2.22 Neuro Exam Flashcards
Things to consider when starting a neuro exam
- organic vs. nonorganic
- localized vs. diffuse
- etiology
- history
organic
- some structure has been damaged
- directly involved nervous system
organic: categories
- stroke
- SCI
- TBI
- GBS
- TOS
- etc.
stroke: cardio vs. neuro
- cardiovascular injury that creates neurological symptoms
- most people classify as a neuro problem
nonorganic
- indirect
- can’t find a structural source of the problem
- based on functional limitations
nonorganic: categories
- CPRS
- PTSD (conversion disorder)
- Munchausen’s
- Munchausen’s by proxy
- malingerer
CPRS and organic/nonorganic
typically have some organic issue, their nervous system goes haywire
conversion disorder
- body can’t deal with something that’s happened
- i.e. military coming back to civilian life
- looks like a stroke
**treated exactly like it’s an organic issue
Munchausen’s
- pt decides there’s something wrong with them
- decide to get treated for some secondary gain
Munchausen’s by proxy
a parent keeps saying there’s something wrong with their child so they can get attention
malingerer
may have started with a true organic injury, but they may be looking for secondary gains
localized
- makes sense
- has a pattern
- can localize the pain
localized: examples
- radiculopathy
- neuropathy
- myelopathy
- myopathy
- plexopathy
- encephalopathy
localized: radiculopathy
nerve root
localized: neuropathy
peripheral nerve
localized: myelopathy
spinal cord
localized: myopathy
muscle
localized: plexopathy
plexus
localized: encephalopathy
- brain stem, cerebrum, cerebellum
- can be caused by trauma or infection
diffuse
- has pattern, but over a larger area
- If it doesn’t follow a localized pattern, need to start considering other things
If diffuse pain doesn’t follow a localized pattern, need to start considering some of these
- CP
- MS
- lupus
- RA
- cancer
- AIDS
What correlates with a decreased chance of having MS?
if formative years spent closer to the equator
When would diffuse symptoms make you consider cancer or AIDS?
- symptoms all over the place
- random, patchy neuro issues
etiology of neuro problems (list)
- traumatic
- insidious/idiopathic
- infection
- congenital
- vascular
- toxic metabilic
- neoplasm (cancer)
- autoimmune
