DONE! WEEK 1: NEUROLOGY - CARDINAL MANIFESTATIONS [Salonga]] Flashcards
Give some disorders involving the cerebrum
- Abnormal mental status
*Cognitive and language impairment
( re: Higher cortical function)
* Behaviour and emotional disorder
*Impairment of motor function
* Sensory impairment
* Visual ( cortical) impairment
*Seizures
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what are some cognition and behavior symptoms
Dementia Intellectual Disability Language dysfunction Conduct and abnormal behaviors Refer to functions of areas 11, 22, 47
Level of sensorium
( arousal) would indicate lesion along the course of
ARAS
what level of consciousness is can be aroused only by painful stimulus?
stupor
level of consciousness aroused by touch or voice?
obtunded
unable to arouse or respond to noxious stimuli
comatose
2 scoring used to grade COMA
GCS and FOUR Score
in GCS, EYE Opening response what are 4 3 2 1
4 spontaneously
3 to speech
2 to pain
1 no respone
in GCS, Verbal response what are grades 5 4 3 2 1?
5 oriented x3 4 confused 3 inapp words 2 incomp sounds 1 no response
in GCS motor response, what are the grading?
6 obeys command 5 localize 4 flexion withdrawal 3 decorticate 2 decerebrate 1 no response
in GCS what grade indicates comatose?
8 or less
indicate if UMNL or LMNL: Muscles Affected in groups, never individual
UMNL
indicate if UMNL or LMNL: Prominent muscle atrophy
LMNL
indicate if UMNL or LMNL: No babinski sign
LMNL
indicate if UMNL or LMNL: fasciculations absent
UMNL
indicate if UMNL or LMNL: normal; NCV, no denervation potentials in EMG
UMNL
indicate if UMNL or LMNL: spasticity with increased DTR
UMNL
dysfunction of the extrapyramidal motor system would result in (2)
Excessive Involuntary Movements; slow movements
4 cardinal signs of parkinsonism
Bradykinesia, resting tremor, rigidity, postural changes
extrapyramidal disorders/ movement disorders are all d/t?
imbalance of activity in the complex basal ganglia circuits
sustained abnormal postures of limbs, neck trunk, tongue protrusion or fixed upward deviation of the eyes
dystonia
what do you call fixed upward deviation of the eyes?
occulogyric crisis
slow contionous stream of slow, writhing movements?
athetosis
jerky semi purposive uncontrollable movements of the limbs, face and trunk
chorea
treatment for ballismus?
anti psychotics
cerebrocerebellum is assigned for?
motor planning and coordination
spinocerebellum fxn?
control of ongoing body and limb movements
vestibulocerebellum fxn?>
posture, balance, eye movements
enumerate the cerebellar signs?
DASHING: Dysdiadochokinesis; ataxia; slurred speech; hypotonia; intention tremor; nystagmus; gait issues
what are the clinical symptoms and signs of Raised ICP?
Headache nausea and vomiting papilloedema imapirment of consciousness cranial nerve 6 palsy: false localizing sign impaired level of consciousness
increased sensitivity to a painful stimulus?
hyperalgesia
inappropriate sensation to a stimulus?
dysesthesia
pain provoked by a non painful stimulus?
allodynia
abn painful and exagerated reaction to a painful stimulus?
hyperpathia
loss of perception of vibration?
pallanesthesia
burning pain in the distribution of one or more peripheral nerves?
causalgia
damage in the optic chiasm would result in?
bitemporal hemianopsia
central or peripheral vertigo: severe and sudden
peripheral
central or peripheral vertigo: usually weeks, months, continuous
central
central or peripheral vertigo: one direction usually?
peripheral
central or peripheral vertigo: no associated neuro findings
peripheral
central or peripheral vertigo: no associted auditory findings?
central
central or peripheral vertigo: vertical and downbeatinf direction of nystagmus?
central`
epileptic vs non epileptic seizure: abnromal electrical discharge?
Epileptic
epileptic vs non epileptic seizure:of psychological in origin?
non epi
epileptic vs non epileptic seizure: abnromal eeg reading?
epi
epileptic vs non epileptic seizure: can occur in sleep
epi
epileptic vs non epileptic seizure:tends to happen gradually?
non epileptic
Difference between seizures and epilepsy
seizure is a brief temporary disturbance in the electrical activity of the brain while epilepsy is a disorder characterized by recurrent seizure. A seizure is a symptom of epilepsy
lesions involving involving the anterior horn cell, spinal root,
muscles and neuromuscular junction
peripheral lesions; kapag central lesions, above the anterior horn cell.
T or F? If it’s vascular, it’s not progressive, it will be acute in
presentation.
TRUE
T or F? In patients presenting with confusion, lapses in memory,
agitation, and if they are secondary to a brain problem, then
what is being involved are the centers for the lower cortical
functions.
False. HIGHER CORTICAL
broddman area 44, 45?
brocas area
BA 11?
prefrontal cortex
BA 8?
frontal eye field
BA 43?
gustatory cortex
Primary auditory cortex what BA?
41, 42
primary visual cortex?
17
visual association area?
18, 19,
BA 22?
Wernicke’s
primary motor? sensory? pre motor? somatosensory association area?
4, 312, 6, 57
metabolic causes of coma?
electrolye imbalance (sodium) and glucose
a coma test for intubated patients. This also helps in localizing brainstem involvement.
four score
If the facial paralysis is a peripheral type, with hemiplegia that is contralateral to the facial paralysis, the problem must be in the
brain stem
the only direct long-fiber connection between the cerebral cortex and the spinal cord.
corticospinal tract
pathway of the corticospinal tract?
cerebral cortex - corona radiata (subcortical white matter) -internal capsule - cerebral peduncle - ventral pons) pyramid of the upper medulla - decussates in the lower medulla - lateral column of the spinal cord
babinski reflex is suggestive of ___________ int he central control?
inhibition
in Myopathy, the paralysis is more of proximal, in comparison to Polyneuropathy where the weakness will be in the distant parts of the extremity. T or F?
T
most common type of dystonia?
Focal
extrapyramidal manifestation that is commonly associated with rheumatic fever
chorea
identify if seizure or syncope: occurs at any posture?
seizure
identify if seizure or syncope: blue lips during attack?
seizure (pale and clammy sa syncope)
identify if seizure or syncope: brief jerking movements may occur after the LOC?
syncope ( sa seizure kasi ay sabay sa LOC)
identify if seizure or syncope: quick recovery?
syncope