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Neuro PT Lecture > II- Clinical Localization and Its Diagnostic Significance > Flashcards

II- Clinical Localization and Its Diagnostic Significance Flashcards

1
Q

Give me the areas of dysfunction.

A
  1. Meninges
  2. Cortex
  3. Diencephalon (basal ganglia, thalamus, internal capsule)
  4. Brainstem (pons, midbrain, medulla)
  5. Cerebellum
  6. Spinal Cord
  7. Peripheral Nerve
  8. Autonomic Nervous System
  9. Neuromuscular Junction
  10. Muscle
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2
Q

Give me the Meningeal Diseases

A
  1. Meningitis
  2. Subarachnoid Bleeds
  3. Chemical irritation of meninges
  4. Tumors stretching meninges
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3
Q

What type of disease is meningitis?

A

Infectious Disease

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4
Q

What type of disease is subarachnoid bleed?

A

Vascular Disease

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5
Q

What type of disease is chemical irritation of meninges?

A

Traumatic Disease

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6
Q

What type of disease is tumor stretching meninges?

A

Neoplastic Disease

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7
Q

Diseases affecting the cortex

A
  1. Strokes
  2. Encephalitis (infectious)
  3. Demyelinating Disease
  4. Tumors
  5. Trauma
  6. Congenital
  7. Metabolic
  8. Degenerative
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8
Q

Diseases of the basal ganglia

A
  1. Parkinson’s Disorders
  2. Movement Disorders (usually degenerative disease)
  3. Strokes (Putaminal bleed is common)
  4. Infarcts of candelabra branches of middle cerebral artery
  5. tumors
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9
Q

Diseases affecting thalamus and internal capsule

A
  1. Strokes (both infarcts and thalamic bleed) Internal capsular lacunar stroke is common
  2. Tumors
  3. Demyelinated Disease (internal capsule)
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10
Q

Diseases affecting the brainstem

A
  1. Stroke (bleed and infarcts)
  2. Tumors (2/3 pediatric tumors)
  3. Demyelinated Disease
  4. Infections ( brainstem encephalitis or bickerstaff)
  5. Craniopathies
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11
Q

Cerebellar Diseases

A
  1. Strokes
  2. Tumors
  3. Brain abscess
  4. Demyelinated disease
  5. Trauma
  6. Congenital (dandy walker syndrome)
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12
Q

Spinal Cord Disease

A
  1. Trauma
  2. Tumors
  3. Demyelinating Disease
  4. Infections (viral: transverse myelitis) (tuberculosis: potts disease)
  5. Vascular (infarcts or AVM)
  6. Congenital (spinal muscular atrophy)
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13
Q

Peripheral Nerve Disease

A
  1. Neuropathies (polyneuropathy, mononeuropathy, mononeuropathy complex)
  2. Trauma
  3. Demyelinated Disease: Guillain-Barre Syndrome
  4. Degenerative Disease (Charcot Marie Tooth)
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14
Q

Disease of the Muscle

A
  1. Myopathies
  2. Infectious (polymyositis, dermatomyositis)
  3. metabolic (hypokalemic paralysis)
  4. Congenital (muscular dystrophy)
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15
Q

stiffness of flexion of head (neck stiffness)

A

nuchal rigidity

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16
Q
  1. start with knees flexed, then extend the knee
    • sign
A
  1. Kernig’s sign
  2. Pain in the back area
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17
Q
  1. flex the head
    • sign
A
  1. Brudzinski’s Sign
  2. Flexion of the head, flexion of the knee.
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18
Q

reponsible for the voluntary movement and for all conscious awareness

A

cortex

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19
Q

cortical signs

A
  1. Aphasia
  2. Apraxia
  3. Agnosia
  4. Visual field defects (homonymous hemianopsia and bitemporal hemianospia)
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20
Q
  1. tap the glabella while asking the patient to keep the eyes open
    • sign
A
  1. Glabellar Tap or Meyerson’s Reflex
  2. Everytime you tap, the patient blinks the eyes
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21
Q

Frontal release signs implies what?

A

Lobe dysfunction

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22
Q
  1. Stroke the inner palm
    • sign
A
  1. Grasp reflex
  2. Thumb will adduct
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23
Q
  1. stroke the thenar eminence of the palm
    • sign
A
  1. Palmomental reflex
  2. dimpling under the chin
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24
Q

it resides under the cortex

A

diencephalon

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25
Q

gray matter contains what structure?

A

basal ganglia and thalamus

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26
Q

white matter contains what structure?

A

internal capsule

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27
Q

too much movement

A

hyperkinesia

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28
Q

irregular jerk of hands or feet (distal irregular movements)

A

chorea

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29
Q

snake like movement

A

athetosis

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30
Q

wild flailing movement of UE and LE

A

ballismus

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31
Q

accumulating snake like movement (more prolonged)

32
Q

rigidity by examining the UE

A

bradykinesia

33
Q

when there is tremors, when patient is not moving then absent when patient is moving

A

resting tremors

34
Q

3 types of tremors

A
  1. resting tremors
  2. intention/essential tremors
  3. physiologic tremors
35
Q

cortex basal ganglia loop and present at rest, but when you move the extremity, tremors are absent

A

resting tremors

36
Q

brainstem cerebellar loop (red nucleus-midbrain) , at rest there is no tremor but when a person moves, there are tremors.

A

intention/essential tremors

37
Q

spinal cord muscle loop, fine tremors, and these are enhanced tremors in certain people when they are nervous or anxious

A

physiologic tremors

38
Q

this type of tremors are not specific to basal ganglia and irregular, non-rhythmic jerks seen proximally, and either from cortical or spinal origin

39
Q

these part of the diencephalon have non-specific signs of sensory loss or paralysis but allude this area for exclusion

A

thalamus and internal capsule

40
Q

cerebellar signs

A
  1. ataxia
  2. titubation
  3. dysmetria
  4. dysdiadochokinesia
41
Q

wide based gait

42
Q

whenever the medial malleoli to medial malleoli distance is more than 3 inches

43
Q

when a px has a to and for movement of the head or the body (either back and forth to side to side movement)

A

titubation

44
Q

do this by finger to nose test heel to shin test

45
Q

abnormalities in alternating movement

A

dysdiadochokinesia

46
Q

what is the one prerequisite to consider that it is a cerebellum affectation?

A

motor strength is normal

47
Q

have two phases: rapid phase and correcting slow phase

48
Q

nystagmus may be due to:

A
  1. vestibular nuclei
  2. cerebellum
  3. paresis of eye muscles
49
Q

what structure is affected if the most prominent signs are cranial nerve dysfunction?

50
Q

what CN are seen in the brainstem?

A

CN 3, 4, 5

51
Q

paralysis of downward or medial eye movement

52
Q

ptosis, medial rectus palsy, and dilated non-reactive pupils. what structure is affected?

53
Q

infratentorial means

A

ipsilateral

54
Q

supratentorial means

A

contralateral

55
Q

no vertical eye movement. what cranial nerve?

56
Q

this means eyes are to one side, not always pontine.

A

preferential gaze

57
Q

both eyes move together

A

frontal gaze center

58
Q

one eye may not move with the other eye

A

pontine gaze center

59
Q

this structure involves the cranial nerve 7

60
Q

eyes cannot abduct; eyes are towards the middle. what condition?

A

lateral rectus palsy

61
Q

distinguish from central type

A

peripheral nerve palsy

62
Q

pt cannot lift the eyebrow

A

peripheral

63
Q

pt can life the eyebrow

64
Q

poor gag reflex

65
Q

deviated uvula. what CN is responsible?

A

CN 9 and CN 10

66
Q
  1. due to pharyngeal involvement. what condition is this?
  2. What CN responsible?
A
  1. dysphonia
  2. CN 10
67
Q

deviated tongue. what CN responsible?

68
Q
  1. localizing; specific to the level; lesion is plus or minus.
  2. What structure is affected?
A
  1. dermatomal cuts
  2. spinal cord
69
Q

distribution of paralysis in spinal cord.

A

quadriplegia or hemiplegia

70
Q

Sx: urinary or bowel incontinence. What structure is affected?

A

spinal cord

71
Q

seen when the corticospinal tract is damaged. what can you infer from the Sx?

A

hyperreflexia and babinski

72
Q
  1. hyporeflexia
  2. sensory loss follows nerve distribution
  3. paralysis fits nerve distribution
  4. paralysis-distal

what structure is affected?

A

peripheral nerve

73
Q
  1. pure motor loss
  2. proximal paralysis (pectoral and pelvic girdle)
  3. no sensory abnormality

what structure is affected?

74
Q

cerebral cortex. what cranial nerve are on this structure?

A

CN 1 and CN 2

75
Q

midbrain. what cranial nerve are on this structure?

A

CN 3, 4, & 5

76
Q

pons. what cranial nerve are on this structure?

A

CN 5, 6, 7, 8

77
Q

medulla. what cranial nerve are on this structure?

A

CN 5, 8, 9, 10, 11, 12

Neuro PT Lecture (5 decks)

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