Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sam: Neurology > Clin Assess -- this could be a blood bath. > Flashcards

Clin Assess -- this could be a blood bath. Flashcards

1
Q

When testing the cranial nerves, which two nerves only have sensory function?

A

I and II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 5 cranial nerves only have motor function?

A

III (pupil constriction, opening of eye, lid elevation, most extra-ocular movements)

IV (downward, internal rotation of the eye)

VI (lateral deviation of the eye)

XI (sternocleidomastoid and upper portion of the trapezius)

XII (tongue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If you have anisocoria (unequal pupils), intracranial hemorrhage, transtentorial herniation, or Horner’s syndrome, what cranial nerves might be affected?

A

II, III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A patient with Bell’s Palsy is having an issue with what cranial nerve?

A

VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cerumen impaction, otitis media, and Meniere’s disease will cause problems with what cranial nerve?

A

VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pharyngeal weakness would be associated with a lesion on what cranial nerves?

A

IX, X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sinusitis, smoking, aging, and cocaine use may cause problems with what cranial nerve?

A

I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Aphonia due to vocal cord paralysis, dysarthria (poor articulation) due to cerebellar disease, aphasia (disorder in producing or understanding language) such as Wernicke’s aphasia or Broca’s aphasia would be associated with what cranial nerves?

A

V, VII, X, XII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Trapezius weakness could be associated with a lesion on what cranial nerve?

A

XI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cortical lesion, amyotrophic lateral sclerosis, or polio would be associated with what cranial nerve?

A

XII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nystagmus, ptosis, diplopia, astigmatism, Grave’s disease are all issues that would be associated with lesions on what cranial nerves?

A

III, IV, VI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Papilloedema, glaucoma, stroke, retinal emboli, and optic neuritis are issues associated with what cranial nerve?

A

II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

True or False

A patient with a lesion within the cerebral cortex, brainstem, or spinal cord will present with increased deep tendon reflexes.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lesions within what part of the brain would present with either normal or decreased deep tendon reflexes?

A

Subcortical gray matter (basal ganglia) or Cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

True or False

A peripheral nervous system disorder will always present with increased deep tendon reflexes?

A

False

Peripheral nervous system lesions will either present with normal or decreased deep tendon reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What could be the cause of a lesion in the neuromuscular junction?

A

Myasthenia Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What could be the cause of a lesion in the muscle?

A

Muscular dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What test do we do to test for metabolic encephalopathy?

A

Asterixis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does a positive Babinski sign look like?

A

Dorsiflexion of the big toe is a positive sign from a CNS lesion in the corticospinal tract

Also seen in unconscious states from drug or alcohol intoxication or in the post-ictal period following a seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What test should we do if DTRs seem hyperactive (4+)?

A

Clonus – dorsiflex and plantar flex foot then sharply dorsiflex foot and hold

If clonus present, may indicated CNS disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the two meningeal signs?

A

Brudzinski’s sign and Kernig’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the Brudzinski’s sign? And what nerve is this affecting?

A

Flex the neck and watch the knees and hips; flexion of both the hips and knees is a positive sign

Femoral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the Kernig’s sign? And what nerve is this affecting?

A

Flex the patient’s leg at both the hip and knee, and the straighten the knee. Positive test is increased pai and increased resistance to extending the knee

Sciatic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pronator drift test? What does a positive test look like?

A

Pt should stand for 20-30 seconds with both arm straight forward, palms up, eyes closed. Tap the arms briskly downward – arms normally return smoothly to horizontal position.

Positive test = sensitive and specific for corticospinal tract lesion originating in the contralateral hemisphere. Downward drift of the arm with flexion of fingers and elbows may also occur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What test is described as follows:

have patient stand with feet together, eyes open and then close both eyes for 30-60 seconds without support. Note patients ability to maintain upright posture.

A

Romberg test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is cerebellar ataxia?

A

Pt has difficulty standing with feet together with eyes opened or closed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why might someone have a positive Romberg test?

A

Dorsal column disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If your patient demonstrates “winging of the scapula”, what does this suggest?

A

Serratus anterior muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In what diseases might you see winging of the scapula?

A

Muscular dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When performing the Weber test on your patient, you find that the sounds lateralizes to the impaired ear – does your patient have conductive or sensorineural hearing loss?

A

Conductive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

When perform the Rinne test, if air conduction lasts longer than bone conduction, what type of hearing loss does your patient have?

A

Sensorineural hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

If your patient has a Glasgow coma scale score between 3 and 8, what does that mean?

A

They’re in a coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

If you speak to your patient in a normal tone of voice and they open their eyes, look at you, and respond fully and appropriately to stimuli, how would do you document this?

A

Your patient is ALERT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

If your patient remains unarousable with eyes closed and there is no response to inner need or external stimuli, they are….

A

Comatose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

If your patient appears drowsy but opens eyes and looks at you, responds to questions, and then falls back asleep, they are….

A

Lethargic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

If you have to shake your patient to awake them, and they respond slowly and seem somewhat confused, your patient is…

A

Obtunded.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If your patient can only be aroused from sleep with a painful stimulus, they are?

A

Stuporous

38
Q

Heroin and other narcotics will cause large or small pupils.

A

Small, pinpoint pupils.

39
Q

Cocaine and amphetamine will cause large or small pupils?

A

Large

40
Q

A pupil that is ______ and _______ warns of herniation of the temporal lobe, causing compression of the oculomotor and midbrain.

A

Fixed, dilated

41
Q

When is a single large pupil most commonly seen?

A

Diabetics with infarction of CN III.

42
Q

What type of gait is described as staggering, unsteady, wide-based, with exaggerated difficulty on turns.

A

Cerebellar ataxia – seen with diseases of cerebellum or associated tracts

43
Q

What type of gait is seen in loss of position sense in the legs. Their gait will be unsteady and wide based – throw their feet forward and outward and bring them down first on heels and then toes with double-tapping sound.

A

Sensory ataxia – seen in polyneuropathy or posterior column change

44
Q

Posture is stooped with flexion of head, arms, hip, and knees. Patient will be slow to get started. Steps are short and shuffling with involuntary hastening (festination). What type of gait is this?

A

Parkinsonian gait – seen in basal ganglia defects of Parkinson’s disease

45
Q

What type of gait will have bilateral lower extremity spasticity including adductor spasm and abnormal proprioception? Furthermore, their giat will be stiff, with thighs crossing forward on each other.

A

Scissors gait – spinal cord disease

46
Q

This type of gait is seen in foot drop, usually secondary to peripheral motor unit disease. Patients either drag the foot or lift it high.

A

Steppage gait.

47
Q

Slower and more twisting/writhing than choreiform movements and have a large amplitude. Most commonly involves the face and distal extremities; often associated with spasticity. Causes include cerebral palsy.

What is being described?

A

Athetosis

48
Q

Brief, rapid, jerky, irregular and unpredictable movements

A

Chorea

49
Q

What is similar to athetoid movements but often involves larger portions of the body (i.e. trunk)?

A

Dystonia

50
Q

What kind of tremor is absent at rest, appears with movement, and gets worse as the target gets close?

A

Intention tremor

51
Q

Rhythmic, repetitive, bizarre movements that chiefly involve the face, mouth, jaw, and tongue.

A

Oral-face dyskinesias

52
Q

What type of tremor appears when the affected part is actively maintaining a posture?

A

Postural tremor

53
Q

What type of tremor is most prominent at rest and may decrease or disappear with voluntary movement.

A

Resting tremor

54
Q

Brief, repetitive, stereotyped coordinated movements occurring at irregular intervals.

A

Tics

55
Q

head – dermatomes

A

C1-C2

56
Q

diaphragm, breathing – dermatomes

A

C3-C4

57
Q

deltoid, biceps (shoulder abduction and elbow flexion) – dermatome

A

C5

58
Q

biceps flexion and wrist extensors – dermatome

A

C6

59
Q

triceps, wrist flexors, and fingers extensors – dermatome

A

C7

60
Q

finger flexors and muscles — dermatome

A

C8

61
Q

interossei muscles only – dermatome

A

T1

62
Q

hip flexion – dermatome

A

L2

63
Q

knee extension – dermatome

A

L3

64
Q

Ankle dorsi flexion – dermatome

A

L4

65
Q

Great toe extension – dermatome

A

L5

66
Q

Ankle plantar flexion, ankle eversion, hip extension – dermatome

A

S1

67
Q

knee flexion– dermatome

A

S2

68
Q

How do we rate a normal, average reflex?

A

2+

69
Q

How would we document a hyperactive w/ clonus reflex?

A

4+

This is as high as the reflex scale goes!

70
Q

Loss of the anal wink reflex may indicate what?

A

Cauda equina

71
Q

How do you document normal muscle strength?

A

5/5

72
Q

What would a 3/5 muscle strength look like?

A

Active movement against gravity

73
Q

What tests do we do to test for coordination?

A

Rapid alternating movements, point to point movements, gait and related movements

74
Q

What tests do we do for sensory testing?

A

Pain: sharp or dull testing

Temperature: usually only tested if pain testing reveals deficit

Position (proprioception): grasp big toe on sides, move up and down, asking patient to identify position

Vibration: Use 128Hz fork over distal interphalangeal joint of patient’s finger and great toe

Light touch: light wisp of cotton

75
Q

What test might we do to diagnose a brain/spinal cord tumor, eye disease, inflammation, infection, and vascular irregularities that lead to stroke?

A

Brain MRI

76
Q

What test might we do to diagnose a stroke, determine location and size of tumor, aneurysm, or vascular formation?

For this test dye is injected via capsule placed (catheter), serial x-rays taken.

A

Cerebral angiogram

77
Q

When do we use cisternography and what does the procedure look like?

A

To detect problems with spine and spinal nerve roots. Allows for clear image of spinal canal and nerve root.

Procedure: lumbar puncture –> fluid mixed with contrast dye and injected into spinal sac.

78
Q

What test involves injecting small amounts of dye via x-ray guidance into spinal disc?

A

Discography

79
Q

What test monitors brain activity through the skull?

A

EEG (electroencephalography)

80
Q

What test is used to diagnose nerve/muscle dysfunction and spinal cord disease? It measures electrical activity from brain/spinal cord to peripheral nerve root.

A

EMG (electromyography)

81
Q

What group of tests is used to diagnose d/o such as involuntary eye movement, dizziness, balance issues?

A

ENG (electronystagmography)

82
Q

What test measures electrical signals to brain generated by hearing, sight, and touch?

A

Evoked potentials.

83
Q

What test do we do to diagnose muscular dystrophy?

A

Muscle/tissue biopsy

84
Q

What test is done by injection water or oil-based contrast into spinal cord to enhance x-ray imaging?

A

Myelography

85
Q

When might we use myelography?

A

Spinal nerve injury, herniated discs, fractures, back or leg pain, spinal tumors

86
Q

What test is an ultrasound of the brain and spinal cord to enhance x-ray imaging of spine?

A

Neurosonography

87
Q

What test measures brain and body activity during sleep?

A

Polysomnogram

88
Q

What test provides 2 and 3 dimensional images of brain activity by measuring radioactive isotopes that are injected into the bloodstream?

A

Positron Emission Tomography (PET scan)

89
Q

What test evaluates blood flow to tissues, a follow-up test to MRI to diagnose tumors, infections, degenerative spinal d/o, and stress fractures?

A

Single Photon Emission CT (SPECT scan)

90
Q

What test uses infrared sensing device to measure small temperature changes between two sides of the body or within a certain organ?

A

Thermography (infrared thermal imaging)

91
Q

Complete basilar artery occlusion causes?

A

“locked in syndrome” – w/ intact consciousness but with inability to speak and quadriplegia

Sam: Neurology (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions