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Patient Assessment > Chapter 17 Neuro > Flashcards

Chapter 17 Neuro Flashcards

1
Q

5 categories of Neurological Exam

A

Mental status (speech & language), cranial nerves, motor system, sensory system, and reflexes

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2
Q

LOC

A

Alertness (responds fully), lethargy (appears drowsy), obtundation (responds slowly/confused), stupor (minimal awareness), coma (no evident awareness)

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3
Q

Speech

A

Look for underlying abnormalites; is there evidence of dysarthria, aphasia, or other psychological problems?

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4
Q

Thought processes

A

Logical, Relevant, Organized, Coherent

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5
Q

CN I

A

Olfactory: smell

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6
Q

CN II

A

Optic: Visual acuity, visual fields, ocular fundi, and pupillary reactions

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7
Q

CN III

A

Oculomotor: Pupillary reactions, extraocular movements

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8
Q

CN IV, VI

A

Trochlear (IV) Abducens (VI): Extraocular movements

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9
Q

CN V

A

Trigeminal: Corneal reflexes, facial sensation, voice and speech, and jaw movements

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10
Q

CN VII

A

Facial: facial movements and voice and speech

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11
Q

CN VIII

A

Acoustic: Hearing

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12
Q

CN IX & X

A

Glossopharyngeal: swallowing and rise of the palate, gag reflex
voice and speech (X)

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13
Q

CN XI

A

Spinal Accessory nerve: shoulder and neck movements

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14
Q

CNXII

A

Hypoglossal: Tongue symmetry and position, and voice and speech

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16
Q

Muscular atrophy

A

fasciculations, hyporeflexia (lower motor nerver lesion)wasting away/ loss of muscle bulk. Seen in diabetic neuropathy and flattening of thenar and hypothenar eminences

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17
Q

Muscle tone

A

look for hyperreflexia, clonus, spasticity, and barbinski’s sign (upper motor neuron lesion) versus atrophy

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18
Q

Muscle strength

A

impaired strength (paresis), absence of strength (plegia),

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19
Q

Weakness of extension at elblow

A

CNS disease producing hemiplegia- stroke, MS

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20
Q

Weak grip

A

de Quervain’s tenosynovitis, CTS, arthritis

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21
Q

Rapid alternating movements

A

Dysdiadochokinesis: one movement cannot be followed quickly by its opposite and movement are slow

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22
Q

Positive Romberg sign

A

Ataxia from dorsal column disease and loss of position sense

Patient stands fairly well with eyes open but loses balance when they are closed.

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23
Q

Pronator drift test

A

A sideward or upward drift, sometimes with searching, writhing movements of hand suggest loss of position sense.

Cerebellar incoordination- arms returns to original positiion but overshoots and bounces

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24
Q

Gait

A

Ataxia (cerebellar disease) lacks coordination with reeling and instability

25
Q

Muscle atrophy

A

loss of muscle bulk wasting; results from diseases such as diabetic neuropathy

26
Q

Hypertrophy

A

increase in bulk with proportionate strength;

27
Q

Pseudohypertrophy

A

Increase in bulk with diminished strength (seen in the Duchenne form of muscular dystrophy)

28
Q

flaccidity

A

marked floppines that indicates hypotonia

29
Q

Spasticity

A

increased resistance that worsens at the extreme range (seen in central corticospinal tract diseases

30
Q

Rigidity

A

increased resistance throughout rangle of movement in both directions

31
Q

upper motor neuron lesion

A

hyperreflexia, clonus, spasticity, and barbinski’s sign

32
Q

Clonus

A

a hyperactive response required for assigning a reflex grade of 4, usually elicited at the ankle. The ankle plantar flexes and dorsiflexes repetitively and rhythmically

caused by CNS disease

33
Q

lower motor neuron lesion

A

atrophy, fasciculation, hyporeflexia

34
Q

hyperthesia

A

decrease sensitivity

35
Q

Anesthesia

A

absence of touch sensitivity

36
Q

Loss of position sense

A

tabes dorsalis, MS, B12 deficiency

37
Q

Astereognosis

A

inability to recognize objects place in hand

38
Q

Lesion in sensory cortex

A

inability to recognize numbers

39
Q

Graphesthesia

A

tests the individual’s ability to use sensory input to identify a number or letter drawn onto his/her hand while visually occluded.

40
Q

Positive Barbinski’s reflex

A

dorsiflexion of big toe

41
Q

0 (grading reflexes 0-4 scale)

A

no reponse

42
Q

1+ (grading reflexes 0-4 scale)

A

somewhat diminished; low normal

43
Q

2+ (grading reflexes 0-4 scale)

A

Average; normal

44
Q

3+ (grading reflexes 0-4 scale)

A

Brisker than average; possible not necessarily indicative of disease

45
Q

MMSE

A

Date, Place, Object, Serial sevens, Naming, Recall, Repeat, Verbal commands, written command, writing, drawing

46
Q

4+ (grading flexes 0-4 scale)

A

very brisk; hyperactive, with clonus (rhythmic oscillations between flexion and extension)

47
Q

Symmetric weakness of proximal muscles suggests:

A

a myopathy or muscle disorder

48
Q

Symmetric weakness of distal muscles suggests:

A

polyneuropathy or disorder of peripheral nerves

49
Q

Dysdiadochokinesis

A

In cerebellar disease, when one movement cannot be followed quickly by its opposite movement

50
Q

Cerebellar Ataxia

A

patient has difficulty standing with feet together whether they eyes are open or closed.

51
Q

First sensation to be lost in a peripheral neuropathy

A

vibration sense

52
Q

Causes of peripheral neuropathy:

A

Diabetes, alcoholism, vit. B12 deficiency, and tertiary syphilis

53
Q

Causes of loss of position sense:

A

tabes dorsalis, MS, B12 deficiency, diabetes

54
Q

Astereognosis and the inability to recognize numbers both suggest a lesion of:

A

the sensory cortex

55
Q

Causes of hyperreflexia

A

CNS lesions along the descending corticospinal tract

Associated findings of weakness, spasticity, or positive Babinski’s sign.

56
Q

Causes of hyporeflexia

A

Diseases of spinal nerve roots, spinal nerves, plexuses, or peripheral nerves.

Associated findings of weakness, atrophy and fasciculations

57
Q

Kernig’s Sign

A

Pain and increased resistance to extending the knee

Suggests meningeal irritation

Patient Assessment (18 decks)

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