11/13/13 Flashcards
1
Q
Which part of the brain is responsible for the motor cortex & executive functions?
A
The frontal lobe
2
Q
Which part of the brain is responsible for sensory data, tactile sensations, visual, gustatory, olfactory, auditory, & proprioception?
A
The parietal lobe
3
Q
Where is the primary vision center of the brain?
A
The occipital lobe
4
Q
Which part of the brain is primarily responsible for sounds & the integration of tastes, smell, & balance?
A
The temporal lobe
5
Q
What part of the brain refines motor movements?
A
Basal ganglia
6
Q
Which part of the brain integrates multiple inputs, esp voluntary movements, balance, posture, & precise movements?
A
Cerebellum
7
Q
Which part of the brain is responsible for controlling involuntary functions? What does it contain?
A
Brainstem
12 cranial nerves
8
Q
What is your cranial nerves mnemonic?
A
Oprah Ought Order Tasty Treats And Finally Value Growing Voluptuous And Happy
9
Q
What is Cranial Nerve 1?
A
Olfactory
10
Q
What is Cranial Nerve 2?
A
Optic
11
Q
What is Cranial Nerve 3?
A
Oculomotor
12
Q
What is Cranial Nerve 4?
A
Trochlear
13
Q
What is Cranial Nerve 5?
A
Trigeminal
14
Q
What is Cranial Nerve 6?
A
Abducens
15
Q
What is Cranial Nerve 7?
A
Facial
16
Q
What is Cranial Nerve 8?
A
Vestibulocochlear/ Acoustic
17
Q
What is Cranial Nerve 9?
A
Glossopharyngeal
18
Q
What is Cranial Nerve 10?
A
Vagus
19
Q
What is Cranial Nerve 11?
A
Accessory (Spinal)
20
Q
What is Cranial Nerve 12?
A
Hypoglossal
21
Q
Where does the spinal cord begin & end?
A
Begins exiting the skull @ the foramen magnum & ends @ L1 or L2.
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.
23
Q
What does the white matter of the spinal cord contain?
A
Ascending & Descending Nerve Tracts
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
25
What are the 2 specific names of the dorsal column & what information do they transmit?
```
Fasiculis Gracilis (from the leg)
Fasiculis Cuneatus (from the arm)
**transmit touch, vibration, proprioception
```
26
What information does the spinothalamic tract transmit?
Pain & temperature
27
What information does the corticospinal tract transmit?
signals of skilled, delicate, & purposeful movements.
28
Where does the rubrospinal tract come from?
Red nucleus in the midbrain
29
What are some extra associated symptoms that you have to question w/ a headache?
aura (visual, auditory changes--sorta a hallucination); photophobia (intolerance to light); tearing of eyes; phonophobia
30
What are some extra questions you need to ask if someone has had a seizure?
aura
preceding event
loss of consciousness
fall
31
If a patient complains of disorientation or confusion...what are some extra questions you need to ask?
Hallucinations?
Trauma?
Fever?
Infection?
32
If somebody has a tremor...what are some possible differential diagnoses?
Hyperthyroidism
Alcohol Consumption
Multiple Sclerosis
Familial Tremor
33
With a neurologic exam...aside form CHADS...what are conditions you want to ask the patient if they have a history of?
```
Meningitis
Encephalitis
Aneurysm
Neurologic Disorder
Anxiety
Depression
```
34
In the family Hx of a neurologic exam what are some hereditary disorders you want to ask about?
Neurofibromatosis
Huntington's Disease
Muscular Dystrophy
Tay-Sachs Disease
35
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?
Alzheimer's
Mental Retardation
Problems w/ Gait
Thyroid Disease
36
What are some environmental/occupational hazards that you want to check in on w/ a person in the social Hx of a neurological exam?
lead
arsenic
insecticides
organic solvents
37
What are 2 things you are thinking of in a neurological exam when you ask about sexual history?
The possibility of neurosyphilis
| The possibility of HIV related dementia
38
What is one REALLY important thing to ask a patient about in social history of a neurological exam?
Their ability to support themselves at home...their support system.
39
What is the MMSE? What does it test for? What is one complicating factor w/ this test?
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
```
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?
```
```
Out of 30.
over 25 mean? Normal
21-24? Mild Cognitive Impairment
10-20? Moderate Cognitive Impairment
Less than 9? Severe Cognitive Impairment
```
41
What is cranial nerve 1? How do you test it?
Olfactory
Close eyes. Occlude one nare.
Test familiar odors.
42
What is Cranial nerve 2? How do you test it?
Optic
Viscual Acuity Test
Pupils reactive to light
Confrontation of visual fields
43
What is the cranial nerve 3? how do you test it? When you test this one---which nerves do you also test?
Oculomotor
Movement thru 6 cardinal motions
pupil size, reactive, shape, accomodations
**also tests trochlear & abducens
44
What is cranial nerve 4? How do you test it?
Same test as for the oculomotor.
45
What is cranial nerve 5? What are the 4 divisions of how you test it?
```
Trigeminal: facial sensation
Inspection
Palpation
Sensation
Cornea Reflex
```
46
What do you inspect in the trigeminal nerve examination?
Look for atrophy, deviations, or fasciculations (muscle twitch) of the face
46
What do you inspect in the trigeminal nerve examination?
Look for atrophy, deviations, or fasciculations (muscle twitch) of the face
47
What do you palpate in the trigeminal nerve examination?
You palpate the muscles of the jaw when the pt has their teeth clenched. Look for fasciculations.
47
What do you palpate in the trigeminal nerve examination?
You palpate the muscles of the jaw when the pt has their teeth clenched. Look for fasciculations.
48
What are the 3 divisions of the sensation portion of the trigeminal nerve examination? What are the other portions of this exam?
```
V1: opthalmic
V2: maxillary
V3: mandibular
**look for light, dull, & sharp sensation
**patient has eyes closed.
**test temp sensation
```
48
What are the 3 divisions of the sensation portion of the trigeminal nerve examination? What are the other portions of this exam?
```
V1: opthalmic
V2: maxillary
V3: mandibular
**look for light, dull, & sharp sensation
**patient has eyes closed.
**test temp sensation
```
49
What is the corneal reflex portion of the trigeminal nerve examination?
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
What is the corneal reflex portion of the trigeminal nerve examination?
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
What is the first cranial nerve to go w/ an increase in intracranial pressure? How do you test for this?
Abducens
| Same as for oculomotor.
51
superior oblique works w/ which cranial nerve?
4 trochlear
| moves in
52
lateral rectis works w/ which cranial nerve?
6 abducens
| moves out
53
What do you inspect for the 7th cranial nerve? What do you test?
Facial
Inspect: Facial Expressions, blowing cheeks out
Taste 4 solutions
54
How do you test cranial nerve 8?
Auditory Tests.
55
How do you test cranial nerve 9?
Glossopharyngeal
test posterior 1/3 of tongue
Gag reflex
56
How do you test cranial nerve 10?
```
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
How do you test cranial nerve 11? What 2 muscles does this test?
Accessory Spinal
Shrug
trapezius & sternocleidomastoid.
58
How do you test cranial nerve 12?
Hypoglossal
| mess w/ the tongue
59
In the Rinne & Weber Test: if the tuning fork lateralizes to the good ear...what type of loss is this?
Sensorineural loss
60
If the Rinne & Weber Test: if the tuning fork materializes to the bad ear...what type of loss is this?
Conductive loss
61
What qualifies as primary sensory fcn?
superficial touch, pain, pressure, vibration
62
What qualified as cortical sensory fcn?
Stereognosis
2 point discrimination
Graphesthesia
Point location
63
What is stereognosis?
ability to identify an object by touching it w/ your hand.
64
Negative stereognosis is called what? What does this indicate?
Tactile Agnosia
| indicates a parietal lobe lesion
65
What is graphethesia?
You draw on a pt w/ a cotton swab & ask them to identify what you drew.
66
What are the 3 superficial reflexes?
Abdominal Reflex
Cremasteric Reflex
Plantar Reflex
67
What is the cremasteric reflex?
stroke the inner thigh of the male & look for elevation of the scrotum.
68
What is a normal reaction to the plantar reflex? What is an abnormal reaction called?
Stroke bottom of the foot.
Normal: Flexion of toes
Abnormal: Flaring of toes; called the Babinski sign
69
At what age is the Babinski sign considered normal?
Considered normal up to 2 years of age.
70
What are the 5 places you look for deep tendon reflexes?
```
Brachioradialis
Biceps
Triceps
Patellar
Achilles
```
71
What is the grading of deep tendon reflexes?
Scale 0-4
0: no reflex
1: hyporeflex
2: Normal
3: hyperreflex
4: Clonus-->repetitive shortening after single stimulation.
72
What are the 3 categories of cerebellar function tests?
Rapid rhythmic alternation movements
accuracy of movements
Balance
73
What is the test for rapid rhythmic alternation movements?
switching hands from palm down to up while on your lap really fast. Do w/ both hands & w/ only one hand.
74
What are the 2 tests you can do w/ accuracy of movements?
Nose to doc's finger touch.
| Heel to shin test.
75
What are the 2 things that you are looking for w/ testing balance?
Equilibrium
| Gait
76
What are 3 ways to test equilibrium?
Romberg Test: close eyes & don't fall
Stand on one foot
Hop on one foot
77
What is spastic hemiparesis? Related to gait
Weakness on one side of the body
78
What is spastic diplegia? Related to gait
a form of Cerebral Palsy...tightness in the lower limbs
79
What is steppage gait?
foot drop due to loss of dorsiflexion...person has to raise their feet higher than normal when they walk.
80
What is cerebellar ataxia? Related to Gait.
A form of ataxia: lack of ability to control voluntary movements...that originates from problem in the cerebellum
81
What is sensory ataxia? Related to gait.
difficulty controlling voluntary movements b/c of a lack of sensory info
82
What is the Wernicke area? Broca's Area?
Wernicke: interpretation of speech
Broca: voluntary speech
83
Does injury to upper motor neurons or lower motor neurons cause permanent paralysis?
lower motor neurons.
84
What is anosmia? What could cause this?
loss of sense of smell
| trauma to cribriform plate or olfactory tract lesion
85
How many spinal nerves are there?
31
86
How long is the spinal cord?
40-50 cm long.
87
Which reflexes are present at birth?
patellar tendon reflexes
88
Which reflexes appear at 6 months of age?
Achilles
| Brachioradial tendon reflexes
89
What is sustained clonus associated w/?
upper motor neuron disease
90
When does the major portion of brain growth occur?
the first year of life
