Ch. 7 Neurological System Disorders Flashcards
Common symptoms of a middle cerebral artery (MCA) CVA
contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia (usually left MCA), apraxia (usually left MCA), spatial dysfunction (usually right CVA)
common symptoms of internal carotid artery CVA
similar symptoms as MCA: contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia (usually left MCA), apraxia (usually left MCA), spatial dysfunction (usually right CVA)
common symptoms of anterior cerebral artery (ACA) CVA
contralateral hemiplegia, grasp reflex, incontinence, confusion, or alexia
common symptoms of posterior cerebral artery CVA
homonymous hemianopsia, thalamic pain, hemi-sensory loss, or alexia
common symptoms of vertebrobasilar CVA
pseudobulbar signs (dysarthria, dysphagia, emotional instability), tetraplegia
common symptoms of left CVA
the following are affected: movement on R side, processing sensory information on R side, visual reception from R field, visual verbal processing, bilateral motor praxis, verbal memory, bilateral auditory reception, speech, processing of verbal auditory information
common symptoms of right CVA
the following are affected: L-sided movement, processing L-side sensory information, visual reception from L field, visual spatial processing, L motor praxis, nonverbal memory, attention to incoming stimuli, emotional lability, processing of nonverbal auditory information, interpretation of abstract information, interpretation of tonal inflections
ASIA level A
complete, no sensory or motor function is preserved in the sacral segments S4-S5
ASIA level B
incomplete, sensory but no motor function is preserved below the neurological level and extends through sacral segments
ASIA level C
incomplete, motor function is preserved below the neurological level, and the majority of key muscle groups below the neurological level have a muscle grade less than 3/5
ASIA level D
incomplete, motor function is preserved below the neurological level, and the majority of key muscle groups below the level have a muscle grade greater than or equal to 3/5
ASIA level E
normal, sensory and motor function are normal
Brown Sequard symptoms
ipsilateral: paralysis, loss of position sense (prop), loss of discriminative touch
contralateral: loss of pain, loss of thermal sense
anterior cord SCI symptoms
bilateral loss of motor function, pain, pinprick, and temperature sensation below lesion
proprioception and light touch are preserved :)
posterior cord SCI symptoms
loss of proprioception
motor function is preserved in varying degrees
pain, temperature, and touch are preserved :)
Conus medullaris SCI symptoms
lower extremity motor and sensory loss and an areflxic bowel and bladder.
reflexes are occasionally preserved IF lesion is in sacral section
cauda equina syndrome symptoms
LMN lesion; flaccid paralysis with no spinal reflex activity
areflexic bowel and bladder
Describe decorticate positioning
Upper extremities are in spastic flexed position with internal rotation and adduction. Lower extremities are in spastic extended position, internally rotated, and adducted.
Describe decerebrate positioning
Upper and lower extremities are in spastic extension, adduction, and internal rotation. Wrist and fingers flex, plantar portions of the feet flex and invert, the trunk extends, and the head retracts.
What reflexes are impacted with TBI?
- Impaired righting reflexes observed with midbrain damage
- Absence of equilibrium reactions and protective extension with basal ganglia damage
What does a Glasgow coma score of 8 indicate?
Scores below 8 indicate a severe brain injury.
What does a Glasgow coma score of 10 indicate?
Scores between 9 and 12 indicate a moderate brain injury.
What does a Glasgow coma score of 14 indicate?
Scores above 14 indicate a minor brain injury.
What 3 areas does the Glasgow Coma Score assess?
eye opening, verbal responses, and motor responses
Describe function at a Ranchos Los Amigos Level I
No response: is completely unresponsive to any stimuli presented
Describe function at a Ranchos Los Amigos Level II
Generalized response: exhibits inconsistent and nonpurposeful reac- tions to stimuli
Describe function at a Ranchos Los Amigos Level III
Localized response: reacts specifically to stimuli, though inconsis- tently
Describe function at a Ranchos Los Amigos Level IV
Confused/agitated: has heightened state of activity with severely de- creased ability to process information
Describe function at a Ranchos Los Amigos Level V
Confused, inappropriate nonagitated: appears alert with fairly consis- tent reactions, although increased complexity of commands causes more ran- dom responses
Describe function at a Ranchos Los Amigos Level VI
Confused, appropriate: exhibits goal-directed behavior but is depen- dent on external input for direction
Describe function at a Ranchos Los Amigos Level VII
Automatic/appropriate: behaves appropriately and is oriented to place and routine but frequently displays shallow recall
Describe function at a Ranchos Los Amigos Level VIII
Purposeful and appropriate: is alert and oriented and able to re- call and integrate past and recent events. Each level (VIII, IX, and X) represents a decreasing need for assistance with routine daily living skills.
