Midterm 1 Flashcards
Define hemisensory neglect
Inability of a person to process and perceive stimuli on 1 side of the body/environment
Dysfxn of the CONTRAlateral parietal lobe (sensory cortex)
List the “Pure Patches” with a sensory exam
C5 C6 C7 L4 L5 S1
What is astereognosis a disease of?
Dorsal Column
What is astereognosis?
Loss of vibration sense, proprioception, pressure sensation/deep touch
What is graphesthesia?
Ability to recognize letters or numbers being traced on the skin
What type of lesion causes agraphesthesia?
Contralateral parietal lobe affecting the association centre
What are secondary sensory modalities we use?
Stereognosis
Graphesthesia
2 point discrimination
T/F DTRs are a voluntary reaction of a muscle to being stretched by percussion of the tendon
False! Theyr’e involuntary
T/F DTRS have a sensory and motor component
True! Motor integrity is usually what is being tested though
T/F A grade of 3+ for a DTR of the biceps tendon is always considered pathologic
False
Grades of 1+, 2+ and 3+ are not normal nor pathologic
T/F A common cause of hyporeflexia is operator error
True
What do LMN lesions present with?
Hyporeflexia
Flaccid paresis (specific muscles)
Fasciculations
Marked atrophy
Another term for a grade 4+ DTR is?
Clonus (rhythmic oscillations b/w flexion and extension)
UMN lesion!
Patient present with the ability to feel the rough surface of sandpaper but cannot identify that it is sandpaper (lacks ability to associate). What would you suspect?
Middle Cerebral Artery Stroke
Which DTR is always abnormal?
Clonus
T/F Asymmetry of reflexes is often more important than overall tonus
True!
T/F Absence of one or both reflexes can never be attributed to age
False! Age can be a huge factor
Which nerve root does the biceps tendon reflex test?
C5
Which nerve root does Brachioradialis tendon test?
C6
Which nerve root does triceps tendon DTR test?
C7
T/F It is always necessary to test DTRs bilaterally?
True
What is the afferent/efferent nerve associated with biceps tendon DTR?
Musculocutaneous
What is the afferent/efferent nerve associated with brachioradialis DTR?
Radial nerve
Which afferent/efferent nerve is associated with triceps DTR?
Radial nerve
Which nerve root is associated with the patellar tendon DTR?
L4
Which nerve root does medial hamstring tendon DTR test?
L5
Which nerve root does Achilles tendon DTR test?
S1
What is the afferent/efferent nerve associated with patellar DTR?
Femoral nerve
What is the afferent/efferent nerve associated with Medial Hamstring DTR?
Sciatic nerve
Which afferent/efferent nerve is the achilles tendon DTR associated with?
Tibial nerve
What is the motor exam looking for?
Motor neuron disease/lesion
Radiculopathies
Peripheral neuropathy weakness
T/F Paralysis is the loss of voluntary movement which may be accompanied by sensory loss
True
Patient presents with no tremors upon resting but when they go to scratch their leg, their hand begins to shake. Which type of tremor is it?
Kinetic tremor
Patient presents with no additional movements during rest but when they reach for a glass, their hand begins to shake. The shaking gets worse as they get closer to the glass. Which type of tremor is this?
Kinetic tremor that is also intentional
What is dysmetria?
Past-pointing, seen with ipsilateral lesion of the cerebellar hemisphere
Finger-nose testing will demonstrate even mild limb ataxia
What tests can you use to test ipsilateral lesions of the cerebellar hemisphere?
Heel to Shin
Finger-nose tests
What is truncal ataxia indicative of?
Midline cerebellar lesion
Name a few things characteristic of a Parkinsonian Gait
Pt walks w/forward flexion
First step retardation/apraxia
Propulsion required to start gait
Marche a petit pas (march of little steps)
Festination (pt picks up speed as they move)
Difficulty stopping movement because of speed
Lack of arm movement during gait
