Week 2 Neuro Flashcards Preview

Question 1

1

Cerebellar disorders

Answer

Ataxia, decreased tendon reflexes, asthenia, tremor, nystagmus

Question 2

2

Spinal cord: ascending tracts

Answer

Pain-temp, proprioception, light touch

Question 3

3

Spinothalamic tract

Answer

Pain-temp, light touch. Crosses over to other side then ascends to thalamus and cerebral cortex on opposite side.
*lesion in this tract --> loss of pain-temp sensation contralaterally, below level of lesion.

Question 4

4

Damage to upper motor neurons

Answer

Hypertonia/spasticity, decreased motor control, spastic reflexes, +Babinski

Question 5

5

Damage to lower motor neuron

Answer

Hypotonia, weakness, decreased reflexes in affected areas

Question 6

6

+ Babinski

Answer

UMN lesion. Abnormal dorsiflexion of great toe and fanning of other toes

Question 7

7

Gray matter

Answer

Neuronal cell bodies and synapses

Question 8

8

White matter

Answer

Ascending: sensory info to brain
and descending: motor instructions from brain

Question 9

9

Spinocerebellar tract

Answer

Does NOT cross the spinal cord therefore ipsilateral symptoms. Receives afferent from periphery.

Question 10

10

Spinothalamic tract

Answer

Crosses spinal cord immediately, therefore contralateral sxs

Question 11

11

Descending tracts

Answer

Extends from motor area of cerebral cortex through brain stem, cross at medial lemniscus, synapse in anterior horn of spinal cord
UMNs and LMNs

Question 12

12

UMN

Answer

Pathway from brain to spinal cord before synapse. Do not directly stimulate target muscle

Question 13

13

LMN

Answer

Post synaptic pathway from spinal cord to periphery. Directly stimulate target muscle

Question 14

14

Diencephalon

Answer

All structures with "thalamus": thalamus, hypothalamus, epithalamus, subthalamus.
Connects endocrine with nervous and limbic systems

Question 15

15

Disorders of basal ganglia

Answer

Parkinsonism: tremors (degeneration of this and substantia nigra)
Chorea: sudden, jerky, purposeless movements
Athetosis: slow writhin, snake like movements
Hemiballismus: Wild flail of one arm

Question 16

16

Review of sys questions for neurological patient

Answer

Pain
HEENT: HA, vision chnages, dizziness
Neuro: tremor, weakness or sensory loss, LOC, motor dysfunction, speech/swallowing issue

Question 17

17

Mental status exam

Answer

Family hx of memory loss
Orientation
General info
Spelling

Question 18

18

Cranial nerves

Answer

CN 7: have them smile to test for stroke

Question 19

19

Basic labs

Answer

CBC, CMP, TSH, bedside glucose
Lumbar puncture, CT, MRI

Question 20

20

Ischemic stroke

Answer

Due to thrombosis (or emboli, lacunar, TIA)

Sxs: embolic-- acute onset, during day, headache precedes neuro deficit
Thrombotic--slower onset, during night, without headache/pain/fever
Lacunar--hemiparesis

Question 21

21

Risk factors for stroke

Answer

Prior stroke, age, male, smoking, cocaine, family history

Question 22

22

Labs for ischemic stroke

Answer

1st: CT
2nd: MRI
3rd: bedside glucose testing

Question 23

23

Hemorrhagic stroke

Answer

Intracerebral and subarachnoid. 20% of strokes

Question 24

24

Intracerebral hemorrhage

Answer

Usu HTN (trauma, brain tumor)
Sxs: headache, nausea, impairment of consciousness

Severe presentation!

Question 25

25

Subarachnoid hemorrhage

Answer

Usu ruptured aneurysm

Sxs: sudden, severe headache with LOC, severe neurologic deficits, seizures

Question 26

26

Delirium

Answer

Sudden, days-weeks, due to infection/dehydration/drugs, reversible, poor attention
May be changes in personality, confusion

Question 27

27

Dementia

Answer

Slow, progressive, LOC not impacted
Etiology:
Alzheimer's, vascular, Lewy Body, Parksinson Dz, HIV assoc dementia, frontotemporal dementia

Question 28

28

How to diagnose dementia?

Answer

History w mental status, PE with complete neuro, TSH/B12/CBC/LFT/HIV, CT/MRI
Requires:
1. Cognitive or behavioral changes (aphasia, agnosia, apraxia)
2. Decline
3. Rule out delirium

Question 29

29

Alzheimer's Disease

Answer

Beta amyloid deposits and neurofibrillary tangles (tau) and Ach def. Must be >40yrs to be diagnosed. Half of people >85 yrs.

Risk factors: age, family history, trisomy 21

Question 30

30

To diagnose Alzheimer's Dz

Answer

Dementia established clinically
Deficits in > 2 areas of cognition
Gradual onset and progressive worsening of memory
No disturbance of consciousness
Onset after 40, most after 65 yrs
No systemic or brain disorders

Question 31

31

Risk factors for vascular dementia

Answer

HTN, DM, hyperlipidemia, smoking, strokes

Question 32

32

Vascular dementia signs and symptoms

Answer

Exaggerated DTRs, gait abnormalities, hemiplegias

History: of stroke(s)!

Question 33

33

Lewy body dementia

Answer

Lewy bodies in cytoplasm of cortical neurons. Cognitive and extra pyramidal Sxs within one year. Rigidity of axial muscles with gait instability, symmetrical deficits, tremors

Question 34

34

Parksinson Dz Dementia

Answer

Motor Sxs then 10-15years later cognitive Sxs. Psychiatric Sxs uncommon
Definitive diagnosis requires autopsy

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Week 2 Neuro Flashcards Preview

CPD Vocab III > Week 2 Neuro > Flashcards

Cerebellar disorders

Ataxia, decreased tendon reflexes, asthenia, tremor, nystagmus

Spinal cord: ascending tracts

Pain-temp, proprioception, light touch

Spinothalamic tract

Pain-temp, light touch. Crosses over to other side then ascends to thalamus and cerebral cortex on opposite side.*lesion in this tract --> loss of pain-temp sensation contralaterally, below level of lesion.

Damage to upper motor neurons

Hypertonia/spasticity, decreased motor control, spastic reflexes, +Babinski

Damage to lower motor neuron

Hypotonia, weakness, decreased reflexes in affected areas

+ Babinski

UMN lesion. Abnormal dorsiflexion of great toe and fanning of other toes

Gray matter

Neuronal cell bodies and synapses

White matter

Ascending: sensory info to brain and descending: motor instructions from brain

Spinocerebellar tract

Does NOT cross the spinal cord therefore ipsilateral symptoms. Receives afferent from periphery.

Spinothalamic tract

Crosses spinal cord immediately, therefore contralateral sxs

Descending tracts

Extends from motor area of cerebral cortex through brain stem, cross at medial lemniscus, synapse in anterior horn of spinal cordUMNs and LMNs

UMN

Pathway from brain to spinal cord before synapse. Do not directly stimulate target muscle

LMN

Post synaptic pathway from spinal cord to periphery. Directly stimulate target muscle

Diencephalon

All structures with "thalamus": thalamus, hypothalamus, epithalamus, subthalamus. Connects endocrine with nervous and limbic systems

Disorders of basal ganglia

Parkinsonism: tremors (degeneration of this and substantia nigra)Chorea: sudden, jerky, purposeless movements Athetosis: slow writhin, snake like movements Hemiballismus: Wild flail of one arm

Review of sys questions for neurological patient

PainHEENT: HA, vision chnages, dizzinessNeuro: tremor, weakness or sensory loss, LOC, motor dysfunction, speech/swallowing issue

Mental status exam

Family hx of memory lossOrientationGeneral infoSpelling

Cranial nerves

CN 7: have them smile to test for stroke

Basic labs

CBC, CMP, TSH, bedside glucoseLumbar puncture, CT, MRI

Ischemic stroke

Due to thrombosis (or emboli, lacunar, TIA)Sxs: embolic-- acute onset, during day, headache precedes neuro deficitThrombotic--slower onset, during night, without headache/pain/feverLacunar--hemiparesis

Risk factors for stroke

Prior stroke, age, male, smoking, cocaine, family history

Labs for ischemic stroke

1st: CT2nd: MRI3rd: bedside glucose testing

Hemorrhagic stroke

Intracerebral and subarachnoid. 20% of strokes

Intracerebral hemorrhage

Usu HTN (trauma, brain tumor)Sxs: headache, nausea, impairment of consciousness Severe presentation!

Subarachnoid hemorrhage

Usu ruptured aneurysmSxs: sudden, severe headache with LOC, severe neurologic deficits, seizures

Delirium

Sudden, days-weeks, due to infection/dehydration/drugs, reversible, poor attentionMay be changes in personality, confusion

Dementia

Slow, progressive, LOC not impactedEtiology: Alzheimer's, vascular, Lewy Body, Parksinson Dz, HIV assoc dementia, frontotemporal dementia

How to diagnose dementia?

History w mental status, PE with complete neuro, TSH/B12/CBC/LFT/HIV, CT/MRIRequires:1. Cognitive or behavioral changes (aphasia, agnosia, apraxia)2. Decline3. Rule out delirium

Alzheimer's Disease

Beta amyloid deposits and neurofibrillary tangles (tau) and Ach def. Must be >40yrs to be diagnosed. Half of people >85 yrs.Risk factors: age, family history, trisomy 21

To diagnose Alzheimer's Dz

Dementia established clinicallyDeficits in > 2 areas of cognitionGradual onset and progressive worsening of memoryNo disturbance of consciousnessOnset after 40, most after 65 yrsNo systemic or brain disorders

Risk factors for vascular dementia

HTN, DM, hyperlipidemia, smoking, strokes

Vascular dementia signs and symptoms

Exaggerated DTRs, gait abnormalities, hemiplegiasHistory: of stroke(s)!

Lewy body dementia

Lewy bodies in cytoplasm of cortical neurons. Cognitive and extra pyramidal Sxs within one year. Rigidity of axial muscles with gait instability, symmetrical deficits, tremors

Parksinson Dz Dementia

Motor Sxs then 10-15years later cognitive Sxs. Psychiatric Sxs uncommon Definitive diagnosis requires autopsy

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Pain-temp, light touch. Crosses over to other side then ascends to thalamus and cerebral cortex on opposite side.
*lesion in this tract --> loss of pain-temp sensation contralaterally, below level of lesion.

Ascending: sensory info to brain
and descending: motor instructions from brain

Extends from motor area of cerebral cortex through brain stem, cross at medial lemniscus, synapse in anterior horn of spinal cord
UMNs and LMNs

All structures with "thalamus": thalamus, hypothalamus, epithalamus, subthalamus.
Connects endocrine with nervous and limbic systems

Parkinsonism: tremors (degeneration of this and substantia nigra)
Chorea: sudden, jerky, purposeless movements
Athetosis: slow writhin, snake like movements
Hemiballismus: Wild flail of one arm

Pain
HEENT: HA, vision chnages, dizziness
Neuro: tremor, weakness or sensory loss, LOC, motor dysfunction, speech/swallowing issue

Family hx of memory loss
Orientation
General info
Spelling

CBC, CMP, TSH, bedside glucose
Lumbar puncture, CT, MRI

Due to thrombosis (or emboli, lacunar, TIA)

Sxs: embolic-- acute onset, during day, headache precedes neuro deficit
Thrombotic--slower onset, during night, without headache/pain/fever
Lacunar--hemiparesis

1st: CT
2nd: MRI
3rd: bedside glucose testing

Usu HTN (trauma, brain tumor)
Sxs: headache, nausea, impairment of consciousness

Severe presentation!

Usu ruptured aneurysm

Sxs: sudden, severe headache with LOC, severe neurologic deficits, seizures

Sudden, days-weeks, due to infection/dehydration/drugs, reversible, poor attention
May be changes in personality, confusion

Slow, progressive, LOC not impacted
Etiology:
Alzheimer's, vascular, Lewy Body, Parksinson Dz, HIV assoc dementia, frontotemporal dementia

History w mental status, PE with complete neuro, TSH/B12/CBC/LFT/HIV, CT/MRI
Requires:
1. Cognitive or behavioral changes (aphasia, agnosia, apraxia)
2. Decline
3. Rule out delirium

Beta amyloid deposits and neurofibrillary tangles (tau) and Ach def. Must be >40yrs to be diagnosed. Half of people >85 yrs.

Risk factors: age, family history, trisomy 21

Dementia established clinically
Deficits in > 2 areas of cognition
Gradual onset and progressive worsening of memory
No disturbance of consciousness
Onset after 40, most after 65 yrs
No systemic or brain disorders

Exaggerated DTRs, gait abnormalities, hemiplegias

History: of stroke(s)!

Motor Sxs then 10-15years later cognitive Sxs. Psychiatric Sxs uncommon
Definitive diagnosis requires autopsy