Final: Neuro Flashcards
Central nervous system
Includes the brain and spinal cord
Peripheral nervous system
Includes 12pairs of cranial nerves, 31 pairs of spinal nerves
Postcentral gyrus of parietal
primary sensory area
Precentral gyrus
Located in the precentral gyrus of the frontal lobe; primary motor area
Anterolateral (spinothalamic) tract
Contains sensory fibers that transmit sensations of pain, temperature, touch
Burn your finger -> the impulse travels from a nerve ending in the skin through a nerve fiber -> DRG -> dorsal root -> dorsal horn neurons and interneurons
Dorsal Column (posterior) tract
Contains sensory fibers that transmit sensations of position (proprioception), 2-point discrimination, light touch, vibration, stereognosis, graphesthesia.
Lower motor neurons
Motor fibers located mostly in the peripheral nervous system; from the anterior horn the fiber extends to the muscle. LMN is the “final common pathway.”
Upper motor neurons
Motor fibers located completely within the central nervous system (brain and spinal cord)
Dermatomes
Area of skin that is supplied mainly from one spinal cord segment through a particular spinal nerve.
Clonus
Rapid rhythmic contraction of muscle groups in response to rapid stretch of muscle.
Ataxia
Uncoordinated or unsteady gait
hallmark of cerebellar disease
difference b/t cerebellar and sensory? -> sensory look at their feet and slap feet down
Dysmetria
Clumsy movement
found w/ EtOH and cerebellar disorders
Neuro subjective data
Headache
Head injury
Dizziness/vertigo
Seizures
Tremors
Weakness
Incoordination
Numbness or tingling
Difficulty swallowing
Difficulty speaking
Environmental/occupational hazards
Sensations/test for spinothalamic tract
pain & temp, crude touch, pressure
sharp & dull sensory test
Sensations/test for dorsal tract
proprioception, 2PD, vibration, position, light touch
Romberg, tuning fork, 2PD
Where do the tracts cross over?
spinothalamic - grey matter of the cord
dorsal - medulla
If only half the cord were damaged what would be the S/S below the level of the lesion for spinothalamic?
crosses over -> so contralateral deficits of pain & temp
If only half the cord were damaged what would be the S/S below the level of the lesion for dorsal?
same side w/in cord -> so ipsilateral deficits of proprioception, vibration, 2PD, etc.
A patient has a lesion of the anterior horns on one side only. Describe the motor signs/symptoms.
anterior horns = LMN = flaccid paralysis
ipsilateral, flaccid paralysis at level of lesion only (not below entirely bc isn’t effecting the cord)
A patient has a lesion that destroyed the corticospinal tract on the right side only. Describe the motor signs and symptoms.
tract w/in cord = UMN = spastic paralysis
ipsilateral, spastic paralysis below level of lesion
A patient has a lesion in his brain on the right side. Describe motor signs and symptoms.
brain = UMN = spastic paralysis
contralateral, spastic paralysis and the part of body impacted depends on location of lesion
could diagnose where lesion is based on motor/sensory maps and noticeable deficits
Dermatomes for:
C6
C7
C8
C6 - thumb
C7 - digits 2 & 3
C8 - digits 4 & 5
Dermatomes for:
T4/5
T10
T4/5: nipples
T10: umbilicus
Dermatomes for:
L4
L5
S1
L4: big toe
L5: middle 3 toes
S1: little toe
Cerebellar function tests
“coordination is intact bilaterally”
finger-nose, heel to shin, rapid alternating movements
Proprioception tests
“balance is intact w/ minimal sway” - Romberg
Romberg, position sense, gait
Babinski
upgoing toe response -> abnormal (UMN lesion)
Spinal cord segments responsible for:
bicep reflex
triceps reflex
brachioradialis
patellar
Achilles
bicep - C 5-6
triceps - C6-8
brachioradialis - C5-6
patellar - L2-4
Achilles - S1-2
stereognosis
identify object based on feel
contralateral parietal lobe cortex and posterior dorsal column
graphesthesia
recognize # or letters written on hand
functional parietal lobe and dorsal column
AEIOUTIPS
things that might change LOC
Alcohol
Epilepsy/seizures
Insulin
Overdose/O2
Underdose
Trauma
Infection
Poison/psychosis
Shock/stroke
decerebrate
brain stem - extension
sign of herniation - very poor outcomes
decorticate
cerebral cortex - flex
better outcomes
What 3 things does GCS look at?
Eye opening
Verbal response
Motor response