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Year 1: 2019 PCM I Final > Lecture 3: Neurologic Exam > Flashcards

Lecture 3: Neurologic Exam Flashcards

1
Q

What is dysarthria?

A

Defective articulation

-Usually caused by defect in motor control of speech apparatus

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2
Q

What is aphasia?

A

Disorder in producing or understanding language

-Normally due to lesions in left hemisphere

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3
Q

What are the four things checked in AxO?

What is x1, x2, x3, x4?

A 
Alert and Oriented:
Person
Person and Place
Person, Place, and Time
Person, Place, Time, and Event
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4
Q

What is anhedonia?

A

Inability to feel pleasure

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5
Q

What is delirium?

A

Confused thinking and reduced awareness of the environment

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6
Q

Is delirium reversible?

A

Yes

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7
Q

Is dementia reversible?

A

No

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8
Q

What is ptosis?

A

Drooping of eyelid

-Due to levator palpebrae weakness

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9
Q

What does CN IV lesions lead to?

A

Exotropia: Eyes drift laterally
Weakness of Downward Gaze
Vertical Diplopia: Worsens when looking down (e.g. walking down the stairs)
Head tilts to side opposite of lesion

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10
Q

What does CN VI lesions lead to?

A

Esotropia: Cannot abduct eye

Horizontal Diplopia

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11
Q

What is nystagmus?

A

Rhythmic oscillation of the eyes

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12
Q

What are possible causes of nystagmus?

A

Vision Impairment
Disorder of Labyrinth or Cerebellar Systems
Drug Toxicity

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13
Q

What does CN V lesions lead to?

A

Decreased sensation to face
Loss of Corneal Reflex
Weakness of mastication muscles
Jaw deviation toward weak side

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14
Q

What is Trigeminal Neuralgia?

A

Brief episodes of unilateral shock-like pains along trigeminal nerves

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15
Q

What does CN VII lesions lead to?

A

Bell’s Palsy
Loss of Corneal Reflex
Hyperacusis: increased sensitivity to sound
Crocodile Tears Syndrome: Patient sheds tears when chewing

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16
Q

How can bilateral facial palsies occurs?

A

variant of Guillain-Barre Syndrome

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17
Q

What is supranuclear (central) facial palsy?

A

Weakness to one side of body (spares upper face)

18
Q

What are two tests to test for CN VIII?

A

Whisper Test

Finger Rub Test

19
Q

What does CN VIII vestibular lesions lead to?

A

Dysequilibrium: imbalance

Nystagmus

20
Q

What does CN VIII cochlear lesions lead to?

A

Sensorineural Hearing Loss

Tinnitus: ringing in the ear

21
Q

How can you test CN IX and X?

A

Listen for hoarseness and nasal tone
Check gag reflex and difficulty of swallowing
Check symmetric elevation of soft palate and uvula

22
Q

What specific symptoms indicate a lesion of CN IX?

A

Loss of gag reflex
Loss of sensation and tase in posterior ⅓ of tongue
Slight dysphagia (difficulty swallowing)

23
Q

What specific symptoms indicate a lesion of CN X?

A

Dysphonia
Dysphagia
Dyspnea
Loss of cough or gag reflex

24
Q

What symptoms would you see if a patient had a CN XI lesion?

A

Difficulty turning head to opposite direction

Weakness and unilateral shoulder drop

25
Q

What symptoms would you see if a patient had a CN XII lesion?

A

Tongue will deviate to side of lesion and cannot push tongue to opposite side

26
Q

What sensations are you testing for when testing the sensory system?

A

Pain
Temperature
Vibration
Proprioception (position)

27
Q

What is stereognosis?

A

Ability to identify shapes of objects or recognize objects placed in hand

28
Q

What is graphesthesia?

A

Ability to identify numbers written on the palm

29
Q

How would sensory loss occur is there was a lesion to the brainstem?

A

Crossed findings with ipsilateral in the face and contralateral in the body

30
Q

How would sensory loss occur is there was a lesion to the thalamus?

A

Hemisensory loss of all modalities

31
Q

How would sensory loss occur is there was a lesion to the cortex?

A

Intact primary sensations but loss of cortical sensations

32
Q

What are some cerebellar and coordination tests?

A 
Rapid Alternative Movements
Finger to Nose
Heel to Shin
Gait
Stance
33
Q

What specific test can test stance?

A

Romberg Test

Pronator Drift

34
Q

What do you observe for when testing the motor system?

A 
Gait
Body Position
Involuntary Movements
Muscle bulk: Hypertrophy/atrophy
Muscle tone
35
Q

What is cerebral ataxia?

A

Staggering, unsteady, feet wide apart

36
Q

What is sensory ataxia?

A

Unsteady, feet wide apart, feet thrown forward and slapped down first on heels then forefoot
Patients watch ground when walking

37
Q

Describe the Parkinsonian Gate

A

Stooped forward with short steps (shuffling gait)

Festination: involuntary hesitation

38
Q

What is a Babinski sign?

A

Fanning of toes to a stimulus at the bottom of the foot

39
Q

What is the main symptom of meningitis?

A

Nuchal Rigidity: neck stiffness with resistance to flexion

40
Q

What two signs are positive for meningitis?

A

Brudzinksi Sign

Kernig Sign

Year 1: 2019 PCM I Final (10 decks)

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