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Neurology for SLP > Chapters 5, 6, & 7 > Flashcards

Chapters 5, 6, & 7 Flashcards

1
Q

Name the two types of the spinal peripheral nerves

A

Anterior Root and Posterior Root

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2
Q

(Spinal Peripheral Nerves) Anterior Root are bundles of nerve fibers that transmit impulse in what direction?

A

Away/efferent

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3
Q

Is Anterior root motor or sensory?

A

Motor

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4
Q

Where does Anterior Roots originate?

A

Anterior (Ventral) Horn Cells

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5
Q

(Spinal Peripheral Nerves) POSTERIOR ROOT are bundles of nerve fibers that transmit impulses __in what direction___?

A

To/Afferent

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6
Q

Is Posterior root motor or sensory?

A

Sensory

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7
Q

What do the spinal nerves of the dorsal ramus supply?

A

Branches supply the muscles and the skin of the back

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8
Q

What do the 1st four cervical nerves of the ventral ramus supply?

A

The muscles and the skin of the front of the neck

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9
Q

What to the last four cervical nerves and part of the ventral ramus of the 1st thoracic nerve form?

A

Forms the brachial plexus by a series of communicating branches

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10
Q

Gray commissure

A

Bridge that links the wings of the butterfly

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11
Q

Dorsal/Posterior Horn

A

They are sensory and they are the two wingtips in the back

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12
Q

Ventral/Anterior Horn

A

They are motor and the two wingtips in the front

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13
Q

Somatic motor cells

A

Axons leave via ventral roots and supply the skeletal muscles

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14
Q

Autonomic motor cells

A

Axons leave via ventral roots to the autonomic ganglia

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15
Q

Transmission Neurons

A

Rise to ascending projections to the brain and to the connections with other spinal cord levels

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16
Q

Interneurons

A

connect with other neurons at the same spinal cord levels with sensory and reflex mechanisms

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17
Q

What is a plexus

A

A group of intersecting nerves.

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18
Q

Name the 7 plexus

A 
Cervical 
Brachial 
Lumbar 
Sacral 
Celiac
Coccygeal
Auerbachs
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19
Q

What does C1 control?

A

Controls the carotid plexus which determines blood pressure

controls blood supply to the brain

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20
Q

What does C2 control?

A

eyes, ears, and sinuses

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21
Q

What does c3 control?

A

Face and teeth

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22
Q

What does C4 control?

A

Pharynx and Larynx

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23
Q

What does c5 control

A

neck and throat

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24
Q

C 3, 4, and 5 have a long branch called ___ which innervated the ___

A

Phrenic Nerve, Diaphragm

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25
Q

The cervical plexus communicates with which two nerves?

A

X vagus and IX Hypoglossal Cranial Nerves

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26
Q

The Brachial Plexus goes to what parts of the body? (4)

A

Chest, shoulders, arms, and hands

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27
Q

What does T1 control?

A

trachea, esophagus, esophageal sphincter

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28
Q

What lumbar plexus goes to what parts of the body? (6)

A

back, abdomen, groin, thighs, knees, and calves

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29
Q

The Sacral Plexus goes to what parts of the body? (6)

A

pelvis, buttocks, genitalia, thighs, calves, and feet

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30
Q

What is the Celiac plexus in charge of?

A

Internal organs

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31
Q

What is the Auerbachs Plexus in charge of?

A

GI Tract

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32
Q

What is segmentation distrubution?

A

each muscle in the body is supplied by a particular level or segmnt of the Spinal Cord and its corresponding nerve

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33
Q

dermatones

A

Area of skin supplied by nerve fibers originally from a single dorsal root bands of innervation around the body

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34
Q

What are the 3 major division of the autonomic nervous system?

A

The Enteric Division
The Sympathetic Division
The Parasympathetic Division

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35
Q

The Enteric Division is formed by

A

the neuronal plexus of the GI Tract (Auerbach’s)

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36
Q

Sympathetic Division is the body’s “___”

A

alerting system; fight or flight

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37
Q

The Sympathetic Division is responsible for preparatory measures such as: (4)

A

Accelerating the heart rate,
causing constriction of the peripheral blood vessels
raising blood pressure
redistributing blood away from skin and intestines to be used in the brain, heart, and skeletal muscles

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38
Q

What is the Parasympathetic Division? (3)

A

It is the body’s calming effect
it conserves and restores energy
slows heart rate and increases peristalsis (saliva, and secretion of GI Tract)

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39
Q

Name the neurons of the Spinal Cord (4)

A

Somatic motor cells
Autonomic motor cells
Transmission Neurons
Interneurons

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40
Q

Definition of Proprioception

A

ability to determine the body’s position in space

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41
Q

What is the definition of Two-point discrimination?

A

Ability to discriminate the shortest distance between two Tactile points on the body

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42
Q

What is Vibration?

A

Ability to recognize vibration from touch

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43
Q

What is Stereognosis/Form perception?

A

The Ability to recognize objects by touch

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44
Q

What are the two Proprioception Pathways?

A

Spinocerebellar tract and dorsal columns

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45
Q

(Sensory exam) what are two ways to determine light touch?

A

Test the ability to perceive light stroking of skin with a cotton ball
Determine ability to localize by closing eyes and asking to point where being touched

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46
Q

If the ability to perceive the cotton ball light touch exam is DECREASE what could that mean?

A

Hypothesia

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47
Q

If the ability to perceive the cotton ball light touch exam is COMPLETELY LOSS, what could that mean?

A

Anethesia

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48
Q

If the ability to perceive the cotton ball light touch exam is INCREASED, what could that mean?

A

hyperthesia

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49
Q

If a client has an uniablity to localize the light touch exam where they close their eyes and point to where they were touch, what could that mean?

A

atopognosis

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50
Q

What could the loss of Two-Point Discrimination mean?

A

suggests a parietal lobe lesion

51
Q

What could it mean if the client has double stimulation when doing the two point discrimination exam?

A

determines lateralized loss

52
Q

What is testing the two point discrimination important to SLP?

A

Sensory pathways or cortical sensory loss frequently is seen with lesions that produce cerebral language disorders

53
Q

How can you do a sensory exam on pain? Explain the possible findings if they are INCREASE, DECREASED, or COMPLETELY LOSS.

A

Pinprink or deep pressure
INCREASED: Hyperalgesia
Decreased: Hypoalgesia
LOSS: analgesia

54
Q

How can you do a sensory exam on temperature?

A

test the ability to identify a tube of warm water and a tube of cold water

55
Q

What is a propioception sensory exam?

A

Test by closing your eyes and determine if joints of an arm, hand, or leg is in flexion or extension

56
Q

What is Astereognosis? how can you exam this?

A

inability to recognize common objects by touch.

have the client close their eyes, place an object in their hand to identify

57
Q

What is Tactile Agnosia?

A

recognition disorder caused by a cortical sensory lesion rather than pathway (can’t name by touching but can by sound)

58
Q

How do you do a sensory exam for Vibratory?

A

Test by vibrating a tuning for to a bony prominence vs. non vibrating

59
Q

How do you do a sensory exam on body sway?

A

Romberg’s Test (Stand with feet together, observe for swaying)

60
Q

What are the three great motor subsystems?

A

Pyramidal, extrapyramidal, cerebellar

61
Q

What is pyramidal system?

A

it controls voluntary movement of muscles of speech, all are cortifugal (originate in or away from the cortex)

62
Q

What are the 3 major tracts of pyramidal system?

A

Corticospinal tract
Corticobullbar tract
corticopontine tract

63
Q

Define the FAST perception of pain

A

sharp, prickly sensation
Involves myelinated axons
Easily located

64
Q

Define the SLOW perception of pain

A 
Slower onset 
greater persistence 
burning sensation 
Has a general area 
Unmyelinated
65
Q

Define the VISCERAL/REFERRED perception of pain

A

achy feeling
sometimes burning
vaguely localized

66
Q

What is Upper Motor Neurons?

A

All neurons of the anterior and lateral CS Tracts
They are the first order neurons and they are long axons
They do not leave the neuraxis

67
Q

What is a Lower Motor Neuron?

A

Neurons that send motor axons into peripheral nerves

Second order neurons that start at the brainstem or ventral horn of the SC (The Great Common Pathway-Sherrington)

68
Q

Define Paralysis

A

gross limitation of movement

69
Q

Define Paresis

A

Incomplete paralysis (weakness)

70
Q

Define Hemiparalyisis/Hemiplegia

A

Complete or nearly completely paralysis on one side

71
Q

What is Bilateral Symmetry

A

Bilateral innervation for motor nuclei
is the Majority of midline speech muscles
provides a safety valve for speech in CB lesion

72
Q

What is the MOST AFFECTED area when the cranial nuclei receives unilateral and contralateral innervations instead of bilaterally?

A

Lower part of face and Trapezious muscles

73
Q

What is the INTERMEDIATELY AFFECTED area when the cranial nuclei receives unilateral and contralateral innervations instead of bilaterally?

A

The Tongue

74
Q

What is the MILDLY AFFECTED area when the cranial nuclei receives unilateral and contralateral innervations instead of bilaterally?

A 
diaphragm
ocular
upper face 
jaw
pharynx
larynx
75
Q

What is the corticobulbar innervation in the cranial nerve V TRIGEMINAL, IX GLOSSOPHARYNGEAL, X VAGUS?

A

Bilateral

76
Q

What is the corticobulbar innervation in the cranial nerve VII FACIAL and XII HYPOGLOSSAL?

A

Mixed Bilateral/Contralateral

77
Q

What is the corticobulbar innervation in the cranial nerve XI SPINAL ACCESORY

A

Contralateral

78
Q

Rods are associated with?

A

night vision; shapes

79
Q

Cones are associated with?

A

day vision (color; visual acuity)

80
Q

Define Hemianopia. What are the to types of Hemianopia?

A

1/2 of visual field is lost
Heteronymous
Homonymous

81
Q

Define Heteronymous. What are the two types of heteronymous?

A

loss of 1/2 of the visual field on different sides.

Bitemporal (can’t see temporal side) and Binasal (can’t see nasal side)

82
Q

Define Homonymous

A

visual lost in both RVF or LVF

83
Q

What are for possible results for lesions in the optic chiasm?

A

Injury to decussating fibers of optic nerve
left eye does not perceive images in left 1/2 of visual field
right eye does not perceive images in right 1/2 of visual field
Bilateral hemianopia

84
Q

What are 3 possible results for lesions of the Optic Tract?

A

Loses communication from 1/2 of each retina
right optic tract is destoyed
which means left homonymous hemianopia

85
Q

What is the result if there is a lesion of the entire visual area of one occipital lobe or all fibers of one optic radiation?

A

Produces a homonymous hemianopia of the opposite side of visual field

86
Q

What MOTOR innervation for V Trigeminal? (7)

A 
Masseter 
Temporalis 
Lateral and medial pterygoids 
Tensor Tympani 
Tensor Veli Palatini
Mylohyoid 
Anterior Belly of Diagastric
87
Q

What are the 3 sensory innervations of the V Trigeminal Nerve

A

Opthalamic nerve
Maxillary nerve
Mandibular nerve

88
Q

Ophthalamic nerve is in charge of: (3)

A

Sensation to Forehead, eyes, and nose

89
Q

Maxillary Nerve is in charge of: (6)

A 
Upper lip mucosa
maxilla
upper teeth 
cheeks
palate 
maxillary sinus
90
Q

Mandibular nerve is in charge of:

A 
anterior 2/3 tongue
mandible 
lower teeth
lower lop 
part of cheek 
and part of external ear
91
Q

How do you do Trigeminal Nerve Testing of the masseter?

A

palpate 2 cm above and in front of angle of mandible, bite down/relax

92
Q

How do you do Trigeminal Nerve Testing of the Temporal?

A

above ear, chewing, temples can appear shrunken if atrophied

93
Q

How do you do Trigeminal Nerve Testing of Jaw closure?

A

Hand on tip of mandible as jaw is held open, other hand on forehead. Ask pt to bite down.

94
Q

How do you do Trigeminal Nerve Testing of the Lateral pterygoids?

A

ask pt to open jaw to resistance, watch for top of mandible lining up between upper medial incisors

95
Q

How do you do Trigeminal Nerve Testing of lateralizing against resistance?

A

Have pt move jaw to one side and hold it while attempting to push it to center

96
Q

What are the functions of VII Facial Nerve? (8)

A 
Guard all facial aperatures
Wrinkle forehead
close eyes tightly 
close mouth tightly 
smiling 
frowning 
Guards middle ear by innervating the stapeduis muscle to protect from loud noises 
partially responsible for taste
97
Q

What are 3 ways to test facial nerve testing?

A

Observe facial symmetry by having the pt: wrinkle the forehead, close eyes tightly, and smile/pucker

98
Q

Auditory Nerve Lesions in the Vestibular Nerve can consist of? (4)

A

Vertigo
Postural deviations
Unsteady walking and standing
Deviations of the eyes

99
Q

VII Auditory Nerve Lesions in the Acoustic Nerve can cause

A

Deafness or partial deafness

100
Q

Ways to do VII Auditory Nerve Testing for Vestibular Nerve (2) and Auditory Nerve (1)

A

Vestibular: rotating chair to induce nystagmus, and caloric test
Auditory: Tuning Fork

101
Q

What is the anatomy of the IX glossopharyngeal

A

origin near the inferior cerebellar penduncles

pathway through the jugular foramen

102
Q

What is the innervation of IX glossopharyngeal?

A

Taste buds on the posterior 1/3 of tongue

Upper pharyngeal constrictor muscles

103
Q

What can result of lesions in the IX glossopharyngeal nerve? (4)

A

Loss of sensation and taste in the posterior 1/3 of tongue
Unilateral loss of gag reflex
Deviation of uvula to the involved side
Difficulty in the initial phase of swallowing

104
Q

How can you test IX glossopharyngeal nerve? What could it mean if patient is hyperactive, hyporeflexic, and no reflex?

A

Elicit gag reflex
Hyperactive: UMN Lesion in the CB tract
Hyporeflexic: unilateral IX damage
No reflex: Bilateral IX damage

105
Q

What is the function of the X Vagus Nerve? (4)

A

Visceral motor nerve
With V and XII innervates the palatal muscles
with IX innervates pharyngeal constrictors
Innervates intrinsic muscles of the larynx

106
Q

Name five results X vagus lesions

A 
Paralysis of the soft palate
difficulty swallowing 
Variety of voice problems (aphonia and roughness)
UMN- Spastic Dysphonia
LMN- Left branch RLN partial paralysis
107
Q

5 ways to test X vagus nerve

A

observe the palate at rest, symmetry of arches
phonate “ah” soft palate should elevate posteriorly
elicit gag reflex
Laryngoscopy for laryngeal fx
Voicing: prolong /ah/ normal 15 secs

108
Q

What can result in the lesions in the XI spinal accesory? (3)

A

Inability to turn head away from the side of lesion
General neck weakness
laryngeal dysfunction/voice problems

109
Q

How can you test for XI spinal accessory lesions? (4)

A

size and symmetry of the sternocleidomastoids
Turn head to one side and hold it while trying to push to midline
thrust head forward while resisting movement against forehead
shrug shoulders while pushing down

110
Q

What is the function for XII Hypoglossal Nerve INTRINSIC MUSCLES? (5)

A

control shortening, concaving, narrowing, elongating, and flattening of the tongue

111
Q

What is the function for XII Hypoglossal Nerve EXTRINSIC MUSCLES? (3)

A

genioglossus: tongue protusion
hyoglossus: retraction and depression
Styloglossus: drawing tongue up and back

112
Q

Concussion

A

traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches, and problem with concentration, memory, balance, and coordination

113
Q

Traumatic Brain Injury

A

a blow or jolt to the head or a penetrating head injury that disrupts the functions of the brain

114
Q

Primary Brain Trauma Injuries (3)

A

Acceleration/Deceleration
Discrete Focal Lesions
Diffuse Axonal Injury

115
Q

Secondary Brain Trauma Injuries (6)

A 
Ischemia
Hypoxia
Edema
Hermorrhage
Brainshift
Raised intracranial pressure
116
Q

Define Ischemia

A

Lack of blood getting to an area

117
Q

Hypoxia

A

Lack of oxygen getting to an area

118
Q

edema

A

swelling of brain

119
Q

Hemorrhage

A

bleeding and bruising of the brain

120
Q

Cognitive Disorganization include (7)

A 
Attention 
Perception 
Memory 
Learning 
Organization 
Problem solving 
Judgement
121
Q

Dementia may have an impairment which of the following

A

Language, Memory, Visuospatial Skills, Emotion, Personality, Cognition

122
Q

What is the diagnosis of Mild Cognitive Impairment? (4)

A

Normal general cognition
Normal ADL’s
No diagnosis for the dementia
Deficits in one of cognitive area

123
Q

What are the four phases of swallowing

A

oral preparation phase
oral transfer phase
pharyngeal phase
esophageal phase

Neurology for SLP (1 decks)

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