CNS 2 Flashcards
A difference of >0.4 mm in the diameter of one pupil compared to the other, is seen in
up to 38% of healthy individuals.
Anisocoria
An involuntary jerking movement of the eyes with quick and slow components.
nystagmus
drooping of the upper eyelid. Seen in 3rd nerve palsy, Horner syndrome and myasthenia gravis.
Ptosis
are fine flickering irregular movements in small groups of muscle fibers
Fasciculations
When a normal muscle with an intact nerve supply is relaxed voluntarily, it maintains a slight residual tension known as
muscle tone
is velocity-dependent increased tone that worsens at the extremes of range.
Spasticity
is increased resistance throughout the range of movement and in both directions; it is not rate-dependent.
Rigidity
Impaired strength or weakness is called
paresis
Absent strength is
paralysis, or plegia
refers to weakness of one half of the body
Hemiparesis
refers to paralysis of one half of the body.
hemiplegia
means paralysis of the legs
Paraplegia
means paralysis of all four limbs.
quadriplegia
Scale for Grading Muscle Strength
0 —No muscular contraction detected
1 —A barely detectable flicker or trace of contraction
2 —Active movement of the body part with gravity eliminated
3 —Active movement against gravity
4 —Active movement against gravity and some resistance
5 — Active movement against full resistance without evident fatigue. This is normal muscle strength.
Symmetric weakness of the proximal muscles suggests
myopathy
symmetric weakness of distal muscles suggests
polyneuropathy
In cerebellar disease, instead of alternating quickly, these movements are slow, irregular, and clumsy, an abnormality called____. It points to cerebellar disease.
dysdiadochokinesis
Consistent deviation to one side which worsens with the eyes closed, referred
to as ___, suggests cerebellar or vestibular disease.
past pointing
A uncoordinated gait with reeling and instability is
ataxic
The patient stands fairly well with eyes open but loses balance when they are closed a positive of
Romberg sign
Condition where the patient has difficulty standing with feet together whether the eyes are open
or closed.
cerebellar ataxia
occurs when one forearm and palm turn inward and down and is both sensitive
and specific for a corticospinal tract lesion in the contralateral hemisphere.
Pronator drift
a sensory level (when one or more sensory modalities are reduced below a dermatome on one or both sides) suggests
spinal cord lesion
Symmetric distal sensory loss suggests a
diabetic polyneuropathy
Dermatomes: ● both shoulders ● the inner and outer aspects of the forearms ● the thumbs and little fingers ● the fronts of both thighs ● the medial and lateral aspects of both legs ● the little toes ● the medial aspect of each buttock
● both shoulders (C4)
● the inner and outer aspects of the forearms (C6 and T1)
● the thumbs and little fingers (C6 and C8)
● the fronts of both thighs (L2)
● the medial and lateral aspects of both legs (L4 and L5)
● the little toes (S1)
● the medial aspect of each buttock (S3)
___ refers to absence of pain sensation, ___ refers to decreased sensitivity to pain, and
___ refers to increased pain sensitivity.
- Analgesia
- hypalgesia
- hyperalgesia
___ is absence of touch sensation, ___ is decreased sensitivity to touch, and ___ is increased sensitivity.
- Anesthesia
- hypesthesia
- hyperesthesia
refers to the inability to recognize objects placed in the hand.
Astereognosis
refers to the ability to identify an object by feeling it.
Stereognosis
The inability to recognize numbers, or ____, indicates a lesion in the sensory cortex.
graphanesthesia
is the band of skin innervated by the sensory root of a single spinal nerve.
Dermatome
Scale for Grading Reflexes
4 3 2 1 0
4 - Very brisk, hyperactive, with clonus (rhythmic oscillations between flexion
and extension)
3 - Brisker than average; possibly but not necessarily indicative of disease
2 - Average; normal
1 - Somewhat diminished; low normal
0 - Reflex absent
a technique involving isometric contraction of other muscles for up to 10 seconds that may increase reflex activity.
Reinforcement
Dorsiflexion of the big toe is a positive of ___, is occasionally accompanied by reflex flexion at hip and knee.
Babinski response
Loss of the anal reflex suggests a lesion in the S2–3–4 reflex arc, seen in
cauda equina lesions
