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POM > 11/13/13 > Flashcards

11/13/13 Flashcards

1
Q

Which part of the brain is responsible for the motor cortex & executive functions?

A

The frontal lobe

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2
Q

Which part of the brain is responsible for sensory data, tactile sensations, visual, gustatory, olfactory, auditory, & proprioception?

A

The parietal lobe

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3
Q

Where is the primary vision center of the brain?

A

The occipital lobe

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4
Q

Which part of the brain is primarily responsible for sounds & the integration of tastes, smell, & balance?

A

The temporal lobe

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5
Q

What part of the brain refines motor movements?

A

Basal ganglia

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6
Q

Which part of the brain integrates multiple inputs, esp voluntary movements, balance, posture, & precise movements?

A

Cerebellum

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7
Q

Which part of the brain is responsible for controlling involuntary functions? What does it contain?

A

Brainstem

12 cranial nerves

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8
Q

What is your cranial nerves mnemonic?

A

Oprah Ought Order Tasty Treats And Finally Value Growing Voluptuous And Happy

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9
Q

What is Cranial Nerve 1?

A

Olfactory

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10
Q

What is Cranial Nerve 2?

A

Optic

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11
Q

What is Cranial Nerve 3?

A

Oculomotor

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12
Q

What is Cranial Nerve 4?

A

Trochlear

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13
Q

What is Cranial Nerve 5?

A

Trigeminal

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14
Q

What is Cranial Nerve 6?

A

Abducens

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15
Q

What is Cranial Nerve 7?

A

Facial

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16
Q

What is Cranial Nerve 8?

A

Vestibulocochlear/ Acoustic

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17
Q

What is Cranial Nerve 9?

A

Glossopharyngeal

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18
Q

What is Cranial Nerve 10?

A

Vagus

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19
Q

What is Cranial Nerve 11?

A

Accessory (Spinal)

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20
Q

What is Cranial Nerve 12?

A

Hypoglossal

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21
Q

Where does the spinal cord begin & end?

A

Begins exiting the skull @ the foramen magnum & ends @ L1 or L2.

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22
Q

What does the butterfly shape of the spinal cord contain? What is it called?

A

Gray matter

contains cell bodies of autonomic & sensory neurons.

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23
Q

What does the white matter of the spinal cord contain?

A

Ascending & Descending Nerve Tracts

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24
Q

What are the 3 main tracts of the white matter in the spinal cord? Which are ascending & which are descending?

A

Dorsal Column: ascending
Spinothalamic Tracts: ascending
Corticospinal Tracts: descending

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25
Q

What are the 2 specific names of the dorsal column & what information do they transmit?

A 
Fasiculis Gracilis (from the leg)
Fasiculis Cuneatus (from the arm)
**transmit touch, vibration, proprioception
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26
Q

What information does the spinothalamic tract transmit?

A

Pain & temperature

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27
Q

What information does the corticospinal tract transmit?

A

signals of skilled, delicate, & purposeful movements.

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28
Q

Where does the rubrospinal tract come from?

A

Red nucleus in the midbrain

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29
Q

What are some extra associated symptoms that you have to question w/ a headache?

A

aura (visual, auditory changes–sorta a hallucination); photophobia (intolerance to light); tearing of eyes; phonophobia

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30
Q

What are some extra questions you need to ask if someone has had a seizure?

A

aura
preceding event
loss of consciousness
fall

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31
Q

If a patient complains of disorientation or confusion…what are some extra questions you need to ask?

A

Hallucinations?
Trauma?
Fever?
Infection?

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32
Q

If somebody has a tremor…what are some possible differential diagnoses?

A

Hyperthyroidism
Alcohol Consumption
Multiple Sclerosis
Familial Tremor

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33
Q

With a neurologic exam…aside form CHADS…what are conditions you want to ask the patient if they have a history of?

A 
Meningitis
Encephalitis
Aneurysm
Neurologic Disorder
Anxiety
Depression
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34
Q

In the family Hx of a neurologic exam what are some hereditary disorders you want to ask about?

A

Neurofibromatosis
Huntington’s Disease
Muscular Dystrophy
Tay-Sachs Disease

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35
Q

Aside from CHADS & the possible hereditary disorders…what are some other diseases you want to ask about in the family Hx of a neurologic exam?

A

Alzheimer’s
Mental Retardation
Problems w/ Gait
Thyroid Disease

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36
Q

What are some environmental/occupational hazards that you want to check in on w/ a person in the social Hx of a neurological exam?

A

lead
arsenic
insecticides
organic solvents

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37
Q

What are 2 things you are thinking of in a neurological exam when you ask about sexual history?

A

The possibility of neurosyphilis

The possibility of HIV related dementia

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38
Q

What is one REALLY important thing to ask a patient about in social history of a neurological exam?

A

Their ability to support themselves at home…their support system.

39
Q

What is the MMSE? What does it test for? What is one complicating factor w/ this test?

A

Folstein Mini Mental Status Exam

  • *screening tool for dementia, looks @ orientation, registration, attention, calculation, language
  • *could be obscured by level of education & language skills
40
Q 
What is the max number of points you can get on the MMSE? 
What does a score over 25 mean?
21-24?
10-20?
Less than 9?
A 
Out of 30.
over 25 mean? Normal
21-24? Mild Cognitive Impairment
10-20? Moderate Cognitive Impairment
Less than 9? Severe Cognitive Impairment
41
Q

What is cranial nerve 1? How do you test it?

A

Olfactory
Close eyes. Occlude one nare.
Test familiar odors.

42
Q

What is Cranial nerve 2? How do you test it?

A

Optic
Viscual Acuity Test
Pupils reactive to light
Confrontation of visual fields

43
Q

What is the cranial nerve 3? how do you test it? When you test this one—which nerves do you also test?

A

Oculomotor
Movement thru 6 cardinal motions
pupil size, reactive, shape, accomodations
**also tests trochlear & abducens

44
Q

What is cranial nerve 4? How do you test it?

A

Same test as for the oculomotor.

45
Q

What is cranial nerve 5? What are the 4 divisions of how you test it?

A 
Trigeminal: facial sensation
Inspection
Palpation
Sensation
Cornea Reflex
46
Q

What do you inspect in the trigeminal nerve examination?

A

Look for atrophy, deviations, or fasciculations (muscle twitch) of the face

46
Q

What do you inspect in the trigeminal nerve examination?

A

Look for atrophy, deviations, or fasciculations (muscle twitch) of the face

47
Q

What do you palpate in the trigeminal nerve examination?

A

You palpate the muscles of the jaw when the pt has their teeth clenched. Look for fasciculations.

47
Q

What do you palpate in the trigeminal nerve examination?

A

You palpate the muscles of the jaw when the pt has their teeth clenched. Look for fasciculations.

48
Q

What are the 3 divisions of the sensation portion of the trigeminal nerve examination? What are the other portions of this exam?

A 
V1: opthalmic
V2: maxillary
V3: mandibular
**look for light, dull, & sharp sensation
**patient has eyes closed.
**test temp sensation
48
Q

What are the 3 divisions of the sensation portion of the trigeminal nerve examination? What are the other portions of this exam?

A 
V1: opthalmic
V2: maxillary
V3: mandibular
**look for light, dull, & sharp sensation
**patient has eyes closed.
**test temp sensation
49
Q

What is the corneal reflex portion of the trigeminal nerve examination?

A

When the patient looks up & away, you lightly touch the cornea w/ a cotton wisp…You should see the patient equally blink.
Contact wearers won’t blink.

49
Q

What is the corneal reflex portion of the trigeminal nerve examination?

A

When the patient looks up & away, you lightly touch the cornea w/ a cotton wisp…You should see the patient equally blink.
Contact wearers won’t blink.

50
Q

What is the first cranial nerve to go w/ an increase in intracranial pressure? How do you test for this?

A

Abducens

Same as for oculomotor.

51
Q

superior oblique works w/ which cranial nerve?

A

4 trochlear

moves in

52
Q

lateral rectis works w/ which cranial nerve?

A

6 abducens

moves out

53
Q

What do you inspect for the 7th cranial nerve? What do you test?

A

Facial
Inspect: Facial Expressions, blowing cheeks out
Taste 4 solutions

54
Q

How do you test cranial nerve 8?

A

Auditory Tests.

55
Q

How do you test cranial nerve 9?

A

Glossopharyngeal
test posterior 1/3 of tongue
Gag reflex

56
Q

How do you test cranial nerve 10?

A 
Vagus
Gag reflex--watch uvula movement
Say ah & watch symmetry of soft palate
Sip & swallow water--make sure it doesn't get up your nose
Listen to patient speech.
57
Q

How do you test cranial nerve 11? What 2 muscles does this test?

A

Accessory Spinal
Shrug
trapezius & sternocleidomastoid.

58
Q

How do you test cranial nerve 12?

A

Hypoglossal

mess w/ the tongue

59
Q

In the Rinne & Weber Test: if the tuning fork lateralizes to the good ear…what type of loss is this?

A

Sensorineural loss

60
Q

If the Rinne & Weber Test: if the tuning fork materializes to the bad ear…what type of loss is this?

A

Conductive loss

61
Q

What qualifies as primary sensory fcn?

A

superficial touch, pain, pressure, vibration

62
Q

What qualified as cortical sensory fcn?

A

Stereognosis
2 point discrimination
Graphesthesia
Point location

63
Q

What is stereognosis?

A

ability to identify an object by touching it w/ your hand.

64
Q

Negative stereognosis is called what? What does this indicate?

A

Tactile Agnosia

indicates a parietal lobe lesion

65
Q

What is graphethesia?

A

You draw on a pt w/ a cotton swab & ask them to identify what you drew.

66
Q

What are the 3 superficial reflexes?

A

Abdominal Reflex
Cremasteric Reflex
Plantar Reflex

67
Q

What is the cremasteric reflex?

A

stroke the inner thigh of the male & look for elevation of the scrotum.

68
Q

What is a normal reaction to the plantar reflex? What is an abnormal reaction called?

A

Stroke bottom of the foot.
Normal: Flexion of toes
Abnormal: Flaring of toes; called the Babinski sign

69
Q

At what age is the Babinski sign considered normal?

A

Considered normal up to 2 years of age.

70
Q

What are the 5 places you look for deep tendon reflexes?

A 
Brachioradialis
Biceps
Triceps
Patellar
Achilles
71
Q

What is the grading of deep tendon reflexes?

A

Scale 0-4

0: no reflex
1: hyporeflex
2: Normal
3: hyperreflex
4: Clonus–>repetitive shortening after single stimulation.

72
Q

What are the 3 categories of cerebellar function tests?

A

Rapid rhythmic alternation movements
accuracy of movements
Balance

73
Q

What is the test for rapid rhythmic alternation movements?

A

switching hands from palm down to up while on your lap really fast. Do w/ both hands & w/ only one hand.

74
Q

What are the 2 tests you can do w/ accuracy of movements?

A

Nose to doc’s finger touch.

Heel to shin test.

75
Q

What are the 2 things that you are looking for w/ testing balance?

A

Equilibrium

Gait

76
Q

What are 3 ways to test equilibrium?

A

Romberg Test: close eyes & don’t fall
Stand on one foot
Hop on one foot

77
Q

What is spastic hemiparesis? Related to gait

A

Weakness on one side of the body

78
Q

What is spastic diplegia? Related to gait

A

a form of Cerebral Palsy…tightness in the lower limbs

79
Q

What is steppage gait?

A

foot drop due to loss of dorsiflexion…person has to raise their feet higher than normal when they walk.

80
Q

What is cerebellar ataxia? Related to Gait.

A

A form of ataxia: lack of ability to control voluntary movements…that originates from problem in the cerebellum

81
Q

What is sensory ataxia? Related to gait.

A

difficulty controlling voluntary movements b/c of a lack of sensory info

82
Q

What is the Wernicke area? Broca’s Area?

A

Wernicke: interpretation of speech
Broca: voluntary speech

83
Q

Does injury to upper motor neurons or lower motor neurons cause permanent paralysis?

A

lower motor neurons.

84
Q

What is anosmia? What could cause this?

A

loss of sense of smell

trauma to cribriform plate or olfactory tract lesion

85
Q

How many spinal nerves are there?

A

31

86
Q

How long is the spinal cord?

A

40-50 cm long.

87
Q

Which reflexes are present at birth?

A

patellar tendon reflexes

88
Q

Which reflexes appear at 6 months of age?

A

Achilles

Brachioradial tendon reflexes

89
Q

What is sustained clonus associated w/?

A

upper motor neuron disease

90
Q

When does the major portion of brain growth occur?

A

the first year of life

POM (4 decks)

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