Approach to the Neurologic Exam Flashcards
what is defective articulation?
dysarthria
what is dysarthria usually caused by?
defect in motor control of speech apparatus
what is a disorder in producing or understanding language?
aphasia
what is aphasia usually caused by?
lesions in the dominant hemisphere
what is the major difference between delirium and dementia?
delirium is reversible while dementia is not
ptosis can be caused by a lesion on what cranial nerve?
CN III
if a patient has a lesion on CN III what direction will their eye present as?
down and out
what is the medical term for the presentation of the eye direction of down and out?
opthalmoplegia
a patient with a cranial nerve IV lesion will present with what?
eye position that drifts medially and upwards
what is the most common isolated CN palsy?
CN VI palsy
a CN VI palsy is seen most often in patients with what?
subarachnoid hemorrhage, late syphilis, and trauma
a patient with a cranial nerve V lesion will have jaw deviation where?
toward the weak side
what reflex is lost if a patient has a CN V lesion?
corneal reflex
what is trigeminal neuralgia?
recurrent brief episodes of unilateral shock-like pain along one or more distributions of the trigeminal nerve
what is trigeminal neuralgia cuased by?
aberrant vein or artery compression on the nerve
if you have a lesion of the CN VII, what will result?
paralysis of the muscles of facial expression (Bell’s palsy)
what type of facial paralysis is bell’s palsy?
peripheral facial paralysis
what type of facial palsy is a supranuclear facial palsy?
central
how can you tell if a lesion of CN VII is central or peripheral in nature?
peripheral lesions of CN VII will cause paralysis of both the upper and lower quadrant of one side of the face while a central lesion will only causes paralysis of one lower quadrant
lesions of CN VIII-vestibular result in what?
disequilibrium and nystagmus
lesions of CN VIII- cochlear result in what?
hearing loss or tinnitus
what are the two phases of nystagmus?
- slow drift away from an object 2. saccade (quick reaction back)
what is a nystagmus named for?
the saccade phase
which cranial nerves are responsible for the gag reflex?
IX and X (in IX out X)
if there is a lesion of cranial nerve XI and there is paralysis of the SCM, what will result?
difficulty turning the head to the opposite side
if there is a lesion of cranial nerve XI and there is weakness of the trapezius muscle what will result?
unilateral shoulder droop
testing for pain is testing what tract?
the spinothalamic tract
testing for temperature is testing what tract?
the spinothalamic tract
testing for vibration is testing what?
the posterior columns
testing proprioception is testing what?
the posterior columns
what is stereognosis?
the ability to identify shapes of objects
what is graphesthesia?
ability to identify numbers written on the palm
what does the rhomberg test for?
vision, vestibular, proprioception
what are the signs of cerebellar ataxia?
staggering, unsteady, feet wide apart
what are the signs of sensory ataxia?
unsteady, feet wide apart, feet thrown forward and slapped down first on the heels then forefoot, patients watch the ground when walking
