exam 1: neuro exam Flashcards
what the three parts of balance
static standing balance
dynamic standing balance
walking balance
functional skills included
bed mobility
STS
transfers
walking
stairs
hands and arm use
basic function - mental exam
LOC
orientation
complex function - mental exam
language
memory
sensory perception
meta-cognition - mental exam
executive functioning
self awareness
what is seen through the entire mental exam
mood and motivation
receptive lang
the pt is asked to follow commands in order to demo that they can understand the meaning of what they have heard
expressive lang
the pt performs a task that requires spontaneous speech or writing
naming objects
repeating phrases
noting the fluency and correctness of words
Receptive aphasia
when someone is able to speak well and use long sentences, but what they say may not make sense, world salad
Expressive aphasia
a condition where a person may understand speech, but they have difficulty speaking fluently themselves
Global aphasia
may only say a few words, such as “no” or “hey” or “what”, or they may speak in “stereotypies”.
short term memory is in what part of the brain
temporal lobe
how can you test STM
say three words
immediately and 5 min recall
where working memory and abstract reasoning stored in brain
frontal lobe
how to test abstract reasoning
the pt is asked to solve problem
restorative approaches
strategy training program
cognitive exercise program
compensatory approches
habit training
enviro adaptation
what are field cuts
specific regions where pt have lost the ability to see
near point convergence - accommodation
this is an auto response of the eyes to move to focus the image on the fovea of the eye
what can you do to look at the oculomotor reflex
eye movement
NPC - accommodation
movement of the upper eyelid
light reflex
what do you do to test the cochlear portion of VC
snap test and whisper test
looking at the organ of corti
what do you do to test the vestibular portion of VC
semicircular canals, utricle and saccule
gaze stabilization
what does horizontal and vertical VOR look at
pt ability to maintain stable gaze with head turns
what is the head impulse test looking at
passive vestibular-ocular reflex
what are signs of a lesion to glosso and vagus
loss of taste
loss of gag reflex
dysphagia - pt have a hard time swallowing
action of vagus
motor to the pharynx and larynx, and involuntary muscle of the air ways
actions of glosso
sensory and taste to post 1/3 of the tongue, pharynx and soft palate
what do we see if there is a issue with spinal accessory
shoulder droop
muscle atrophy of SCM and traps
what is the trigeminal system for
sensation to the face
tested in the cranial nerve exam
spine nerve will have what kind of distribution
dermatonal distribution
peri nerve lesion distribution
peri nerve distribution
polyneuropathy
many nerves in different parts of the body are involved
polyneuropathy distribution
this will have a stocking and glove distribution because the longest axons are the most effected - dying back rule
ST is responsible for what
pain and temp
DCML is responsible for what
JPS
vibration
kinesthesia
what is stereognosis
the mental perception of depth or three-dimensionality by the senses
usually in reference to the ability to perceive the form of solid objects by touch.
what is testing in cortical discrimination
stereognosis
two-point discrimination
touch localization
superficial sensations
pain perception
temp awarness
deep senses
JPS
vibration
kinesthesia
what is graphesthesia
the ability to recognize symbols when they’re traced on the skin
what makes up the motor cortex
primary cortex
premotor cortex
supplemental motor areas
subcortical nuclei
BG
dorsal thalamus
red nucleus
vestibular nuclei
reticular nuclei
cortical-spinal tract - main influence
motor neurons that innervate muscles of distal extremities
motor neuron in the lateral part of the ventral horn
CST collaterals
modulate and control the indirect BS motor centers that axial and antigravity neurons
this allows for the right amount of supporting tone
what is the direct pathway for motor control
the CST
what is the indirect pathway for motor control
brainstem motor control centers
what is the function of brainstem motor control centers
tonically activate LMN that innervate axial and antigravity muscles
motor neurons that are in the medial part of the ventral horn
what are the three brainstem motor control centers
rubrospinal tract
vestibulospinal tract
recticulospinal tract
what are the parts of the motor
tone
PROM
AROM
reflexes
involuntary movement
muscle mass
what are the two types of hypertonia
spasticity
rigidity
what is dystonia
characterized by involuntary (unintended) muscle contractions that cause slow repetitive movements or abnormal postures that can sometimes be painful.
what is spasticity - UMN or LMN issue
UMN
what is spasticity due to - what pathway is affected
corticalspinal pathways in the cere, BS, or motor pathways in the SC
rigidity - presents as
resistance to passive movements
rigidity is often seen with what
parkinsons
hypotonia is seen with LMN or UMN issue and
LMN
vetsibular center
cere
can muscle strength alone tell you about motor function
no
movement coordination deficits due to hypokinesia
altered movement timing and amount
what are action tremors
tremors that are exaggerated at the end of voluntary movement
can be present at the start or through the entire movement
the tremor with often go away when the affected body part is at rest
fasciculations
muscle twitch
fasciculations are caused by
ant horn cell and motor unit firing without a stimulus
can see but do not move the joint
fibrillation
small firing of a muscle fiber seen with an EMG
this is a sign of a patho
signs of neuropathy
balance core outcomes
BERG
FGA
ABC
deficit in a peripheral vestibular nerve and ocular movements
A deficit in a peripheral vestibular nerve WILL NOT
present with abnormal oculomotor function
An abnormality in oculomotor function is indicative of what kind of involvement
central involvement
Dysarthria
difficulty speaking because the muscles you use for speech are weak
Dysphagia
swallowing difficulties.
cere and ocular movement
the cere fine tunes eye movements
role of the dorsal oculomotor vermis (OMV)
receives information about
performance during saccades and
adjusts as needed to assure the
saccade arrives on target
OMV lesions lead to what
hypometric and
hypermetric saccades
are imparied sacccades a central or peri sign
central sign
three systems that contribute to balance
visual, vestibular, and sensory
what outcome can you use to look at static balance
Berg
m-CTSIB
mini-best
what outcome can you use to look at dynamic balance
BERG
mini-BEST
standing reach
is a ball toss dynamic or static balance
dynamic
push and release test - static or dynamic balance
static balance
weight shifting - static or dynamic
dynamic
Timed walking tests
Timed Up and Go (TUG)
* 10 Meter Walk Test (10mWT)
* Six Minute Walk Test (6MWT)
