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PCM 1 Final > Approach to Neuro Exam > Flashcards

Approach to Neuro Exam Flashcards

1
Q

Dysarthria vs. Aphasia

A
  • Dysarthria - defective articulation, due to neuro or non neuro issue
  • Aphasia - cannot produce or understand speech, neuro issue
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2
Q

Describe what is meant by AxOx4

A 
Alert
Oriented to: 
- Person (x1)
- Place (x2)
- Time (x3)
- Situation (x4)
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3
Q

What is anhedonia? What condition is this associated with?

A

cannot feel pleasure, assoc w depression

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4
Q

Delirium vs. Dementia

A
  1. Delirium - reversible (ex: ICU delirium)

2. Dementia - not reversible (ELIMINATE delirium and depression before dx)

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5
Q

What lesions are assoc with CN III?

A

ptosis (Horners), pulpillary dilation/asymm, compressive brain stem lesions

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6
Q

What lesions are assoc with CN IV?

A
  1. exotropia (eyes drift laterally), weakness downward gaze
  2. visual diplopia (worse when looking down)
  3. head tilting (to opp side lesion, do not misdx as torticollis)
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7
Q

What lesions are assoc with CN VI? What diseases is this commonly assoc with?

A

Dz: SAH, late syphilis, trauma

  1. medial strabismus (esotropia)
  2. horizontal diplopia
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8
Q

What lesions are assoc with CN V?

A
  1. loss of corneal reflex
  2. weakness mastic m
  3. dec sens face
  4. jaw deviation (toward weak side)
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9
Q

What lesions are assoc with CN VII?

A
  1. Bell’s Palsy
  2. Hyperacusis
  3. Crocodile tears syndrome - tears while chewing
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10
Q

What lesions are assoc with CN VIII?

A
  1. dysequilibrium
  2. nystagmus
  3. sensorineural hearing loss
  4. tinnitus
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11
Q

What lesions are assoc with CN IX?

A
  1. loss of gag reflex
  2. loss of sensation in pharynx and post 1/3 tongue
  3. slight dysphagia
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12
Q

What lesions area assoc with CN X?

A
  1. hoarseness (dysphonia)
  2. dysphagia
  3. dyspnea
  4. loss of gag or cough reflex
  5. asymm palatal elevation
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13
Q

What lesions are assoc with CN XI?

A

SCM - difficulty turning head to opp side

Trap - shoulder droop

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14
Q

What lesions are assoc with CN XII?

A

tongue deviation to weak side

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15
Q

How should you document CN testing?

A

Ideal: “CN II-XII are intact to testing” - went thru each b/l
Ok: “CN are grossly intact” -talking to pt and havent seen anything that would demonstrate CN are not intact, did not actually test them

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16
Q

Sensory Dermatomes to know

A 
C2 - auricle
C3 - earlobe, ant/post neck
C6 - radial aspect forearm
C8 - 5th digit
T4 - nipple
T10 - umbilicus
L1 - inguinal
L4 - patella
L5 - anterolateral calf, great toe
S5 - perianal area
17
Q

What 4 modalities should you test during sensory exam?

A
  1. Pain - broken tongue depressor
  2. Temp - test tubes w warm or cold water
  3. Vibration - tuning fork bony prominences
  4. Proprioception - move big toe up an down w eyes closed
18
Q

Sterogenesis

A

ability to ID objects in hand (discriminative sens)

19
Q

Graphesthesia

A

ability to ID numbers written on you hand (discriminative sens)

20
Q

2 - pt discrimination

A

can distinguish being touched by one or two points (discriminative sens)

21
Q

Double simultaneous stimulation (extinction)

A

ability to feel two locations being touched simultaneously

22
Q

Patterns of Sensory Loss

A
  1. Thalamic - hemisensory all modalities
  2. Cortical - intact primary sensations, loss of cortical sensations (discrim sens)
  3. Functional loss- non anatomical distribution (ex: diabetic neuropathy)
23
Q

Muscle bulk vs. muscle tone

A

bulk - atrophy, hypertrophy

tone - musc that is relaxed voluntarily retains slight tone

24
Q

Cerebellar ataxia

A

staggering, unsteady, feet wide

25
Q

Sensory ataxia

A

unsteady, feet wide, feet slapped down on ground

26
Q

Parkinsonian

A

stooped forward, shuffle, invol hesitation (festination), dec arm swing

27
Q

Abdominal Reflex

A

swipe finger across abd and muscles contract

28
Q

Anal Reflex

A

anus “winks” in response to stimuli

29
Q

Nuchal Rigidity

A
  • neck stiffness w resistance to flexion

- common w meningitis and SAH

30
Q

Brudzinski Sign

A

stretches FEMORAL n.

+ sign = pt hips and knees flex

31
Q

Kernig Sign

A

stretches SCIATIC n.

+ sign = pain or increased resistance to knee ext

PCM 1 Final (10 decks)

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