Ch 6 Neurologic Exam Part II Flashcards
Define akinesia
lack of movement
Define athetosis
slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture
Define chorea
irregularly timed excessive jerky movements
Define ballismus
extreme choreiform movement
What are tone abnormalities
resistance to passive stretching of a joint.
What are upper motor neurons? (UMN)
They include projections from the cortex to spinal cord (corticospinal tract) including the part that crosses in the medulla (pyramidal tract)
What are lower motor neurons? (LMN)
They include projections from the brainstem and spinal cord, via motor nerves to innervate skeletal muscle
Hyperreflexia and increased tone are indicative of what type of lesions
Upper motor neuron lesions (UMN)
atrophy, fasiculations, hyporeflexia can be indicative of what type of lesions?
Lower motor neuron lesions (LMN)
Pronator drift reflects problems in which area?
Upper motor neurons
Stereognosis
the ability to perceive and recognize the form of an object in the absence of visual and auditory information
graphesthesia
the ability to recognize writing on the skin purely by the sensation of touch
Gait abnormalities can be described in which 5 ways?
spastic scissored steppage parkinsonian ataxic
Spastic gait
spastic hemiparesis
when affected leg swings in arc motion
Scissored gait
corticospinal dysfunction
gait appears stiff and thigh crosses over in front of the other thigh
steppage gait
when a foot or both feet are weak, resulting in foot drop
parkinsonian gait
short shuffling steps
person has difficulty starting or stopping
stooped over, arm swing reduced
ataxic gait
unsteady, wide based gait
hard to turn
cerebellar dysfunction
What is dysmetria? Where is the dysfunction located in the brain?
touching nose and examiner’s finger
ipsilateral cerebellar hemispheric dysfunction
What is dysdiadocholinesia?
Where is the dysfunction located in the brain?
switching hand movements facing up to palm facing down
ipsilateral cerebellar hemispheric dysfunction
heel shin test assesses what
cerebellar functions in lower extremity
Romberg test
stand with feet together, eyes closed
romberg sign
unsteadiness within several seconds of closing eyes
suggests poor proprioception
dysfunction in posterior column of spinal cord
Vitamin b12 deficiency
What do deep tendon reflexes evaluate?
evaluate afferent and efferent functioning
How is DTR assessed
single brisk tap from reflex hammer on skin of tendon
DTR increased reflexes (hyperactive)
corticospinal dysfunction
DTR decreased reflexes (hypoactive)
peripheral nerves or nerve roots dysfunction
dysfunction of corticospinal tracts can lead to what? seen in what condition
ipsilateral paralysis (inability to move) paresis (decreased motor strength) hypertonia (increased tone) long tract signs seen in normal pressure hydrocephalus
long tract signs mean?
symptoms that are attributable to the involvement of the long fiber tracts in the spinal cord.
signs related to UMN lesions
example of long tract signs
e.g. spasticity, hyperreflexia, and abnormal reflexes such as Babinski or Hoffman’s sign
Babinski sign can indicate what condition
corticospinal system dysfunction
UMN dysfunction
Define blown pupil
pupil that is dilated and unresponsive to changes in light
What is Babinski sign
fanning of toes and upward flexion of big toe (extensor plantar response)
Define bilateral temporal hemianopsia
loss of visual temporal fields due to a abnormality in optic chiasm
Clonus
repetitive, involuntary vibratory movement
Diplopia
experience of double vision
hemianopsia
loss of visual hemifield
homonymous
on the same side
Lower motor neuron
Motor neuron that originate in the anterior horn of spinal cord / brainstem and project to skeletal muscles
Nystagmus
rapid involuntary eye movement
can be lateral, vertical, rotational or mixed
Proprioception
perception of one’s body position in space (based on sensory input from muscles and tendons)
Quandrantopsia
loss of one quadrant of visual field
Spasticity
increased muscle tone or increased resistance to stretching
Upper motor neuron
neurons that originate from the cerebral primary motor cortex (precentral gyrus) or from certain brainstem nuclei
Vestibular
sense of balance
Pyramidal Tract
- divides into corticospinal and corticobulbar tract
- part of the UMN system
- system of efferent nerve fibers
- originate in the cerebral cortex and carry signals from the cerebral cortex to brainstem or spinal cord
- responsible for voluntary control of body and face muscle
Corticobulbar tract
motor cortex to cranial nerve
controls voluntary movement of the muscles of the face, head and neck
Extrapyramidal tract
- originate in the brain stem
- carrying motor fibers to the spinal cord
- responsible for the involuntary and automatic control of muscle tone, balance, posture and locomotion
Corticospinal tract
motor cortex to LMN in spinal cord
controls voluntary movement of the muscles of the limbs and trunk
