. Arm will drift when asked to pronate arm

48
Q

Oculocephalic reflex

A

. Doll eye movements
. Lifting up eyelids and being able to move eyes back in forth
. When lost, can’t move eyes

49
Q

Dysdiadochokinesis

A

. Occurs in cerebellar disease

. Can’t complete rapid alternating movement

PSP (35 decks)

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