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DCCJP > M7 CCJ Neurology 2 > Flashcards

M7 CCJ Neurology 2 Flashcards

1
Q

Neuro Examination Areas

A
  1. Neuron Cellular level
  2. Cortex: (Frontal, Parietal, Temporal, Occipital)
  3. Basal Ganglia - Hyperkinetic vs hypokinetic
  4. Limbic System
  5. Brainstem: Cranial Nerves, Autonomic Nervous System
  6. Cerebellum
  7. Vestibular system - peripheral and central
  8. Spinal Cord
  9. Peripheral nerves
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2
Q

Observations for Cellular Level Neuron disease. (7)

A
  1. Assess fatigue-ability
  2. Patient presentation:
    1. wound up vs depressed
    2. Anxious vs unmotivated
    3. What is their central integrative state?
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3
Q

Neuron Cellular Level

Multiple Sclerosis

Subjective

A
  • Headache
  • Dizziness
  • Numbness
  • Tingling
  • Pain
  • Spasticity
  • Vision Issues
  • Heat Intolerance
  • Anxiety
  • Depression
  • Cognitive Changes
  • Episodic
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4
Q

Neuron Cellular Level

Multiple Sclerosis

Objective Findings

A
  • Dysconjugate eye movements
  • Abnormal sensory findings (test all sensory systems as it may not affect all.)
  • gait disturbance
  • wide stance
  • spasticity
  • hyper-reflexia
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5
Q

Neuron Cellular Level Disfunction

Multiple Sclerosis

Special Tests

A
  • Slowing of visual and sensory evoked potentials
  • MRI with lesions in 2 or more areas (30% of patients with MS will not show lesions on MRI)
  • lumbar puncture with oligoclonal Ig (potential sequelae from the actual test make this a last resort).
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6
Q

TEST

Visual and Sensory Evoked Potentials

(VEP and SEP)

A

Testing the speed that visual or sensory stimuli is registered in the brain.

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7
Q

Neuron Cellular Level Dysfunction

Multiple Sclerosis

Treatment

A
  1. Chiropractic
  2. Autoimmune Treatment (Treating the gut is key)
    1. Extreme Anti-inflammatory Diet (Auto-immune Paleo - AIP).
    2. Supplementation
  3. Neuro-rehab base on area of lesion / deficit.
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8
Q

Neuron Cellular Level Dysfunction

Multiple Sclerosis

Treatment

Supplementation

A
  • Omega-3 (Fish Oil)
  • turmeric
  • magnesium threonate
  • vitamin-D
  • trisomal glutathione
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9
Q

SUPPLEMENT

magnesium threonate

A
  1. Crosses the blood-brain barrier
  2. Good for headaches
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10
Q

Cortex

Frontal Lobe

Primary Motor (M1)

Test

A

Finger Tap

Contralateral Frontal Lobe

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11
Q

TEST

Finger Tap

A
  • Tests contralateral Motor Control area in Frontal Cortex
  • “Make an “L”, make your finger and thumb tap as big and as fast as you can like this (demonstrate).” Then stop
    because it is easier to mirror you and skew the test. If the patient is closely observing fingers, have them close
    their eyes.
  • Look for Loss of speed, loss of amplitude, dysmetric, hesitations, freezes
  • If mirroring and/or accessory muscle use have them stop and redo without it.
  • Score using UPDRS.
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12
Q

UPDRS Score

A
  • Unified Parkinson’s Disease Rating Scale
  • Grade 1 – Breakdown in 7-10
  • Grade 2 – Breakdown in 4-6
  • Grade 3 – Breakdown in 1-3
  • Grade 4 - Freeze
  • Used to score finger tap test
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13
Q

Cortex

Frontal Lobe

Primary Motor (M1)

Pathology

Cerebrovascular Accident (Stroke)

Symptomatology / Subjective

A
  • Arm weakness
  • leg weakness
  • facial weakness
  • irreversible tightness in muscles
  • speech difficulties
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14
Q

Cortex

Frontal Lobe

Primary Motor (M1)

Pathology

Cerebrovascular Accident (Stroke)

Objective

A
  • Contralateral spasticity (dystonia) or flaccidity
  • dysarthria
  • hyperreflexia
  • loss of facial tone in bottom 2/3
  • diminished gross motor control
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15
Q

Cortex

Frontal Lobe

Primary Motor (M1)

Pathology

Cerebrovascular Accident (Stroke)

Special Tests

A

MRI

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16
Q

Cortex

Frontal Lobe

Primary Motor (M1)

Pathology

Cerebrovascular Accident (Stroke)

Treatment

A

Mirror Exercises

17
Q

TREATMENT

Mirror Exercises

A
  • Used to treat side of deficit in stroke patients, also good for phantom limb pain and focal dystonias.
  • Get a long full mirror, hold up to their good side, sagitally, so they look in the mirror and see their good side, but their brain sees it as the bad side and therapy works. Brain rebuilds a map with different parts of the brain other than damaged part, so make sure they look at front and
    back of their hand, feet etc.
  • Have them move their limb in a complex manner, or remap with eyes, use laser pointer and they follow around their hand, slow or fast, with eyes. Try to use as many sensory modalities as possible.
18
Q

Cortex

Frontal Lobe

Primary Motor (M1)

Pathology

Cerebrovascular Accident (Stroke)

Types

A
  • Ischemic
  • Hemorrhagic
19
Q

Cortex

Frontal Lobe

Premotor Area

Test

A

DCCJP (7 decks)

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