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PCM Last Exam > Abnormal Neuro Exam - Cohen > Flashcards

Abnormal Neuro Exam - Cohen Flashcards

1
Q

neuro exam

A 
mental status
cranial nn
cerebellum
strengths
DTRs
sensory testing, as needed
gait, if possible
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2
Q

LOL AMEN

A

mental status exam

LOC
orientation
language

attention
memory
executive/intellectual fxn
nondominant hemisphere

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3
Q

LOC

A

alert, sleepy, stupor, coma

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4
Q

orientation

A

person, place, time

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5
Q

language

A

fluent, articulation, repetition

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6
Q

attention

A

digit span, slepping, month/days forwards/backwards

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7
Q

memory

A

anterograde/retrograde

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8
Q

executive/intellectual fxn

A

verbal fluency, similarities, proverbs, estimates

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9
Q

non-dominant hemisphere

A

visual spatial, construction, music

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10
Q

fully awake without stimulation - able to cooperate

A

alert

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11
Q

patient prefers sleep, will stay away with minimal verbal or physical stimulation

A

lethargic

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12
Q

patient requires repeated physical stimulation to stay away

A

stuporous

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13
Q

sleep like state - pt cannot be awakened

A

comatose

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14
Q

abnormal LOC

A

always significant

causes:

  • decline organ fxn
  • new med
  • bacterial sepsis
  • low Hct, glucose, PP O2
  • increased CO2
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15
Q

orientation

A

person, place, time

some docs - awareness of their reason for being in hospital

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16
Q

aphasia

A

always dominant hemisphere impairment

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17
Q

brocas aphasia

A

frontal lobe

brief telegraphic output
retained understanding - frustrated

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18
Q

wernickes aphasia

A

superior temporal lobe

fluent speech - poor understanding

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19
Q

anomia

A

inability to name objects

both wernickes and brocas

also - both agraphia

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20
Q

slurred/thick speech

A

dysarthria

med effect
disease of larynx/mouth

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21
Q

testing language

A

listen to patient

have pt REPEAT simple word
have pt READ paragraph
have pt WRITE a sentence
have pt NAME simple objects

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22
Q

apraxia

A

loss of complex tasks

damage dom lobe
-damage to connections

common in stroke survivors/severely demented ppl

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23
Q

gerstmann syndrome

A

damge to angular gyrus of dom parietal lobe

acalculia
agraphia
inability to distinguish R or L
inability to distinguish individual fingers

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24
Q

tests for attention

A

digit span - 7 forward and 5 backwards

serial sevens - from 100

read series of letters - raise hand when hear A

spell WORLD forward and backward

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25
disoriented or inattentive patient - fails serial sevens - no longer give location, time, place - cant stick to subject at hand
may have delirium
26
delirium
acute confusion state encephalopathy agitation, hallucinations, tremors, BP and HR fluctuates hyperreactive to stimuli - or sleepy diffuse systemic problem - affecting large part of brain
27
abnormal memory
bilateral medial temporal lobe damage | -hippocampus
28
anterograde
recent memory - store new info
29
retrograde
distant memories
30
executive function
higher fxn of cerebarl cortex insight, judgment, decision making similarities of two objects
31
verbal fluency
test of how frontal lobes retrieve information name as many of category as they can healthy - 20 or more path - 12 or less
32
abnormal executive fxn, judgemeny, abnormal nondom hemisphere
dementia
33
non-dominant parietal lobe
visual-spatial lobes construction awareness of ones own body
34
non-dominant temporal lobe
``` music tendency to psychosis depression bipolar anxiety ```
35
non-dominant occipital lobe
left homonymous hemianopia, prosopagnosia (cant recognize faces)
36
hemispatial neglect
not seeing people or objects in left side of room
37
anosognosia
inability to recognize weakness one side of body
38
dressing agnosia
inability to put sleeve on one arm
39
lack of construction skills
nondom - right - parietal lobe damage draw, copy simple object
40
abnormal CN
localized lesion to brainstem
41
CN II check
visual acuity
42
pupil rxn
afferent - CN II | efferent - CN III
43
adies pupil
polyneuropathy - diabetes
44
U/L loss pupil loss
possibly I/L cerebral herniation
45
spare pupil
ischemia inside midbrain
46
ptosis
droopy upper eyelid -loss of CN III loss ov levator palpebrae superiosis
47
horners syndrome
see ptosis weak muellers m damage U/L sympathetics
48
CN IV
only crossed CN to C/L superior oblique m test - pt look down and in
49
CN VI
abducens serves I/L lateral rectus m local disease - pons or skull increased ICP
50
CN VII
facial mm facial expression taste anterior tongue
51
stapedius
limit hearing damage from loud noise facial n innervation
52
test of facial nerve
close eye, raise eyebrows - upper face smiling, pursing lips - lower face
53
peripheral CN VII palsy
lesion after nerve leaves pons both upper and lower facial mm impaired bells palsy if idiopathic
54
central CN VII palsy
lesion in brainstem - only lower facial muscles
55
cerebellum
coordinate movement of same side double cross of efferents lesion - ataxia
56
stroke/hemorrhage in cerebellar hemisphere
BS damage - block 4th ventricle CSF flow
57
ataxia
lack of coordination | not trouble walking
58
romberg test
cerebellar test - test for posterior columns - gracile and cuneus fasciculi
59
upright posture
1 vision 2 cerebellum 3 post columns
60
strength testing
``` 0 no movement 1 flicker of movement 2 min horizontal movement 3 some movement vertical (gravity) 4 mod strength against gravity and some resistance 5 normal contraction ```
61
quadriplegia
upper or mid cerv spine disease
62
hemiplegia
disease one cerebral hemisphere or one side of brainstem
63
paraplegia
disease of SC - thoracic or high lumbar
64
other muscle features
bulk tone fasciculations (twitching)
65
DTR
``` 0 no reflex 1 dim reflex 2 average - normal 3 increased - only one beat 4 - increased with clonus (two or more beats) ``` 4 - always pathologic
66
babinski sign
plantar reflex normal - flexion of big toe abnormal - extension of big toe
67
UMN lesion
increased reflex, babinski sign, spasticity
68
LMN lesion
decreased reflex, rapid atrophy, sometime fasciciulation
69
peripheral nerve or roots of nerves disease
radiculopathy loss of fine touch in dermatome
70
loss of sensation of entire extremity
cerebral hemisphere damage
71
hemiplegic gait
inability to bring leg in
72
spastic gait
inability to bend at hips and knees
73
festinating gait
slow with first steps - faster, then faster, and out of control

PCM Last Exam (6 decks)

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