Phys Dx Neuro

Question 0

Moderately reduced range if affect

Answer 0

Blunted or restricted

Question 1

Unhappy, depressed, dissatisfied

Answer 1

Dysphoric

Question 2

Multiple abrupt changes in affect

Answer 2

Labile

Question 3

Made need to shake pt
Slow response
Decreased interest in environment

Answer 3

Obtundation

Question 4

Often need painful stimuli to arouse
Lapse into unresponsiveness when stimuli cease
Minimal awareness of self and environment

Answer 4

Stupor

Question 5

Dysarthria

Answer 5

Problem with motor speech or articulation

*seen with bulbar or pseudobulbar palsy

Question 6

Dysphonia

Answer 6

Weak breathy voice

Vocal cords not well approximated
*seen with presbyphonia, vocal cord nodules, polyps paralysis or tumors

Question 7

Expressive aphasia (Brocas)

Answer 7

Comprehension intact

Unable to speak to varying disease

Question 8

Receptive aphasia (wernickes)

Answer 8

Comprehension not intact

Fluent but nonsensical speech

Question 9

Global aphasia

Answer 9

Combination of recessive and expressive aphasia

Question 10

Inability to perform a learned motor act

Answer 10

Apraxia

Seen with parietal lobe lesion

Question 11

Inability to recognize sensory stimuli

Answer 11

Agnosia

A/w large parieto-occipital-posterior temporal lesion
-CVA or dementia

Question 12

Individual suddenly abandons a present activity or lifestyle and starts anew one for a period if time, often I a different city and after they allege amnesia

Answer 12

Fugue

Question 13

Psychomotor disturbances seen in schizophrenia characterized by periods of either muscular rigidity, excitement or stupor

Answer 13

Catatonia

Question 14

GCS 15

Answer 14

Wide awake

Question 15

GCS 3

Answer 15

Deep coma

Question 16

Head injury GCS 8 or below

Answer 16

Very poor prognosis if below 8 for more than 72 hours

Question 17

Pts act awake, usually following deep coma
Eyes open, may cough, yawn, swallow
Still essentially brain dead

Answer 17

Coma vigil and alpha coma

Question 18

Decorticate posturing

Answer 18

Flexion

Question 19

Decerebrate posturing

Answer 19

Extension

Question 20

Reflects destructive lesions in corticospinal tract from cortex to upper midbrain

Answer 20

Decorticate posturing

Flexor response

Question 21

A/w damage to corticospinal tract at level of pons or upper medulla

Answer 21

Decerebrate posturing

Extensor posturing

Question 22

Occurs secondary to increased ICP

A/w trauma

Answer 22

Brain herniation

Question 23

Unilateral fixed and dilated pupil w/ Ptosis

Answer 23

Third nerve palsy

• seen with uncal herniation
• also aneurysm compressing CN3

Question 24

Left eye cannot look down when turned inward

Answer 24

Left 4th nerve paralysis

Question 25

Eyes conjugate looking right Estropia looking straight ahead Estropia max to the left

Answer 25

Left 6th nerve paralysis

Question 26

Pupils in Mid position (2-5mm) and fixed

Answer 26

Midbrain lesion

Question 27

Pupils pinpoint and reactive

Answer 27

Pontine lesion

Question 28

Pupils unilaterally dilated and fixed

Answer 28

CN3 lesion or uncal herniation

Question 29

Pupils bilaterally dilated and fixed

Answer 29

Central herniation or hypoxia

Question 30

Oculocephalic reflex

Answer 30

Hold eyes open and rotate head to side to check for dolls eyes - if dolls eyes absent suggests lesion in midbrain or pons

Question 31

Absent or asymmetric dolls eyes reflex horizontally

Answer 31

Brainstem injury

Question 32

Absent or asymmetric dolls eyes reflex vertically

Answer 32

Midbrain injury

Question 33

Vestibulocochlear reflex

Answer 33

Hold head at 30 degrees, lavage ear with ice cold water | Normal response is slow/tonic toward ear and fast/nystagmus away

Question 34

COWS

Answer 34

Cold water opposite | Warm water same

Question 35

If impaired vestibulocochlear reflex, suggests

Answer 35

Brainstem lesion CN3-CN6

Question 36

Cheyne-stokes respirations

Answer 36

Bihemispheric lesions or met enceph

Question 37

Kussmaul's or hyperventilation

Answer 37

Met acidosis or brain herniation

Question 38

Apneustic respirations

Answer 38

Pontine damage

Question 39

Cluster respirations

Answer 39

Early medullary damage

Question 40

Biot's ataxic respirations

Answer 40

Medullary damage

Question 41

Hyposmia or anosmia (Decreased or absent sense of smell) Difficulty with concentration

Answer 41

CN1 deficit | Olfactory groove meningioma

Question 42

Pituitary adenoma presents with

Answer 42

Visual field defect and HA Also signs of increased pituitary hyper secretion: -acromegaly, infertility, amenorrhea, crushingly disease

Question 43

Central CN7 lesion

Answer 43

Contralateral paralysis of the lower face | Sparing forehead

Question 44

Peripheral CN7 lesion

Answer 44

Ipsilateral paralysis of entire side of face

Question 45

Benign growth on CN8 a/w SNHL and peripheral CN7 lesion (ipsilateral) May see cerebellar ataxia with large lesions

Answer 45

Acoustic neuroma

Question 46

CN9 lesion results in

Answer 46

Deviation of palate AWAY from side of lesion | Loss of gag reflex

Question 47

CN12 lesion results in

Answer 47

Deviation of tongue TOWARD the side of the lesion | "Lick the lesion"

Question 48

``` Acute weakness or numbness Abrupt impairment of consciences WHOL Aphasia Dysarthria ```

Answer 48

Signs and sx of CVA

Question 49

Pronator drift

Answer 49

Assess for subtle signs of weakness during motor exam in CVA

Question 50

Increased tone, worse with rapid movement

Answer 50

Spasticity

Question 51

Increased tone and resistance to movement, independent if rate of movement

Answer 51

Rigidity