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Adult Neuro > Comp Exam > Flashcards

Comp Exam Flashcards

1
Q

Scapula Spasticity Pattern

A

retraction

downward rotation

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2
Q

Shoulder Spasticity Pattern

A

adduction and IR

depression

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3
Q

Elbow Spasticity Pattern

A

Flexion

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4
Q

Forearm spasticity pattern

A

pronation

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5
Q

Wrist spasticity pattern

A

flexion

adduction

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6
Q

Hand spasticity pattern

A

finger flexion
clenched fist
thumb adducted in palm

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7
Q

Pelvis spasticity pattern

A

retraction (hip hiking)

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8
Q

Hip spasticity pattern

A

adduction
IR
extension

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9
Q

Knee spasticity pattern

A

extension

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10
Q

Foot and ankle spasticity pattern:

A 
plantarflexin
inversion
equinocarus
toe claw
toe curls
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11
Q

UE flexion synergy pattern:

A

scapular retraction/elevation, shoulder abduction, ER, elbow flexion, forearm supination, wrist and finger flexion

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12
Q

UE extension synergy pattern:

A

scapular protraction, shoulder adduction, IR, elbow extension, forearm pronation, wrist and finger flexion

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13
Q

LE flexion synergy pattern:

A

hip flexion, abduction, ER, knee flexion, ankle dorsiflexion and inversion

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14
Q

LE extension synergy pattern:

A

hip extension, adduction, IR, knee extension, ankle plantarflexion and inversion

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15
Q

BERG balance low fall risk

A

41-56

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16
Q

BERG balance moderate fall risk:

A

21-40

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17
Q

BERG balance high fall risk

A

0-20

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18
Q

ACA stroke:

A

contralateral hemiparesis of mainly LE
contralateral hemisensory loss mainly LE
urinary incontinence
problems with bimanual tasks. apraxia

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19
Q

MCA stroke:

A 
contralateral spastic hemiparesis and sensory loss of face, UE and LE with face and UE more involved
broca's or nonfluent aphasia
wernicke's or fluent aphasia
global aphasia
neglect
contralateral homonymous hemianopsia
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20
Q

PCA stroke:

A 
contralateral homonymous hemianopsia
visual agnosia
dylexia
memory defect
topographic disorientation
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21
Q

Stage 1 motor recovery:

A

initial flaccidity, no voluntary movement

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22
Q

Stage 2:

A

emergence of spasticity, hyperreflexia, syngeries

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23
Q

Stage 3:

A

voluntary movement possible, only in synergies, spasticity strong

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24
Q

Stage 4:

A

voluntary control in isolated joint movement emerging, decline of spasicity and syngergies

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25
Q

Stage 5:

A

increasing voluntary control out of syngery

coordination deficit present

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26
Q

Stage 6:

A

control and coordination near normal

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27
Q

Typical right sided CVA:

A

apraxia, impulsive, neglect

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28
Q

Typical left sided CVA:

A

aphasia, overly cautious

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29
Q

Synergy:

A

stereotyped set of movements that occur in response to a stimulus or voluntary movement

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30
Q

Associated reaction:

A

stereotyped movements in which effortful use of one extremity influences the posture and tone of another

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31
Q

CIMT criteria:

A

10 degrees active wrist extension
thumb abduction
finger extension

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32
Q

Mild TBI

A 
LOC: 0-30 mins
alteration of consciousness: less than 24 hours
amnesia: less than 1 day
GCS 13-15
imagining: normal
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33
Q

Moderate TBI:

A 
LOC: more than 30 mins, less than24 hours
Alteration of consciousness: > 24 hours
amnesia: >1 day < 7 days
GCS: 9-12
imaging: normal or abnormal
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34
Q

Severe TBI

A 
LOC: > 24 hours
Alteration of consciousness: > 24 hours
Amnesia: > 7 days
GCS: < 9
Imaging: normal or abnormal
35
Q

Stage progression following diffuse axonal injury?

A 
coma
unresponsive vigilance/vegetative state
confusional state
emerging independence
intellectual/social competence
36
Q

Common levels of injury to spinal cord:

A

C5, C7, T12, L1

37
Q

Level A:

A

complete

no motor function below lesion

38
Q

Level B;

A

incomplete

sensory but not motor function is preserved below the neurological level

39
Q

Level C:

A

incomplete

motor function is preserved below neurological level and most key muscles have a muscle grade of less than 3

40
Q

Level D:

A

incomplete

motor function is preserved below neurological level and most key muscles have a muscle grade of greater than 3

41
Q

Level E:

A

normal

42
Q

Central Cord Lesion

A

UMN
Loss of bilateral pain and temp
Loss of bilateral motor function; primarily UE
Preservation of proprioception and discriminatory sensation

43
Q

Brown-Sequard Syndrome

A

UMN
hemisection of spinal cord
Ipsilateral loss of tactile discrimination, pressure, vibration and proprioception
Ispilateral loss of motor function and spastic paralysis below level of lesion
Contralateral loss of pain and temp below level of lesion; at level of lesion bilateral loss

44
Q

Anterior cord syndrome:

A

UMN
loss of bilateral motor function, spastic paralysis below level of lesion
loss of bilateral pain and temp
preservation of proprioception kinesthesia and vibration

45
Q

Posterior cord syndrome:

A

UMN
bilateral loss of proprioception, vibration pressure and stereognosis and 2 pt discrmination (DCML)
preservation of motor function, pain, and light touch

46
Q

Stage 1 (PD)

A

minimal or absent disability

unilateral symptoms

47
Q

Stage 2 PD

A

minimal bilateral or midline involvement

no balance involvement

48
Q

Stage 3 PD

A

impaired balance

some restrictions in activity

49
Q

Stage 4 PD

A

all symptoms present and severe

stands and walks only with assistance

50
Q

Stage 5 PD

A

confined to bed or w/c

51
Q

Loss of archicerebellum (flocculonodular)

A

central vestibular symptoms: ocular dysmetria, poor eye pursuits, dysfunctional VOR, impaired hand eye coordination
gait and trunk ataxia

52
Q

Lesion of paleocerebellum (anterior)

A

hypotonia
truncal ataxia: poor posture, wide BOS
ataxic gait

53
Q

Lesion of neocerebellum

A 
intention temor
dysdiadochokineisa
dysmetria
dyssynergia
errors in timming
54
Q

Additional impairments in cerebellar lesions:

A 
asthenia
hypotonia
motor learning impairments
cognition
emotion dysregulation
55
Q

Bulbar palsy:

A

LMN affecting CN VII-XII
flaccid paralysis of pharynx and larynx
CN IX and X

56
Q

Pseudo-bulbar palsy:

A

UMN

spastic paralysis of pharynx and larynx

57
Q

Bell’s palsy:

A

loss of control of salivation and lacrimation
CN VII
drooping of corner of mouth, eyelids that don’t close

58
Q

Which cranial nerves should be examined in GBS?

A

VII, IX, X, XI, XII

59
Q

Which cranial nerves should be examined in ALSS?

A

VII, IX, X, XI, XII

60
Q

Stage I ALS:

A

early disease, mild focal weakness, asymmetrical distribution, symptoms of hand cramping and fasiculations

61
Q

Stage II ALS:

A

moderate weakness in groups of muscles, some wasting of muscles
modified independent with AD

62
Q

Stage III ALS

A

severe weakness of specific muscles, increasing fatigue, mild to moderate functional limitations
ambulatory

63
Q

Stage IV ALS:

A

severe weakness and wasting of LEs, mild weakness if UEs, moderate assistance and AD required, wc

64
Q

Stage V ALS:

A

progressive weakness with deterioration of mobility and endurance, increased fatigue, moderate to severe weakness of whole limbs and trunk; spasticity, hyperreflexia, loss of head control, max assist

65
Q

Stage VI ALS:

A

bedridden, dependent in ADLs, FMS, progressive respiratory distress

66
Q

C1-C4 w/c;

A

electric w/ tilt in space

puff and sip

67
Q

C5 w/c

A

shoulder function and elbow flexion
manual w/c with propulsion
may choose electronic w/c for energy conservation

68
Q

C6 w/c

A

radial wrist extensors
manual w/c with friction surface hand rims
independent

69
Q

C7 w/c

A

triceps

same as C6 with increased propulsion

70
Q

Gait for T6-T9:

A

bilateral KAFO
crutches, swing to
supervised ambulation for short periods

71
Q

Gait for T12-L3:

A 
independent in all ambulation on all surfaces and stairs
swing through or 4 pt pattern
bilateral KAFO and crutches
independent household ambulators
w/c community
72
Q

Gait for L4-L5:

A

independent with bilateral AFOs and crutches or canes
independent community ambulators
may use w/c for high endurance

73
Q

Peripheral vestibular symptoms:

A

sudden memorable onset
less than 24 hours
head movement provokes symptoms
more likely to have auditory involvement

74
Q

Peripheral disorders:

A 
vestibular neuritis
labyrninthitis
acoustic neuroma
meniere's disease
BBPV
toxicity
75
Q

Vestibular neuritis

A

imbalance, nausea improving over 1-4 days

head movement sensitivity

76
Q

Labryinthitis

A

similiar to vestibular neuritis except with hearing loss before onset of vertigo

77
Q

Acoustic neuroma

A

tumors from Schwann cells
progressive unilateral hearing loss or tinnutus without vestibular symptoms
balance issues mild and intermittent

78
Q

Meniere’s disease

A

postural imbalance,nystagmus, nausea, vomitting, hearling loss and aural fullness
vertigo will persist 30-42 hours
vestibular exercises not appropriate

79
Q

BPPV

A

most common

vertigo when head is turned

80
Q

Central vestibular symptoms:

A

sudden onset of vertigo with one of D: diplopia, dysphagia, diaphoresis, dysarthria, drop attacks
vertigo lasts 24/7

81
Q

Central vestibular disorders:

A

disequilibrium of aging
CVA
migraine
head trauma

82
Q

Exam generalizations of peripheral symptoms:

A

direction fixed nystagmus-horizontal
abnormal VOR via head thrust
nystagmus more likely to be seen with fixation removed
nystagmus exacerbated when gazing in fast component (Alexander’s law)
pursuit and saccade normal
nystagmus exacerbated post horizontal head shake (horizontal nystagmus)

83
Q

Exam generalization of central symptoms:

A 
direction change nystagmus
nystagmus seen with fixation 
nystagmus to be pure vertical or torsional
nystagmus post shaking vertically
abnormal pursuit/ saccades
cannot walk or stand with assistance

Adult Neuro (26 decks)

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